Background: There are currently conflicting results regarding the link between vitamin D deficiency and increased risk for stroke and its poor prognosis. The present study aimed to assess the relationship between vitamin D deficiency and prognosis of acute stroke. Methods: This bi-center cross-sectional study was performed on 140 consecutive patients who referred to two general hospitals in Iran with the diagnosis of acute stroke. The levels of 25-hydroxy vitamin D were evaluated by Electrochemiluminescence (ECL) technique. Clinical severity of stroke on admission as well as on discharge time were evaluated using the National Institutes of Health Stroke Scale (NIHSS) or Modified Rankin (mRS) tools. Results: Mean serum level of vitamin D was 25.51 ± 18.87 ng/mL, ranging from 3.0 to 98.6 ng/ml. There was a significant difference between the two groups (with and without vitamin D deficiency) in terms of stroke severity and disability, as reflected by mRS (P=0.003) and NIHSS evaluation (14.24 ± 9.23 versus 9.73 ± 7.36, P=0.003). Also, regarding patients’ clinical condition, the mean NIHSS score in those with deficient and normal levels of vitamin D was 14.24 ± 9.23 and 9.73 ± 7.36, respectively with NIHSS score > 5 in 76.1% and 61.5%, respectively (P = 0.003). Conclusion: According to the results of study, vitamin D status can be related to the severity of stroke. However, considering the cross-sectional design of our study, it could not point out the causality between vitamin D deficiency and acute stroke and further studies are warranted. It is not possible to draw any conclusions in terms of causality. Further studies are required in order to assess the relationship between the serum vitamin D levels and stroke severity.
Background: Nurses suffer from sleep disorders. Sleep disorders will lead to listlessness and distractibility, and interfere with people’s normal working state. Effective methods upon nurses sleep quality should identify. The purpose of this study was determining the efficacy of progressive muscular relaxation (PMR) upon nurses sleeping quality. Methods: The current research was an experimental study with pre-test and post-test design with the control group. The statistical population consisted of all nurses in Imam Sajad hospital in Ramsar 2017 (N=120). In this way, 40 nurses who were in the test of the quality of sleep score above five were randomly selected and randomly divided into two groups. For data gathering, Pittsburgh sleeps quality questionnaire and PMR instruction used. It was used multivariate covariance analysis (MANCOVA) to analysis data by SPSS-22. Results: The findings of this study showed that PMR instruction is useful for nurses’ sleep quality. Also, there is a significant difference between experimental and control groups after the intervention, so that the mean scores of the experimental group were improved significantly compared to the control group (P<0.0001). Conclusion: According to results, PMR instruction can improve the sleep quality and other variables related to sleep problems of nurses. Therefore, it can be used in nursing programs to improve their sleep quality
Background: Psychological disorders often threaten the mental health of individuals with Multiple Sclerosis (MS). Higher levels of psychological wellbeing and life satisfaction provide these patients with better social relationships and greater biopsychological health. The present study aimed to investigate the relationship between psychological wellbeing, early maladaptive schemas, resilience and perceived social support mediated by self-compassion and hope in women with MS. Methods: This descriptive-correlational study was conducted from August to October 2019. The study population consisted of all female patients with MS who were admitted to Imam Khomeini Hospital Complex, Milad Hospital, and Charity Foundation for Special Diseases in Tehran City, Iran. Using the stratification convenience sampling method, 300 patients were recruited as the study sample. The research instruments included the Self-Compassion Scale, Early Maladaptive Schema Questionnaire-Short Form, the Connor-Davidson Resilience Scale, the Multidimensional Perceived Social Support Scale, Ryff’s Scale of Psychological Wellbeing, and the Adult Hope Scale. The collected data were analyzed by structural equation modeling. SPSS and AMOS were used for analyzing the collected data. Results: There was a positive and significant relationship between self-compassion, hope, resilience, perceived social support, and psychological wellbeing (P<0.01). There was also a negative relationship between early maladaptive schemas and psychological wellbeing in the study participants (P<0.01). The indirect path analysis data indicated that self-compassion and hope played a mediating role in the relationship between perceived social support, resilience, early maladaptive schemas, and psychological wellbeing (P<0.01). Conclusion: The designed model fitted the empirical data very well. Therefore, the research components can help researchers, therapists, and psychiatric nurses to design better procedures to care for patients with MS.
Background: Rheumatoid arthritis is a progressive autoimmune disease with variable clinical symptoms. This study aimed to investigate the effectiveness of cognitive behavioral training on C-reactive protein (CRP) and depression in patients with rheumatoid arthritis. Methods: This research was a semi-experimental study with a pretest-posttest design and a control group. The statistical population of this study involved all women suffering from rheumatoid arthritis who went to Iran Rheumatology Center. From among them, 60 individuals were randomly selected and consigned to the control and experimental groups. The control group received only medication, and an educational package about rheumatoid arthritis provided for them. Beck’s depression and biochemical evaluations questionnaires were used to measure dependent variables. To analyze the data, multivariate analysis of covariance and SPSS. 22 software were used. Results: The mean (SD) of depression in the experimental group in the pretest was 25.5 (3.8), which decreased to 18.9 (4.2) in the post-test (P<0.01), but the mean (SD) of the control group was not statistically significant. Also, the mean (SD) of the CRP in the experimental group was 27.3 (6.9) in the pretest, which increased to 22.8 (4.6) in the post-test (P<0.01), but the mean (SD) of the control group was not statistically significant. Conclusion: This research revealed that cognitive behavioral training led to a reduction of CRP and depression in patients with rheumatoid arthritis.
Background: Diabetes is one of the most common diseases affecting peoplechr('39')s mental health and the body. Therefore, psychological interventions seem necessary to solve the problems caused by this disease. Objective: The present study aimed to compare the effectiveness of Compassion-focused Therapy (CFT) and Acceptance and Commitment Therapy (ACT), and commitment to self-care behavior and glycosylated hemoglobin in patients with type 2 diabetes at Tonekabon City Hospital. Materials and Methods: This clinical trial was a one-step cluster sampling study, including 200 patients who were randomly selected from all patients with type 2 diabetes in Tonekabon City Hospital and, at the same time, the scale of self-care behavior of Tobert, Glasgow, and Hamspon (2002). A total of 45 people were randomly selected and divided into three groups of 15 people, including two intervention groups and one control group, 12 compassionate therapy sessions, and 12 admission-based treatment sessions, each lasting 45 minutes. Meetings for each intervention were performed twice a week with an interval of 3 days. At the end of treatment, all three groups were retested. Results: Due to the comparison of the mean differences between the two treatment groups for self-care and glycosylated hemoglobin (5.012) (-2.145), respectively, Acceptance and Commitment Therapy was more effective than compassion-focused therapy. Conclusion: The results owed a positive trend and increased self-care behavior and balanced glycosylated hemoglobin level in the follow-up and effectiveness of both approaches and the superiority of the acceptance and commitment-based treatment approach. Therefore, this treatment can be used in different conditions to improve the lives of patients with type 2 diabetes.
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