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Background: The mental health of the parents of Autism Spectrum Disorder (ASD), particularly the mothers, is poor due to the severity and complex nature of this condition, and they encounter numerous issues. This investigation aimed to determine whether happiness education affected mothers of children with ASD's Expressed Emotions (EE) and Quality of Life (QoL). Materials and Methods: A total of 70 mothers of children with ASD aged 3 to 13 years participated in this clinical trial study research. The experimental group received the Fordyce happiness training program once every 6 weeks via WhatsApp. In three stages, data were collected using a demographic form, the Family Questionnaire (FQ), and the World Health Organization Quality Of Life Instrument, Short Form (WHOQOL-BREF) (before the intervention, immediately afterward, and 1 month later). In the Statistical Package for Social Sciences (SPSS) software, the acquired data were analyzed using independent-sample t-tests, Chi-square tests, and repeated-measures Analysis of Variance (ANOVA). Results: There was no significant difference in EE and QoL mean scores between the two groups before the intervention, but after, the intervention group's mean score of EE (20.91 (4.355)) was substantially lower than the control group's (44.74 (4.77)) (p < 0.001). In comparison, the intervention group's mean score of QoL and its dimensions was more significant than the control group's (p < 0.001). Conclusions: Given the efficacy of the happiness education program in reducing EE and enhancing QoL in mothers of children with ASD, such treatment strategies should be developed and used.

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Background: The aim of this study was to compare noise sensitivity (NS) in schizophrenic individuals with/without hallucinations and healthy individuals. Procedure: A retrospective (causal-comparative) study was conducted in three groups: (i) A group of individuals with schizophrenia and auditory hallucinations (14 participants), (ii) a group of schizophrenic individuals without auditory hallucinations (14 participants) selected by purposive sampling and (iii) a control group (19 participants) selected by convenience sampling. Schutte's Noise Sensitivity Questionnaire was used to measure NS. Analysis of Variance and Kruskal-Wallis tests were applied to compare the three groups. All the analyses were done using SPSS-20. Results: ANOVA results indicated that the groups were significantly different in terms of NS (p<0.001) and that NS was higher in groups whose participants were schizophrenic (119.64 and 102.36, respectively, in groups with or without auditory hallucinations) compared to that in the group with healthy individuals (94.79). Conclusions: On the basis of this study, it became evident that patients with schizophrenia are more sensitive to noise than healthy individuals. The results also indicated that schizophrenic patients with auditory hallucinations are more sensitive to noise than those without auditory hallucinations.

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OBJECTIVE: Developing and promoting professional ethics principles for clinical librarians can help the health care system balance the interests of all stakeholders, including clinical librarians, health care professionals, and patients. Therefore, the goal of this study was to design a model of professional ethics excellence for clinical librarians. METHODS: The authors conducted a descriptive applied study using literature review and the delphi method. The delphi panel included eleven experts in medical librarianship, library and information sciences, or information sciences and knowledge studies. RESULTS: After the delphi rounds, five concepts and forty-six components were identified and confirmed to provide a model of professional ethics excellence for clinical librarians. The highest-rated concept was excellence in communication. The highest-rated component was mastery in developing search strategies in information resources and databases. CONCLUSIONS: Identifying and applying principles of professional ethics among clinical librarians can enhance the professionalization of clinical librarians and result in better information services for physicians. Furthermore, incorporating these principles into the curriculum for health sciences library and information sciences students or into workshops for active clinical librarians can further formalize the profession and practice of evidence-based medicine.

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CONTEXT: One of the most important issues in patients with coronary artery disease is their mental health indices such as perceived stress and perception of disease. AIMS: The aim of this study was to evaluate the effectiveness of mindfulness-based intervention on the perceived stress and disease perception of patients with acute coronary syndrome. MATERIALS AND METHODS: This is a clinical trial, two-group, and three-stage study on 76 patients with acute coronary syndrome who were randomly divided into intervention and control groups. Nine weekly sessions of mindfulness-based training program were administered to the intervention group. The control group received routine services during this period. Data collection was done before, immediately, and 1 month after the intervention, using the Perceived Stress Scale and the Illness Perception Questionnaire. Data were analyzed using descriptive and inferential statistics. RESULTS: There was no significant difference between the mean scores of perceived stress and illness perception before intervention. After the intervention and 1 month after it, the mean score of perceived stress in the intervention group was statistically significantly lower than the control group (P < 0.001), and the perception of disease in the intervention group was statistically significantly higher than that of the control group (P < 0.001). CONCLUSIONS: It is worthwhile to suggest the mindfulness-based training program to reduce the perceived stress and correct the perception of disease for patients with acute coronary syndrome.

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BACKGROUND: The consequences and high costs of psychiatric disorders impact family caregivers greatly. Health services should identify and provide accessible support programs to facilitate effective caregiver coping. PURPOSE: The aim of this study was to determine the effectiveness of a theory-of-planned-behavior-based problem-solving training program on the coping styles of family caregivers of psychiatric inpatients. METHODS: In this two-group, randomized control trial, 72 family caregivers were randomly assigned to either a control group receiving standard care or an intervention group receiving a training program (eight sessions over 4 weeks). Demographic information was recorded at baseline, and the Coping Inventory for Stressful Situations was administered to both groups at baseline, immediately postintervention, and 1-month follow-up. RESULTS: Immediately after the intervention, the intervention group earned significantly higher task-oriented coping style scores (mean difference = 5.03, p = .015) than the control group, but no significant difference was detected between the two groups for either emotion- or avoidance-oriented coping style scores. At 1-month follow-up, the intervention group earned significantly higher scores than the control group for task-oriented (mean difference = 8.56, p < .001) and emotion-oriented (mean difference = 7.14, p = .002) coping styles. No improvement in avoidance-oriented coping style at the postintervention or follow-up time points was detected. CONCLUSIONS: Implementation by nurses and other health professionals of problem-solving training programs that are based on the theory of planned behavior is recommended to strengthen the use of task- and emotion-oriented approaches that help family caregivers of psychiatric patients better cope with stress.

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BACKGROUND: This study aimed at investigating the effect of showing surgery educational documentary film on the anxiety of patients candidate for lumbar disc surgery. MATERIALS AND METHODS: This study, as a randomized clinical trial, was conducted in 2018 on 60 patients undergoing lumbar disc surgery, Iran. The patients were divided into two groups of intervention and control (N = 30). An educational film was shown to the patients of the intervention group for 20 min and the control group was provided with the ward's routine trainings. All patients completed demographic characteristics questionnaire and the Spielberger State-Trait Anxiety Inventory (SSTAI) on the admission day, 1 day before the surgery, and 2 h before the surgery. SSTAI was recompleted by the patients. Data analysis was performed using independent t-test, Chi-square, Mann-Whitney test, and paired t-test. RESULTS: Before the intervention, the mean score of the state (obvious) and trait (hidden) anxieties was not significantly different between the two groups, but after the intervention, the mean [standard deviation (SD)] score of the state anxiety in the intervention group was significantly lower than that of the control group [mean (SD) = 40.78 (10.34) vs. 47.45 (10.33), F 10,33 = 58, p = 0.01]. In addition, after the intervention, the mean (SD) anxiety score of the patients in the intervention group was significantly lower than that of the control group [mean (SD) = 38.65 (11.01) vs. 44.71 (10.34), F 10,34 = 58, p = 0.03). CONCLUSIONS: The results showed that educational film reduces the patients' level of anxiety before the surgery. As such, it is recommended that these trainings be included in preoperative nursing practices.

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BACKGROUND: Diabetes mellitus (DM) is a chronic disease which imposes high costs on patients and society and results in complications in patients. One of these complications includes issues related to mood. Thus, the present study was conducted with the aim to determine the effect of hope therapy on the mood status of patients with DM. MATERIALS AND METHODS: This quasi-experimental study was performed with two groups in three stages in the summer of 2015 on 38 individuals. The study population consisted of all individuals with DM who referred to and had a medical record at Shahid Asghar Shabani Clinic (Isfahan, Iran) affiliated with the social security organization. From among the 350 individuals with medical records at the clinic, 38 who had the inclusion criteria were selected through simple random sampling. Participants were randomly assigned to control (n = 19) and experimental (n = 19) groups. The Zung Self-Rating Depression Scale was completed by both groups before, after, and 1 month after the intervention. RESULTS: There was a significant difference in the mean scores of depression in the intervention group before (F = 19.48, p = 0.001), immediately after (t = 3.30, p = 0.002), and 1 month after the intervention (t = 3.09, p = 0.004), whereas there was no significant difference in the mean scores of depression before, immediately after, and 1 month after the intervention in the control group. CONCLUSIONS: The obtained results showed that hope therapy can reduce depression in patients with DM.

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BACKGROUND: Patients with end-stage renal disease on hemodialysis are affected by psychological stressors, which contribute to poor quality of life and negative clinical outcomes. Stress, anxiety, and depression are highly prevalent in this population. Fordyce's happiness program has been believed to be one of the complementary therapies that could promote psychological wellbeing. The goal of this study was to evaluate the effects of Fordyce's happiness program on the stress, anxiety, and depression in patients with hemodialysis. MATERIALS AND METHODS: This is a clinical trial. A total of 50 patients undergoing hemodialysis were randomly recruited into the study group (n = 25) and the control group (n = 25). Intervention of Fordyce's happiness program was administrated for 20 minutes during hemodialysis sessions once a week for 6 sessions. For the control group, 3 sessions were held by the researcher's colleague through communication, dialogue, and listening to the patients' problems individually. The data was collected by the Stress, Anxiety and Depression (DASS-21) questionnaire. RESULTS: There was a significant difference in the mean scores of stress, anxiety, and depression in the intervention group before immediately after and one month after intervention (P < 0.05), whereas there was no significant difference in the mean scores of stress, anxiety, and depression before, immediately after, and 1 month after intervention in control group. CONCLUSIONS: The obtained results showed that Fordyce Happiness Training Program can reduce the stress, anxiety, and depression in patients treated with hemodialysis.

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BACKGROUND: Level of stress and its management affects the dimensions of psychosomatic patients' quality of life (QoL), which is an important psychological issue. The present study aimed to investigate the effect of cognitive behavioral stress management program on psychosomatic patients' QoL. In cognitive behavioral method, patients discover thought and behavioral mistakes and recover them. The criterion to evaluate the success of the present study was measurement of the patients' QoL and its notable improvement after intervention. MATERIALS AND METHODS: This is a before-and-after clinical trial with a control group. The study participants comprised 70 psychosomatic patients referred to subspecial psychiatry clinic in Isfahan who were selected through convenient sampling and allocated to the study and control groups. Quality of Life Questionnaire (SF36) was adopted to collect the data. The questionnaire was completed by the participants in three stages of before-and-after up to a month after intervention. Cognitive behavioral stress management program was administrated in study group for eight straight sessions, two month, and a month after intervention. Along with this, conventional medical treatments were conducted for both the groups. Data were analyzed by ANOVA. The significance level was P < 0.001. RESULTS: There was no significant difference in QoL mean scores between the two groups before intervention (44, 43.1), but mean scores of QoL were significantly higher in intervention G (55.7, 59.1), compared to control (39.8, 35.7), after intervention (P < 0.001) and one month after intervention (P < 0.001). CONCLUSIONS: Cognitive behavioral stress management, conducted in the present study, had a notable effect on QoL. Therefore, designing psychological interventions based on cognitive behavioral stress management is suggested as an efficient clinical intervention.

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BACKGROUND: Nurses face a great amount of stress that can threaten their health and reduce their motivation. Nurses' present working conditions lead to an increase in emotional pressures and depression. Conducting a study on this seems to be necessary, with regard to nurses' stressful working conditions, in order to take steps toward achieving different and non-meditational treatments to treat their stress, anxiety, and depression and, consequently, promote nurses' and patients' health. MATERIALS AND METHODS: This is a randomized clinical trial conducted on 52 nurses working in cancer patients wards, who were randomly assigned to intervention and control groups. Happiness educational program was administered for six sessions once a week in the study group and a communication training sessions with the patients in the control group, and DASS-42 questionnaire was completed before, immediately after, and 1 month after intervention by the subjects in both study and control groups. Data were analyzed by Chi-square, independent t-test, and analysis of variance (ANOVA) through SPSS 18. RESULTS: Mean scores of stress, anxiety, and depression showed no significant difference before and after intervention. Meanwhile, independent t-test showed that mean scores of stress, anxiety, and depression were significantly lower in the study group compared to the control group immediately after and 1 month after intervention (P < 0.05). CONCLUSIONS: Educational planning of happiness can reduce nurses' depression, anxiety, and stress in the cancer patients' wards. Psychiatric nurses can reduce depression, anxiety, and stress of nurses working in other hospitals also through application of this program.

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BACKGROUND: Marital satisfaction is one of the deepest and the most basic human pleasures and should be established within the family environment; if not, couples might suffer emotionally. Several factors are involved, including attachment and lifestyle. OBJECTIVES: The purpose of this study was to investigate the relationship between styles of attachment and lifestyle with marital satisfaction. MATERIALS AND METHODS: The population in this study included all of the Bandar Abbas oil refining (BAOR) company employees, for a total of 292 people (146 couples). They were selected by multistage random sampling. The enrich marital satisfaction scale was used to measure marital satisfaction, the Collins and read's revised adult attachment scale (RAAS) for adult attachment to determine attachment style, and the life style questionnaire (LSQ) for lifestyle. This research was a descriptive-correlative one, and for the data analysis, we used Pearson's correlation factor and multivariable regression. RESULTS: The results indicate that attachment style and lifestyle factors can predict marital satisfaction. There was also a meaningful negative relationship between insecure attachment avoidant and insecure attachment anxious-ambivalent styles and marital satisfaction. However, there was no meaningful relationship between secure attachment style and marital satisfaction. CONCLUSIONS: The results showed that the early relationship within the family environment supports a certain attachment style and the effects of the avoidant insecure and ambivalent insecure styles affect the interpersonal relations of the couples in adulthood. The effect of attachment styles on interpersonal relations is far greater than that of lifestyle.

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BACKGROUND: Older adults face several physical and psychological problems such as hearing loss, vision loss, and memory loss, which diminish the quality of their communication. Poor communication in turn affects their psychological wellbeing and induces substantial depression, anxiety, and stress. The family has an important role in the mental health of older adults. OBJECTIVES: This study aimed to investigate the effect of a family-oriented communication skills training program on depression, anxiety, and stress in older adults. PATIENTS AND METHODS: For this randomized controlled clinical trial, we enrolled 64 older adults from two healthcare centers affiliated to the Isfahan University of Medical Sciences. The subjects were randomly allocated to an experimental group (n = 32) and a control group (n = 32). In the experimental group, older adults along with their primary caregiver participated in six sessions of communication skill education. The control group participated in two training sessions on nutrition and exercise. All participants answered the DASS21 questionnaire three times-at the start of the study, at the end of the sixth week, and a month after the last educational session of the experimental group. Data were analyzed using chi-square, Fisher's exact and t tests and by repeated measures analysis of variance (ANOVA). RESULTS: In the experimental group, the mean depression score significantly reduced from 10.56 ± 3.34 before intervention to 7.46 ± 2.80 and 6.30 ± 2.75 after intervention and at follow-up, respectively; the mean anxiety score significantly reduced from 8.46 ± 1.88 before intervention to 5.83 ± 1.93 and 5.80 ± 2.12 after intervention and at follow-up, respectively; and the mean stress score significantly decreased from 11.40 ± 4.53 before intervention to 8.90 ± 3.81 and 8.43 ± 3.31 after intervention and at follow-up, respectively (P < 0.05 for all three domains). In contrast, the control group did not show any significant change in the mean depression, anxiety, and stress scores. CONCLUSIONS: Family-oriented education on communication skills could reduce depression, anxiety, and stress in the elderly. Therefore, such programs should be adopted as a non-pharmacological and cost-effective method for reducing depression, anxiety, and stress in older adults.

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BACKGROUND: Improving the patients' quality of life (QOL) after coronary artery bypass grafting (CABG) is one of the main concerns of the treatment team. Educational interventions may affect the aspects of QOL in various ways. The present study aimed to investigate the effect of education based on the main concepts of logotherapy approach on the CABG patients' quality of life. MATERIALS AND METHODS: In this quasi-experimental study, a convenient sample of 67 patients who had undergone CABG in Isfahan Chamran hospital were randomly allocated to two groups of experimental (n = 35) and control (n = 32). While the control group received routine care, the experiment group benefitted from logotherapy-based education program (six 90-min sessions, twice a week). SF-36 questionnaire was completed by both two groups (before and 1 month after intervention). Descriptive and inferential statistical tests (consisting of independent t-test) were employed to analyze data in SPSS version 13. RESULTS: The pre-test mean total score of SF-36 questionnaire and also the mean scores of its eight dimensions were not significantly different between the two groups. The post-test mean score change [Standard Error (SE)] in the intervention group was 24.95 (3) and in the control group was 9.27 (0.82). There were significant differences between the two groups (P < 0.001). Moreover, the mean scores of six dimensions of QOL (vitality, bodily pain, general health, emotional role, social functioning, and mental health) changed significantly in the intervention group. CONCLUSIONS: Our findings indicated that the intervention has improved the patients' QOL after CABG. Integration of such an intervention in these patients' rehabilitation programs is recommended.

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BACKGROUND: Hope is the most important factor in diabetic patients' life. The level of hope may be changing among these individuals as a result of chronic nature of diabetes and its complications. When the level of hope increases among these patients, they can resist against physical and psychological complications of diabetes more, accept the treatment better, enjoy life more, and adapt with their situations more efficiently. This study aimed to define the efficacy of hope therapy on hope among diabetic patients. MATERIALS AND METHODS: This was a quasi-experimental study conducted on 38 diabetic patients referring to Sedigheh Tahereh Research and Treatment Center affiliated to Isfahan University of Medical Sciences in Iran in 2012. The subjects were selected based on the goals and inclusion criteria of the study and then were randomly assigned to study and control groups. Herth Hope Index (HHI) was completed by both groups before, after, and 1 month after intervention. In the study group, 120-min sessions of hope therapy were held twice a week for 4 weeks. Descriptive and inferential statistical tests were adopted to analyze the data through SPSS version 12. RESULTS: Comparison of the results showed that hope therapy significantly increased hope in diabetic patients after intervention in the study group compared to control (P < 0.001). CONCLUSIONS: The results showed that hope therapy increased hope among diabetic patients. This method is suggested to be conducted for diabetic patients.

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BACKGROUND: Mood disorders related behaviors are imposed on family members and influence the family's mental atmosphere and level of quality of life. Therefore, the researchers decided to study the effect of group psycho-educational program on the quality of life in families of patients with mood disorders. MATERIALS AND METHODS: This is a two-group interventional study conducted on 32 members of families of the patients with mood disorders selected through random sampling. A group psycho-educational program was conducted in ten 90-min sessions (twice a week) for the study group. (World Health Organization's Quality of Life-BREF WHOQOL-BREF) questionnaire was adopted in the study and was filled before, immediately after, and 1 month after the intervention. RESULTS: Independent t-test showed a significant difference in the scores of quality of life in the domains of mental health, social communications, and environmental health, immediately after and 1 month after intervention in the study group compared to the control group. Repeated measure analysis of variance showed a significant increase in the mean scores of quality of life in the study group. CONCLUSIONS: The results showed that the impact of group psycho-educational program is observed in the prevention of reduction in quality of life and its promotion in the families of patients with mood disorders.

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BACKGROUND: Dental fear leads to lack of child cooperation. In general, without the patient's cooperation, success in remedy is impossible. This study aimed to evaluate parental view about the origins of the dental fear in children as well as their view about factors contributing to the prevention of child dental fear. METHODS: This was a cross sectional descriptive and analytical study which was carried out on 200 parents of children aged 6-12 years referred to dentistry center of Isfahan University of Medical Sciences. The level of dental fear in these children was screened using Children's Fear Survey Schedule - Dental Subscale (CFSS-DS). This questionnaire consisted of 15 questions and each question had a 5-point Likert-type Scale. Total scores ranged from 15 to 75. Based on the scores, children were divided into two groups: Group with low fear (score of 25 or less) and group with high fear (score of 37 or more). The parents were asked about the causes of their child's dental fear. RESULTS: There was an inverse significant correlation between the average score of fear and the age of the children. In the group with high fear, most of the parents (31%) had chosen previous dental experiences as the cause of their child's fear. There was no significant relationship between parental belief and their gender, the level of education, the level of their own dental fear and the child's age and fear score. CONCLUSIONS: According to the parent's standpoint, previous dental experience was a major factor in the development of childhood dental fear. Temperamental factors also played a major role in some of the fearful children. Most of the parents in group with high fear attributed their child's fear to the external factors and seemed they were unable to control and prevent it. Therefore, more attention should be given to the behavior and attitude of the parents as well as dentists in the future researches.

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BACKGROUND: Mental training considers sharing of mental health care information as the primary objective. The secondary objectives include facilitating dialogue about feelings such as isolation, sadness, labeling, loneliness and possible strategies for confronting with these feelings. Group therapy trainings have supportive functioning in accepting the environment so that the members are able to be part of the indigenous groups. However, no study has been ever done on the impact of this educational method on the communication problems of this group. This study aimed to determine the impact of group therapy training on the communication problems of Afghan immigrants. METHODS: This was a clinical trial study. Eighty-eight Afghan men were investigated. Sampling method was simple sampling method. Thereafter, the study subjects were divided randomly into two groups of test and control based on the inclusion criteria. Data collection tool was a self-made questionnaire about the social problems. For analyzing the data, software SPSS, independent t-test and paired t-test were used. RESULTS: Reviewing the data indicated lower mean score of the social problems after implementing the group therapy training in social communication compared with before implementing the group therapy training. Paired t-test showed a significant difference between mean scores of the social communication problems before and after the implementation of group therapy training. CONCLUSIONS: Given the effectiveness of the intervention, group therapy training on social problems in social communication of Afghan immigrants is recommended. This program should be part of continuous education and training of the Afghan immigrants.

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BACKGROUND: Family caregivers are an essential part of health care services for elderly with dementia disorders, because of providing care for such patients is a big burden for their families. This study aimed to assess the effects of family education program in reducing the burden of families of elderly with dementia. METHODS: This was a clinical trial, in which 50 family caregivers of the elderly patients with dementia who had referred to two referral centers for dementia in the city of Isfahan were selected with convenient sampling method and were randomized to experimental and control groups. The experimental group participated in a family education program but the control group did not. Data were collected by Zarit's caregiver burden scale completed by caregivers of both groups before, right after, and one month after family education program. Also, Mini-Mental Status Examination was conducted for elderly before the program. Finally, data were analyzed in SPSS software. RESULTS: Caregivers' burden was gradually increased in the controls, but decreased in the experimental group during the study. The means of caregivers' burden before, right after, and one month after family education program were 42, 35.44, and 33.56 in the experimental group, respectively, while they were 43.28, 46.8 and 50.64 in the control group, respectively. Also, there was a significant difference between caregivers' burden of the two groups immediately after intervention, but one month after intervention no significant difference was seen between the two groups. CONCLUSIONS: Since conducting this program could reduce caregivers' burden of families of elderly with dementia, developing such programs and evaluating them within research projects are recommended.

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BACKGROUND: Nursing is a dynamic and supportive job, with the main role of taking care of patients. Maintaining appropriate communication of the nurse with the patients is particularly known as the main core of care in mental health. However, in spite of the importance of providing communication, one of the main sources of stress in nurses of psychiatry wards is communication with the patients. Some important reasons for inappropriate relationship between the nurse and patient can be lack of necessary skills to communicate with patients because of insufficient training. Although training communication skills is an important part of the education of medical and paramedical students, in recent studies it has been demonstrated that the communication skills learned in theoretical courses would not necessarily be transferred to clinical settings, and proving training in clinical settings is a must. The present study was carried out to determine the effect of training communication skills using psychoeducation method on the stress level of nurses of psychiatry wards in 2010. METHODS: This is a quasi-experimental study. The participants were 45 nurses; 23 and 22 in the experiment and control groups, respectively, working in psychiatry wards of Noor and Farabi hospitals, Isfahan, Iran. The sampling was carried out by the census method, and then the participants were randomly assigned to the two groups of experiment and control, using random number table. The two groups filled out the demographic data form and also the questionnaire on nurses' occupational stress, designed by the researcher. The questionnaire was filled out three times; before, immediately after, and one month after the training. Training of communication skills was carried out using group psychoeducation method, in six sessions, each lasted for 1.5 hours. The training sessions of the experiment group were held in Farabi Hospital. RESULTS: The findings indicated that before the intervention, the members of the two groups had a high level of occupational stress. Immediately after the training, the stress level of the experiment group decreased significantly, and the decrease was sustained for the following one month. CONCLUSIONS: Training communicative skills using group psychoeducation method can decrease the occupational stress of psychiatry ward nurses.