scholarly journals Fatigue, Stigma, and Mood in Patients with Multiple Sclerosis: Effectiveness of Guided Imagery

Author(s):  
Mina Beitollahi ◽  
Mansooreh Azizzadeh Forouzi ◽  
Batool Tirgari ◽  
Yunes Jahani

Abstract Background and objectives : The present study aimed to assess the effectiveness of guided imagery on fatigue, stigma, and mood in patients with multiple sclerosis. Methods This clinical trial is a double-blind study that was conducted on 60 patients with multiple sclerosis referred to the largest center for special diseases in the southeast of Iran in 2020. The convenience sampling method was used to select the participants who were later divided into two groups of intervention (n=30) and control (n=30) using block randomization method. The intervention group listened to the guided imagery audio file at home for 25 minutes. The control group did not receive any intervention. Data were collected by demographic information questionnaires, Fatigue Severity Scale (FSS), Reece Stigma Scale for Multiple Sclerosis (RSS-MS), and the Profile of Mood States (POMS) before and one month after the intervention. Results According to the results, there was no significant difference between the two groups before the intervention in terms of the score of fatigue (P<0.0=67), stigma (P<0.64), and mood (P<0.17). However, after the intervention, a significant differences was observed in this regard (P<0.0001). In the intervention group, the mean score of fatigue decreased from 59.72±18.32 to 35.8±16.15, and the mean score of stigma decreased from 17.31±15.62 to 5.09±8.06, showing a significant reduction in the levels of fatigue (P<0.0001) and stigma (P<0.0001) compared to before intervention. Also, the mean score of mood decreased from 36.90±12.21 to 28.55±11.87, indicating an improvement in the mood of samples in the intervention group (P<0.0001). Conclusions The results indicated that guided imagery, as a cost-effective method, can decrease the fatigue and stigma, and enhance the mood of patients with MS. Therefore, nursing staff can use this method to improve MS patients’ mood and decrease their fatigue and stigma.

2020 ◽  
pp. jramc-2019-001332 ◽  
Author(s):  
Saeid Amini Rarani ◽  
N Rajai ◽  
S Sharififar

IntroductionMilitary service is a stressful environment. Methods to reduce stress may result in the mental health promotion of military forces. There are various methods for relieving anxiety. Acupressure is one of them. Hence, this study was carried out to explore effects of acupressure at the P6 and LI4 acupressure points on the anxiety level of army soldiers.MethodsA randomised double-blind design was undertaken. A total of 120 Iranian army soldiers were randomly assigned to three groups, namely P6, LI4 and control. The P6 and LI4 acupressure points are effective in lowering the anxiety level. In the intervention groups, acupressure was applied at the P6 and LI4 points three times for 10 min at 30 min intervals. In the control group, the thumb pad, which is not an acupressure point, was pressed. The anxiety level of the subjects was measured before the intervention and 30 min after the last intervention. The instruments included a demographics questionnaire and the State-Trait Anxiety Inventory.ResultsThere was no significant difference between the three groups with respect to the anxiety level in the preintervention phase. However, the mean anxiety score in the P6 group decreased significantly from 53.35±9.7 to 49.02±9.3 (p=0.005). The mean anxiety score in the LI4 group also decreased significantly from 53.37±8.39 to 45.47±8.16 (p<0.001). In the control group, there was no significant difference between the preintervention and postintervention phases (p=0.16). In the postintervention phase, the analysis of variance test showed a significant difference between the three groups in terms of the anxiety level (p=0.04).ConclusionsAcupressure can reduce soldiers’ anxiety at the acupressure points, especially at the LI4 point. It is recommended that this simple and cost-effective intervention be used to relieve soldiers’ anxiety in stressful situations.Trial registration number20150715023216N4.


2021 ◽  
Author(s):  
Seyed Ahmad Hosseini ◽  
Shima Nematollahi ◽  
Durdana Husain ◽  
Nasrin Banaei-Jahromi ◽  
Nastaran Majdinasab ◽  
...  

Abstract Background: Multiple sclerosis (MS) is a complex inflammatory disease in which demyelination occurs in the central nervous system affecting approximately 2.5 million people worldwide. Intestinal microbiome changes play an important role in the etiology of chronic diseases. This study aimed to investigate the effect of probiotic supplementation on systemic inflammation in patients with MS.Methods: A twenty-four-week double-blind clinical trial study was designed and seventy patients with MS were randomly divided into two groups receiving probiotics and placebo. Patients in the intervention group received two capsules containing multi-strain probiotics daily and patients in the control group received the same amount of placebo. Factors associated with systemic inflammation were assessed at the beginning and end of the study.Results: Sixty-five patients were included in the final analysis. There was no significant difference between the two groups in terms of baseline variables except for the duration of the disease (P>0.05). At the end of the study, probiotic supplementation compared to the placebo caused a significant reduction in the serum levels of CRP (-0.93± 1.62 vs. 0.05 ± 1.74, P=0.03), TNF-a ( -2.09 ± 1.88 vs. 0.48 ± 2.53, P=0.015) and IFN-γ (-13.18± 7.33 vs. -1.93± 5.99, P<0.001). Also, we found a significant increase in the FOXP3 and TGF-β levels in the intervention group (P<0.05).Conclusion: The results of our study showed that supplementation with probiotics can have beneficial effects on serum levels of some factors associated with systemic inflammation.Trial registration: Approved by the Ethics Committee of the Ahwaz Jundishapur University of Medical Sciences, Ahvaz, Iran. This study was registered within Iranian Registry of Clinical Trials (IRCT) ( http://www.irct.ir) under the number IRCT20181210041918N2.


2019 ◽  
Vol 33 (1) ◽  
pp. 46-54
Author(s):  
Ardashir Afrasiabifar ◽  
Zahra Mehri ◽  
Hamid Reza Ghaffarian Shirazi

Orem’s self-care model has been introduced as a nursing model to empower participants with chronic diseases. This study aims to investigate the effectiveness of nursing interventions using Orem’s self-care model with multiple sclerosis participants’ balance and motor function. Sixty-three participants with multiple sclerosis were randomly assigned to intervention and control groups. The nursing intervention using Orem’s self-care model was performed for eight sessions of 45–60 minutes in the intervention group. In the intervention group, a significant increase (improvement) was observed in the mean scores of balance before (17.09 ± 1.97) and after the intervention (33.75 ± 6.01). A significant decrease (improvement) was observed in the mean of motor functions before (4.12 ± 0.34) and after the intervention (1.59 ± 0.71) ( p = 0.001). However, no significant difference existed in the mean scores of balance ( p = 0.10) and motor function in the control group ( p = 0.20). The nursing intervention using Orem’s self-care model improved balance and motor function of participants with multiple sclerosis.


2020 ◽  
Vol 1 (3) ◽  
pp. 179-182
Author(s):  
Yoav Yechezkel Pikkel ◽  
◽  
Vadim Igal ◽  
Yael Sara Pikkel Igal ◽  
Adi Nov-Sharabi ◽  
...  

AIM: To identify a link between optical coherence tomography (OCT), length of multiple sclerosis (MS) and the expanded disability status scale (EDSS). METHODS: In a prospective double blind study, 29 patients with a diagnosis of MS were compared with 29 healthy patients, matched by age and sex. All participants underwent an OCT study and neurological EDSS test on the same day. RESULTS: The mean EDSS score was 3.2 in the MS group vs 0.03 in the control group, and the duration of MS is 11.7y. The mean retinal nerve fiber layer (RNFL) thickness was significantly thinner in those with MS (P<0.001). Correlation was found between duration of MS and RNFL thinning. EDSS and thinning of RNFL showed a tendency to correlate but without statistical significance.


Author(s):  
Atieh Sadat Danesh ◽  
Faraz Mojab ◽  
Abolfazl Mohammadbeigi ◽  
Soodabeh Bioos ◽  
Zahra Siaghati ◽  
...  

Objectives: Heavy Menstrual Bleeding (HMB) is the most important problems of Uterine Leiomyoma (UL). This study aimed to assess the effect of the extract of the Capsella bursa-pastoris (CBP) on the control of HMB and quality of life in patients with uterine leiomyoma. Design: In a double-blind randomized, clinical trial 54 women with uterine leiomyoma were randomly assigned to the intervention/control groups by block randomization. Setting: Gynecology outpatient clinics. Intervention: The intervention group received 350 mg of alcoholic extract of Capsella bursa-pastoris and the control group received placebo twice daily for three months. Main Outcome Measures: Amount of bleeding by Pictorial blood loss assessment chart (PBAC), quality of life by menstrual quality of life questionnaires (MQ) and bleeding duration by calendar were evaluated. Results: The mean of PBAC decreased from 464.00± 283.61 at baseline to 323.82±207.66 in the intervention group and decreased from 445.92±362.64 to 214.36±137.68 in control group in the third month. The improvement trend was significant in the two groups, but there was no significant difference between groups. The mean of bleeding duration and menstrual quality of life showed improvement in patients of two groups without significant difference between the two groups. Conclusion: Despite the effectiveness of CBP in the intervention group in decreasing of PBAC score and menstrual bleeding duration and improvement of menstrual quality of life in patients who suffered from UL, it did not show a significant effect compared to the control group. Future studies with a larger sample size in one specific type of UL suggested.


2019 ◽  
Vol 16 (2) ◽  
pp. 223-231 ◽  
Author(s):  
Younes Najafian ◽  
Zahra M. Khorasani ◽  
Mona N. Najafi ◽  
Shokouh S. Hamedi ◽  
Marjan Mahjour ◽  
...  

Background:Diabetic foot ulcer (DFU) is one of the most common complications of diabetic patients. Mostly, non-healing DFU leads to infection, gangrene, amputation and even death. High costs and poor healing of the wounds need a new treatment such as alternative medicine. So, the aim of this study was to evaluate the efficacy of Aloe vera/ Plantago major gel (Plantavera gel) in healing of DFUMethods:Forty patients with DFU enrolled in a double-blind randomized clinical trial. The patients who were randomly assigned into the intervention group (n = 20), received topical Plantavera gel in addition to the routine cares, whereas the patients in the control group (n = 20), received topical Placebo gel in addition to the routine cares. Intervention was done twice a day for 4 weeks in the both groups. Photography and an evaluation of DFU healing were conducted by a checklist and then were scored at baseline and at the end of each week. The collected data was analyzed by SPSS software.Results:At the end of the study, there was a significant difference between the two groups in terms of total ulcer score (P<0.001) and Plantavera gel significantly reduced the ulcer surface comparing with the control group (P=0.039). However, there was not a significant difference between the two groups (P=0.263) in terms of the ulcer depth. During this study, no side effect was observed for Plantavera gel in the intervention group.Conclusion:Topical Plantavera gel seems to be an effective, cheap and safe treatment. Of course, further studies are required to confirm the properties of the wound healing of this gel.


2019 ◽  
Vol 10 (2) ◽  
pp. 70
Author(s):  
Samah Nasser Abd El-Aziz El-Shora ◽  
Amina Mohamed Rashad El-Nemer

Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.


2021 ◽  
Vol 17 ◽  
Author(s):  
Seyedeh Zahra Masoumi ◽  
Khodayar Oshvandi ◽  
Masoumeh Rostami-Moez ◽  
Arezoo Shayan ◽  
Farideh Kazemi

Background: Infertility can cause low marital satisfaction. Marital satisfaction has an important effect on infertile couples’ health. Objective: This study aimed to assess the effect of relationship enrichment training on improving the marital satisfaction of infertile couples. Methods: This randomized clinical trial was conducted on 50 infertile couples in the infertility center of Fatemieh Hospital in Hamadan, Iran in 2018. Participants were matched for demographic characteristics and randomly assigned to intervention and control groups (each group had 25 couples). Informed consent was obtained from all participants. The Enrich Marital Satisfaction questionnaire and demographic information were used to collect data before the study and two months after the intervention. Two trained midwifery students taught only the intervention group the relationship enrichment topics in seven sessions (each session = 90 minutes). The data were analyzed by SPSS Statistics version 21 using analysis of covariance, independent t-test, chi-square, and Mann–Whitney. The significance level was set at p ≤ 0.05. Results: There was no significant difference in demographic and obstetric information between the two groups (p >0.05). The mean of marital satisfaction in the intervention group significantly increased among women and men from 151.00 ±28.61 to 154.88 ±22.62 and from 152.56 ±27.33 to 159.24 ±22.14, respectively, (p <0.001). Conversely, the mean of marital satisfaction decreased among women and men from 158.13 ±13.86 to 146.25 ±19.53 and from 164.25 ±17.00 to 153.17 ±27.50 in the control group (p=0.02). Conclusion: Relationship enrichment training can be effective in promoting the marital satisfaction of infertile couples. Registration number: The National Center for Strategic Research in medical education, No. 960185.


Author(s):  
Maryam Sadeghi ◽  
Naeimeh Moheb ◽  
Marziyeh Alivandi Vafa

Introduction: The aim of current paper was to compare the effectiveness of acceptance and commitment group therapy (ACT) and group cognitive therapy (GCT) on Alexithymia and marital boredom (MB) among women affected by marital infidelity in Mashhad. Method: This clinical trial was a double- blind study with a pretest-posttest design in which two intervention groups and one control group were investigated. The study performed on women who realized their spouse infidelity and referred to Azad University Counseling Center in Mashhad in 2018. The sample consisted of 30 women who were selected by purposive sampling and were randomly assigned to two intervention groups and a control group (n=10 per group). The intervention groups were put under ACT training (twelve 90-minute sessions) and GCT training (twelve 90-minute sessions), but the control group did not receive any intervention. Data was obtained by the Toronto Alexithymia Scale-20 and Pines Marital Boredom Scale and was analyzed by multivariate analysis of covariance with SPSS (version 22) software. Results: The results showed a significant reduction in the mean score of MB in the ACT group, also there was a significant reduction in the mean score of Alexithymia in the GCT group (P <0.05). So comparing both therapies, ACT was more influential on reducing marital boredom whereas GCT was more effective on reducing alexithymia. Conclusion: Although both intervention methods were effective on Alexithymia and Marital Boredom in women affected by marital infidelity, it was demonstrated that ACT and GCT have more effect on Marital Boredom and Alexithymia, respectively.


2020 ◽  
Vol 10 (3) ◽  
pp. 270-283
Author(s):  
Mohammad Ali Nahayati ◽  
◽  
Seyed Abolfazl Vaghar Seyyedin ◽  
Hamid Reza Bahrami-Taghanki ◽  
Zahra Rezaee ◽  
...  

Objective: Stress and anxiety are common in patients with Multiple Sclerosis (MS). These complications exacerbate the symptoms of MS. This study aims to evaluate the effect of acupressure on stress and anxiety of MS patients. Methods: In this randomized clinical trial, participants were 106 MS Patients referred to Multiple Sclerosis Society in Mashhad, Iran. After signing an informed consent form, they completed a demographic form and stress, and the Depression Anxiety Stress Scale - 42 items (DASS-42). Then, they were randomly assigned into intervention and sham groups by tossing a coin. Participants in the intervention group were asked apply a pressure on the Shenmen and Yin Tang acupoints for one month (once per day for 15 minutes), while the sham group applied pressure 2.5 cm below the Shenmen acupoint and 3 cm above the Yin Tang acupoint. Participants in each group were then completed the DASS-42 again one hour after the final session. Data were analyzed using chi-square test, Kolmogorov-Smirnov test, independent t-test, and Paired t-test. Results: In the intervention and sham groups, there was no statistically significant difference between the mean pre-test scores of stress (34.73±5.80 vs. 33.06±6.42) and anxiety (27.09±6.99 vs. 25.31±6.88), and neither between the mean post-test scores of stress (29.20±6.21 vs. 33.73±9.44) and anxiety (22.79±5.68 vs. 25.21±6.72) (P>0.05). However, comparison of DASS-42 scores between groups showed that the mean scores of stress and anxiety in the intervention group were significantly lower than in the sham group (P< 0.05). Conclusion: It seems that acupressure can be used along with other therapeutic and pharmacological interventions to reduce stress and anxiety in patients with MS.


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