Comparing of the Effects of Acceptance and Commitment Therapy and Emotion Regulation Training on Diabetes Empowerment

Background: Diabetes mellitus is a widely diffused chronic condition that affects several aspects of patients’ lives. The patient’s life in this condition depends on diabetes management ability. Therefore, this study aimed to compare the effects of Acceptance and Commitment Therapy (ACT) and Emotion Regulation Training (ERT) on the diabetes empowerment of patients with type 2 diabetes. Methods: This was a quasi-experimental study with a pre-test, post-test-follow-up and a control group design. Of the statistical population of patients referring to the Diabetes Prevention and Control Center of Mashhad Province, Iran, 45 subjects were recruited by convenience sampling method; they were randomly assigned into three groups of ACT, ERT, and control (n=15/group). The study subjects were assessed using the Diabetes Empowerment Scale (F-DES-28) in the pre-test stage, after the intervention, and 3 months later. The obtained data were analyzed by repeated-measures Analysis of Variance (ANOVA) in SPSS V. 22. Results: Both provided interventions presented a significant effect on the empowerment of the research subjects, compared to the controls (P<0.001). The effectiveness of ACT on the diabetes empowerment of patients was significantly higher than that of the ERT group (P=0.04). Conclusion: It is recommended to use ACT and ERT to empower patients with type 2 diabetes.

Organizational Factors Associated With Nurses’ Competence in Averting Failure to Rescue in Acute Care Settings

Background: Organizational characteristics are the main concerns of nursing practice in acute care settings. The present study aimed to assess the organizational factors associated with nurses’ competence in averting Failure to Rescue (FTR) in acute care settings. Methods: This was a descriptive and correlational study. A purposive sampling technique was used to collect the necessary data from the study respondents. In total, 173 of the 204 eligible registered nurses providing sudden, urgent, and emergency direct care to patients in the identified acute care settings of Olabisi Onabanjo University Teaching Hospital in Sagamu City, Nigeria participated in this study. A self-structured 38-item questionnaire, including 4 parts (demographic characteristics, knowledge on FTR, competence in averting FTR, & organizational factors) was employed for data collection. The obtained data were analyzed in SPSS V. 22 using descriptive statistics (i.e. frequency, percentages, mean, standard deviation, & tables) as well as Spearman’s Rho correlation to test the hypotheses based on the assumptions that the variables were measured on an ordinal scale at P<0.05. Results: Most nurses presented a high level of knowledge regarding FTR with a mean score of 5.91. Besides, they were moderately competent in averting FTR with a mean score of 29.3. A significant correlation was also detected between organizational characteristics and the studied nurses’ level of competence in averting FTR (P=0.026). Conclusion: The present study data revealed that FTR could be reduced in acute care settings by the modification of organizational factors.

The Relationship Between Perfectionism, Early Maladaptive Schemas, Attachment Styles, and Body Image Concern by the Mediating Role of Self-esteem in Cosmetic Surgery Applicants

Background: Psychological characteristics could significantly impact applications for cosmetic surgery as well as precognition and satisfaction with surgery. The present study aimed to investigate the relationship between perfectionism, early maladaptive schemas, attachment styles, and body image concern by the mediating role of self-esteem in cosmetic surgery applicants. Methods: This was a predictive correlational study. The statistical population of the study included all female applicants for cosmetic surgery referring to cosmetic surgery centers in Tehran City, Iran, in 2020. A sample size of 400 women was selected based on Klein’s model (2016). The required data were collected by Rosenberg Self-Esteem Scale (RSES) (1989), Multidimensional Perfectionism Scale (MPS), Young Schema Questionnaire (YSQ-S3), Adult Attachment Scale (AAS), and Body Image Concern Inventory (BICI), and analyzed using Pearson correlation coefficient and structural equations in SPSS and AMOS. Results: The obtained results signified a significant relationship between perfectionism, early maladaptive schemas, attachment styles, self-esteem, and body image concerns (P<0.01). Furthermore, the modified model presented a good fit (The Root Mean Square Error of Approximation (RMSEA) =0.061, GFI=0.989, IFI=0.987, P<0.05); the indirect paths of perfectionism, early maladaptive schema, and attachment styles through self-esteem were also significant. Conclusion: The evaluated model indicated a good fit; thus, it can play an essential role in recognizing the factors affecting the body image concerns of female cosmetic surgery applicants.

The Role of Attachment Styles and Spiritual Intelligence in Predicting Women’s Emotional Divorce

Background: Emotional divorce refers to a situation in which the emotional relationship, support, passion, warmth, attention, love, and intimacy between couples (husband & wife) decline or diminish. Such conditions lead to an unaffectionate marital life to the point that the couples are only together under one roof. Accordingly, the present study aimed to explore the role of attachment styles and spiritual intelligence in predicting emotional divorce in women. Methods: This study employed a descriptive-correlational design. The research population included all women filing for divorce who were referred to marriage counseling and couple therapy centers in districts 5 and 6 in Tehran City, Iran, in 2020. In total, 400 women who met the inclusion criteria were selected as the study participants using voluntary response and convenience sampling techniques. The required data were collected by the Emotional Divorce Scale, the Adult Attachment Scale, and the Self-Report Measure of Spiritual Intelligence. The collected data were analyzed using the multiple regression analysis method in SPSS V. 22. Results: The obtained results suggested a significant positive relationship between the anxious-avoidant attachment style and emotional divorce (P<0.01). Furthermore, there was a significant negative relationship between spiritual intelligence and emotional divorce; the higher the spiritual intelligence, the lower the emotional divorce (P=0.02). Accordingly, spiritual intelligence and anxious-avoidant attachment style can predict emotional divorce (Multiple Regressions= -0.58). Conclusion: The present study data suggested that premarital education and counseling before spouse selection help in examining the personality traits of the parties. Moreover, paying attention to the role of health professionals, such as family counselors, psychologists, and psychiatric nurses in providing premarital counseling and education to couples and emphasizing the role of spiritual intelligence and attachment styles may prevent emotional separation and divorce among couples.

Effects of Integrative Behavioral Couple Therapy on Infertility Self-efficacy, Dyadic Adjustment, and Sexual Satisfaction in Infertile Couples

Background: Given the rising rate of infertility, the prevalence of mental health disorders in infertile couples is undeniable. The present study aimed to investigate the effects of Integrative Behavioral Couple Therapy (IBCT) on infertility self-efficacy, dyadic adjustment, and sexual satisfaction in infertile couples. Methods: The present single-case experimental study used a multiple-baseline design. The statistical population of the study included all infertile couples referring to infertility centers in Ahvaz City, Iran, in 2019. The research instruments included the Infertility Self-Efficacy Scale (ISE), the Dyadic Adjustment Scale (DAS), and the Sexual Satisfaction Questionnaire (SSQ). Following a diagnostic interview, 3 couples were selected using the convenience sampling technique. Integrative behavioral couple therapy was conducted in twelve 120-minute sessions for the intervention group. The second couple entered the study in the second session of the first couple; the third couple enrolled the treatment plan in the third session of the first couple and the second session of the second couple. All questionnaires were completed in the first, third, sixth, eighth, and tenth sessions; the study participants were followed up and re-assessed two months later. The collected data were analyzed in SPSS using chart analysis, reliable change index, and significance statistics. Results: The provided IBCT increased infertility self-efficacy (39.04%), dyadic adjustment (25.91%), and sexual satisfaction (55.01%) in infertile couples. Besides, the improvement lasted throughout the follow-up which indicated the effectiveness of IBCT on infertility self-efficiency, dyadic adjustment, and sexual satisfaction in the study subjects. Conclusion: IBCT can be effective in improving personal and marital variables in infertile couples with infertility problems in addition to their marital problems.

The Effects of Relaxing Music on Life Distress and Maternal-fetal Attachment in Pregnant Women

Background: Although pregnancy and motherhood are enjoyable experiences, they are associated with numerous biopsychological changes requiring adaptation. The present study aimed to assess the effects of relaxing music on life distress and Maternal-Fetal Attachment (MFA) in pregnant women. Methods: This was a quasi-experimental study with a pre-test, post-test and a control group design. The research population included all Iranian pregnant women referring to Laleh Hospital in Tehran City, Iran, in 2020. In total, 30 women were selected using the convenience sampling method and randomly assigned into the intervention and control groups (n=15/group). The required data were collected using the Life Distress Inventory (LDI) and the Maternal-Fetal Attachment Scale (MFAS). The intervention group listened to relaxing music for twelve 45-50-minute sessions in the morning and during routine midwifery visits; however, the controls received no intervention. The collected data were analyzed using Multivariate Analysis of Covariance (MANCOVA) in SPSS V. 22. Results: The obtained results indicated that the intervention group reported a lower level of life distress in the post-test, compared to the controls (P=0.0001, F=15.860). The intervention group also achieved a higher mean score on MFA, than the control group (P=0.0001, F=35.872). Conclusion: According to the present research findings, reproductive health, nursing professionals, and psychologists could recommend music as a complementary therapy to reduce stress and distress experienced by expecting mothers and to improve MFA.

The Effects of Emotional Schema Therapy and Differentiation Training on Emotional Divorce in Women

Background: Emotional Divorce (ED) is associated with decreased levels of Emotion Regulation (ER), adaptation, and mental health; subsequently, all such pressures raise stress in various dimensions among the affected individuals. Emotional Schema Therapy (EST), as a socio-cognitive model of ER, may improve marital intimacy and reduce couples’ psychological distress. The present study aimed to investigate the effects of EST and differentiation training on the odds of ED among women. Methods: The mean values of ED significantly decreased in both experimental groups, compared to the control group (P<0.05). A significant difference was also observed between the effects of the two interventions on decreasing the ED rate; thus, the effectiveness of EST was greater than that of differentiation training in this respect (P<0.05). Results: The mean values of ED significantly decreased in both experimental groups, compared to the control group (P<0.05). A significant difference was also observed between the effects of the two interventions on decreasing the ED rate; thus, the effectiveness of EST was greater than that of differentiation training in this respect (P<0.05). Conclusion: EST and differentiation training reduced ED among the study participants. These approaches can be adopted as an effective intervention to solve the couples’ problems and improve their marital relationship to reduce the odds of emotional divorce.

The Perceptions of Families of Comatose Patients in the Intensive Care Unit: A Qualitative Study

Background: There are specific challenges regarding the perceptions of families of comatose patients in Intensive Care Units (ICUs). Identifying these perceptions may attract the cooperation of families with nurses and provide better care for patients. This study aimed to explore the perceptions of families of comatose patients in ICUs. Methods: This was a qualitative content-analysis study. Seventeen families with comatose patients were recruited by the purposive sampling technique. The necessary data were generated by semi-structured interviews, continued until data saturation, and concurrently analyzed by an inductive content analysis method. Results: Four main categories were manifested, including shock and disbelief, the effort for adaptation, exhaustion, and burnout, as well as hope and support. Conclusion: The obtained results signified the importance of nurses’ awareness concerning the family members’ perceptions of their comatose patient status in ICUs. The relevant findings reflected the need for nurses to pay attention to the feelings and emotions of the families of these patients.

Nursing Students’ Performance and Satisfaction Regarding the Classification of Pressure Injuries Using Simulation With Moulage

Background: Simulation-based education is a widely utilized tool for experiential learning in nursing education. The aim of this study was to determine nursing students’ performance and satisfaction in the classification of pressure injuries using simulation with moulage. Methods: It is an evaluation study with a quasi-experimental, single-group, post-test design that was conducted in the spring semester of the 2019-2020 academic year in the Nursing Department of the Faculty of Health Sciences of Izmir Katip Celebi University, Izmir, Turkey. In total, 66 final-year nursing students, voluntarily participated in the Assessment of Pressure Injury Course. A student characteristics form, a Pressure Injury Classification Form, and a Moulage Satisfaction and Evaluation Form were used as data collection tools. Data were entered into SPSS v. 21, and the results of the analysis were described using descriptive statistics. Results: It was found that 67.2% (n=45) of the students correctly assessed all the stages of pressure injury moulages on the standardized patients. Among the students, 62.1% (n=41) strongly agreed that their assessment skills of pressure injury improved after the simulation. The results related to students’ satisfaction indicated that 77.3% (n=51) of the students evaluated the moulages as realistic. The Mean±SD total score of students’ evaluation of moulage simulation sessions on standard patients was 4.56±0.59 (range=1-5). Conclusion: This moulage is a simple, easily accessible, low-cost, and effective tool for teaching pressure injury assessment to nursing students. It can be used in clinical skills training and clinical assessment in nursing education.

The Perceived Barriers to Physical Activity in Pregnant Women: A Review Study

Background: Despite all the positive effects of physical activity on maternal and fetal health, its level is low among pregnant women. Various barriers seem to prevent physical activity during pregnancy. The aim of this study was to investigate and determine the barriers to physical activity during pregnancy based on a review of available literature. Methods: To review the available literature, the authors searched Persian databases, such as Iran Medex, Magiran, MedLib, and SID, and also English databases, including Scopus, PubMed, Elsevier, ScienceDirect, Web of Science, and ProQuest using the keywords of pregnant woman, physical activity, exercise, barriers, pregnancy, constraints, and attitudes individually or in combination between 2000 and 2020 and finally, 10 articles that met the inclusion criteria were reviewed. An ecological model was used to classify the reported barriers. Results: Seven quantitative articles and three qualitative articles were included in the study. Obstacles related to the intrapersonal level of the ecological model were the most reported in these studies and were classified into five areas, including pregnancy symptoms and limitations, time constraints, misunderstanding the adequacy of daily activities, lack of motivation, and maternal and fetus safety concerns. Barriers at the interpersonal level included lack of consultation and information and lack of social support and at the environmental, organizational, and political levels, climate and lack of resources were the most reported barriers. Conclusion: The present study outlined the perceived barriers to physical activity among pregnant women and highlighted the important factors that should be considered when planning interventions to increase the level of physical activity during pregnancy. Further studies are recommended to provide solutions to overcome these barriers and increase the activity of pregnant women.