China’s Psychological Implementation to Overcome COVID-19 Pandemic

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Investigating the Effect of Psychological Capital on Evidence-Based Clinical Practice of Nurses in Dealing With Patients With Coronavirus Disease: The Mediating Role of Psychological Security

Background: The coronavirus pandemic has caused fear and anxiety worldwide, especially amongst nurses. Examining the psychological effects of this disease on the mental health of nurses involved in the care of patients with this infection is critically important. This study aimed to investigate the relationship between the nurses’ psychology capital and their views on mental security, job satisfaction and clinical performance. Methods: One hundred consenting nurses from a university general hospital in Arak, Iran, completed three well-established questionnaires that asked about their psychology knowledge, views on mental security and clinical performance. The data were analyzed statistically, using confirmatory factor analysis and partial least squares method. Also, the path analysis test, t-test and regression beta coefficient were used to test the study’s four hypotheses on psychological capital and security. Results: The findings indicated that there were significant relationships, based on the theoretical model, amongst the nurses’ views on their psychology knowledge (or capital) and that it had a positive and significant effect on nurses' psychological security for working with COVID-19 patients. Also, the knowledge positively impacted their clinical performance and professional efficacy, while improving their sense of optimism, patience and hope for future. Conclusions: There were positive interactions between the nurses’ psychological capital and the clinical performance, mental security, optimism and hope. Nurses with psychology capital had less worries on these subjects than those who lacked it. Such nurses believed they were more resourceful and able to provide better care to patients with coronavirus infection than those who lacked the knowledge.

Effect of Exercise and Meditation on Depression and Anxiety Reduction: A Systematic Review and Meta-analysis

Objectives: Despite the studies that examined the effect of exercise and meditation on depression and anxiety, no meta-analysis has proved this effect so far. Also, the effect of these factors is unknown in terms of gender and aerobic exercise. This meta-analysis addressed these gaps. Methods: Major electronic databases, including PubMed, Web of Science, and Embase, were searched until July 2019. Studies addressing the effect of exercise and meditation on depression and anxiety were found. Q-test and I2 statistic investigated the heterogeneity across the studies. The probability of publication bias was explored using Begg's and Egger's tests. The results were expressed as the Standardized Mean Difference (SMD) with a 95% confidence interval using a random-effects model. Results: We identified a total of 10015 references and 51 studies involving 3594 participants. Compared with the control group, the SMD estimate of anxiety was -0.7 (-1.20, -0.19) for meditation, -0.9 (-1.24, -0.57) for aerobic, and -1.07 (-1.67, -0.46) for other exercises. Also, the SMD estimate of depression was-0.84 (-1.26, -0.42) for meditation, -0.44 (-0.72, -0.17) for aerobic, and -1.10 (-1.55, -0.65) for other exercises. Conclusion: Exercise and meditation had a significant effect on depression and anxiety. Furthermore, there was an effect of the exercise and meditation on depression and anxiety regarding the female gender and aerobic exercise.

Evaluating the Performance of Community Mental Health Centers in Iran: Strengths and Challenges

Objectives: This study aims to evaluate the performance of Community-based Mental Health Centers (CMHCs) in Iran and identifying the strengths and challenges in the provision of mental health services. Methods: This is a qualitative study, conducted using 36 individual interviews and 13 focus group discussions. Content analysis was performed and data were categorized. The findings were presented in terms of the needs for program implementation, achieving the expected goals and outcomes, and the findings of program evaluation. First, the points related to the provision of infrastructure and setting up the centers were mentioned, and then, the features, strengths and challenges facing the program were discussed. Results: Significant successes were achieved in providing infrastructure and implementing the community-based mental health program. Challenges in the implementation of this program included the barriers to attracting more general physicians and the impact of culture and attitudes in each city on the effectiveness of the program. Conclusion: To improve the performance of CMHCs, more attention should be paid to psychiatry and mental health educational programs in the general medicine curriculum, public education about the mental health and providing solutions for better implementation of the program.

Accuracy of Niacin Skin Flush Test for Diagnosing Schizophrenia

Objectives: This study aims to investigate niacin sensitivity in schizophrenia patients compared to healthy people and examine the accuracy of niacin skin flush test in diagnosing schizophrenia. Methods: This diagnostic study was conducted in 2018 in Zanjan, Iran. Three niacin concentrations (0.001 M, 0.01 M, and 0.1 M) was first applied topically to the skin of 36 schizophrenia patients and 33 healthy controls. Flush responses were evaluated at 10 and 15 min after application. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of the test were measured for each niacin concentration and evaluation time. Results: At 10 min, the highest test accuracy was reported when 0.001 M niacin solution was used (Sensitivity=94%, specificity=50%, PPV= 51%, and NPV= 94%). At 15 min, the highest test accuracy was observed at 0.01 concentration (Sensitivity=52%, specificity=92%, PPV=79%, and NPV=77%). Conclusion: Flush responses to niacin is more impaired in patients with schizophrenia. Therefore, niacin can be considered as a biological marker of schizophrenia and can be used for its diagnosis.

From Leaving Home to Losing Identity: A Qualitative Study on Rough Sleeping in Drug Addicts in Iran

Objectives: The phenomenon of rough sleeping in big cities of Iran, particularly in Tehran is a serious social problem. The term rough sleeping is mostly used for those who sleep on the public spaces including pavements, parks or under bridges. It is assumed that rough sleeping and drug addiction are linked to each other. This study aims to evaluate the process of rough sleeping based on the experiences of homeless drug addicted in Iran. Methods: This is a qualitative research. Participants were 20 homeless addicts (9 males and 11 females, mean age= 36.2 years) in Tehran city who were recruited using a purposive sampling method, and sampling continued until data saturation. The data were collected through a semi-structured in-depth interview and observations. Data analysis was performed based on the grounded theory recommended by Strauss and Corbin (1998). Results: The rough sleeping process had two steps: (a) Leaving home voluntarily (to protect family or escape from family problems) or involuntarily (Due to being expelled from home and losing the roof over the head), and (b) Being homelessness which had four main categories: Elusive life, informal and contravened subsistence, involving in exploitative relationships, and loss of individual/social identity. Conclusion: When leaving home and becoming rough sleeper, the individual becomes elusive, delinquent, damaged and socially rejected homeless, in addition to the risk of becoming a drug addict. Therefore, this group can be considered as a severely injured group involved in various social, legal and psychological issues. Given the complexity of the homelessness aspects in drug addicts, there is a need for coordinated interventions between individuals, families and the support systems at all levels.

Urban Mental Health Initiative: Developing Interdisciplinary Collaboration, the Role of the Family Physician in Management of Severe Mentally Ill Patients

Introduction: Mental health in Iran was approved in 1988. However, and then this program was integrated into the primary care system in our country and was implemented within the villagers' family physician program with great success. In urban areas, there is no structured health network. However, regarding the demographic changes in the country's population, huge sprawling of cities, and the changes in urban-rural population proportion, demands for a coherent plan to provide mental health services to the urban population are felt more than ever. This study aimed to investigate the feasibility and establishment of a model of urban mental health network for severe psychiatric patients. Methods: This plan is based on resource reviews, Use the experiences of other countries, Model World Health Organization, The services available in the country currently run by the beneficiary organizations, Description of the responsibilities of the responsible organizations, Collaboration between the Ministry of Health and various organizations responsible for mental health, Having the views of national expert and international constant in this field from other countries cooperated with the aim of examining how to compile a coherent and integrated urban health service plan. This model is estimated by community-based services for 100,000 people. Results: The proposed model for providing immediate psychiatric services with greater cohesion and increasing training and skills capacity among staff 110, 115, 1480, and 123 services, as well as a space for hospitalization of 3 to 5 emergency patients next to the public hospital, is recommended. Depending on the number of patients in a population of 100,000, we will need community-based services, including 2 to 3 home visit teams to cover 80 patients per team, and 3 daily centers to provide services to 40 patients. If community-based services are provided, we will need 12 acute psychiatric beds and 5 beds for mid-term rehabilitation to provide inpatient services. In terms of employment and accommodation, 50 patients will need supported employment, respectively, and two apartments with an area of about 60 meters will be needed to accommodate about eight people. The provision of the above services requires the equal participation of the interested organizations. The family physician will play an essential role in continuing medical care for severe and mild psychiatric patients under the constant supervision of specialists Discussion and Conclusion: To achieve a better model of mental health services in cities that can cover a wide range of people in urban areas and at various levels from prevention and care to treatment and rehabilitation, we need the coordination between the organizations providing these services for the accurate planning of the interests of each organization, elimination of duplicate services, and saving human capital and resources of the country.

Depression, Anxiety, Psychosomatic Symptoms, and Perceived Social Support in Type D and Non-type D Individuals

Objectives: This study examines depression, anxiety, psychosomatic symptoms, and perceived social support among type D and non-type D individuals. Methods: A total of 300 individuals aged 18 to 40 years were recruited in the investigation. We used the distress personality scale (DS 14), Pakistan anxiety and despondency scale, psychosomatic symptoms, and perceived social support scales to obtain the study data. The study participants were divided into Type D (n=166) and non-Type D individuals (n=134) based on their DS 14 cut-off scores. In this descriptive study, a random cluster sampling technique was utilized to choose the samples. The study was conducted from September to December 2017. Data analysis was performed utilizing independent samples t-test and regression analysis. Results: The recurrence of the Type D personality was 55%. Results indicated a considerable difference between Type D and non-Type D personality on depression, anxiety, and psychosomatic side effects (P < 0.001 for all side effects). The findings also suggest that Type D individuals perceived less social support from family, friends, and significant others. Conclusion: People with type D character qualities show more depression, anxiety, psychosomatic symptoms, and less perceived social support when compared with non-Type D people.

Application of Negative Reinforcement and Reward Technique to Reduce Behavior of Collecting Goods In Individual with Schizophrenia

Our subject is a 55-year-old man and a former civil servant. He claimed to have seen someone who others could not see. He believed that he is an important person. He had strange behavior such as separating himself from others, speaking and laughing alone, and collecting rubbish. Based on the assessment through observation, interviews, and psychological tests, the subject was diagnosed with schizophrenia and behavioral problems such as collect things. The subject’s behavior appears because he feels pleasure after collecting goods. He did not do other activities that make him feel good; thus, the behavior was repeated. The intervention aims to reduce the frequency of collecting things through negative reinforcement and rewards techniques. The intervention eventually suppressed the behavior of collecting things carried out by the subject gradually.

Review, Documentation, Assessment of Treatment, and Harm Reduction Programs of Substance Use Disorder in Iranian Prisons

Objectives: This study aims to assess the implementation of drug-related harm reduction programs in Iranian prisons and suggest solutions for their improvement. Methods: This study was conducted in three steps. First, library method was used for collecting data from the central library of Iran’s Prisons, Security and Corrective Measures Organization. In the second step, performance indicators were extracted based on the results of first step and two researcher-made checklists were designed. Finally, a field visit and a semi-structured interview with the authorities involved in the treatment and harm reduction services were carried out. Results: In most of prisons, drug-related harm reduction programs were underway. Despite a lack of human resources and budget at the beginning, the quality of measures was gradually increased and the attitude of authorities was improved. Methadone Maintenance Treatment and Triangular Clinics were the most common harm reduction programs, in addition to HIV and tuberculosis screening programs in collaboration with medical sciences universities. The program continued despite the change of officials. Conclusion: Harm reduction programs are able to reduce infection diseases, self-harm and violent behaviors in prisons of Iran. Cultural programs along with other harm reduction programs, briefings and seeking support from the authorities can greatly help with continuation of the programs in prisons. By eliminating the shortage of manpower and redefining the security areas for ordinary prisoners, it will be possible to make better use of the facilities of universities and research centers.