Introduction: Diabetes is among the common diseases in the elderly which results in depression, anxiety, and emotional distress in the elderly and impacts the disease control by the individual. This study was conducted with the aim of exploring the effectiveness of acceptance and commitment therapy (ACT) in the improvement of emotional distress in the elderly with type 2 diabetes. Materials and methods: In this randomized control trial, 80 elderly with type 2 diabetes aged ≥60 years were randomly selected among the individuals visiting Yazd Diabetes Research Center. Then, the patients were randomly divided into two 40 individual groups, ie, the intervention group and the control group. The intervention group underwent group ACT during eight 90-min sessions. The diabetes-related emotional distress questionnaire was completed before the intervention, after the end of the group sessions and 2 months after that. The statistical software SPSS version 21 was used for data analysis. Results: The emotional mean scores in the intervention and control groups were not significantly different before the intervention. However, the mean score of the intervention group was lower than of the control group immediately after the intervention (p=0.02) and 2 months after the intervention (p=0.02). Conclusion: ACT results in the improvement of diabetes-related emotional distress in the intervention group. Considering the effectiveness of ACT, this therapeutic method is recommended to be used for the amelioration of emotional distress in the elderly with type 2 diabetes.
ObjectivesEdication management is a process in which medications are selected, procured, delivered, prescribed, reviewed, administered and monitored to assure high-quality patient care and safety. This paper explores clinicians’ attitudes towards medication management which is both open to influence and strongly linked to successful changes in mediation behaviour. We aimed to investigate effects of engaging in participatory action research to improve emergency medicine clinicians’ attitudes to safety in medication management.SettingEmergency department of one university affiliated hospital.ParticipantsA total of 85 clinicians including nurses and physicians partook as participants. Eight managers and clinicians participated as representatives.DesignData are drawn from two-cycle participatory action research. Initially, a situation analysis on the current medication management and clinician views regarding medication management was conducted using three focus groups. Evaluation and reflection data were obtained through qualitative interviews. All qualitative data were analysed using content analysis.ResultsClinicians initially expressed negative attitudes towards existing and new plans for medication management, in that they were critical of current medication-related policy and procedures, as well as wary of the potential relevance and utility of potential changes to medication management. Through the action research, improvement actions were implemented including interprofessional courses, pharmacist-led interventions and the development of new guidelines regarding medication management. Participants and their representatives were engaged in all participatory action research stages with different levels of involvement. Extracted results from evaluation and reflection stages revealed that by engaging in the action research and practice new interventions, clinicians’ attitude towards medication management was improved.ConclusionsThe results support the impact of participatory action research on enhancing clinicians’ positive attitudes through their involvement in planning and implementing safety enhancing aspects of medication management.
Background and Objective: Anxiety and depression are among the psychological disorders in heart surgeries. Establishing a simple communication is essential to reduce anxiety and depression. Hence, the objective of the present studywas to examine the impact of Peplau therapeutic communication model on anxiety and depression in patients, who were candidate for coronary artery bypass in Al-Zahra Heart Hospital, Shiraz during 2012-2013. Methods: This is a clinical trial in which 74 patients were randomly divided into intervention and control groups, each consisted of 37 patients. Anxiety and depression levels were assessed before, and two and four months after intervention using the Hospital Anxiety and Depression Scale (HADS). Seven therapeutic communication sessions were held in four stages. Data were analyzed with the SPSS (version 16) using analysis of covariance. Results: The mean anxiety and depression levels decreased in the intervention group after the therapeutic communication (p<0.01). Anxiety scores in the intervention group before and after intervention were 10.23 and 9.38, respectively. While the corresponding scores in the control group were 10.26 and 11.62, respectively. Depression scores in the intervention group before and after intervention were 11 and 9.13, respectively. The corresponding scores in the control group were 11.30 and 12.08, respectively. Conclusion: The results demonstrated the positive role of therapeutic communication in reducing anxiety and depression of the patients. Therefore, the therapeutic communication is recommended as a simple, cost effective and efficient method in this area.
Background: The knowledge and abilities of nurses and physicians in perceiving and dealing with abuse are necessary for the improvement of older people's health. Therefore, the aim of this study was to investigate the role of attachment styles and communication skills in predicting nursing and medical students' perception of elder abuse in Yazd, Iran. Methods: The present study was a descriptive cross-sectional design that was conducted in the form of multistage sampling on 397 nursing and medical students at Shahid Sadoughi University of Medical Sciences in Yazd, Iran. The Elderly Caregiving Questionnaire (ECQ), Adults' Attachment Styles Inventory (AAI), and the revised version of the Communication Skills Questionnaire were used for data collection. Data were analyzed using the SPSS version 22 software. Results: The findings revealed that the participants had an appropriate understanding of elder abuse. The highest level of perception of elder abuse was in the dimension of psychological abuse (24.5± 5.22) and the lowest level was related to the dimension of physical abuse (21.7± 4.74). Additionally, a positive significant relationship was found between the score of students' perception of abuse, and secure and avoidant attachment styles as well as students' communication skills (p<0.01). According to regression analysis, these predictors explained 8.6% of the observed variance in the students' perception of elder abuse. Conclusion: These findings indicate that attachment styles influenced the individual's perception of elder abuse. Therefore, in future planning and research, this should be given more attention.
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