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The Relationship between Depression Symptoms, Physical Self-Concept, and Self-Care in Diabetic Patients رابطه بین افسردگی، خودپنداره بدنی و خودمراقبتی در بیماران دیابتی 2 1 زمینه و هدف: دیابت یکی از شایع ترین بیماری ها در بین افراد جامعه است که شرایط زندگی به هم مرتبط است. خودپنداره بدنی و خومراقبتی  از جمله عوامل مرتبط با دیابت هستند. هدف: این مطالعه با هدف بررسی رابطه افسردگی، خودپنداره بدنی و خودمراقبتی در بیماران دیابتی انجام شد. روش کار: این مطالعه یک مطالعه مقطعی بود. نمونه شامل 90 بیمار مراجعه کننده به کلینیک دیابت مراکز بهداشتی درمانی مشهد بود که به روش نمونه گیری خوشه ای انتخاب شدند. ابزارهای پژوهش شامل پرسشنامه افسردگی بک، پرسشنامه خودمراقبتی دیابت و پرسشنامه خودپنداره بدنی مارش بود. شرکت کنندگان به روش نمونه گیری خوشه ای انتخاب شدند. روایی محتوایی و پایایی ابزار با ضریب آلفای کرونباخ محاسبه شد. داده ها با استفاده از نرم افزار SPSS نسخه 18 و آزمون های همبستگی پیرسون و تحلیل رگرسیون چند متغیره مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: میانگین سنی 378/11±82/51 سال بود. نتایج نشان داد که شیوع افسردگی 2/52 درصد بود. نتایج نشان داد که بین افسردگی و خودپنداره بدنی و افسردگی و خودمراقبتی  رابطه معکوس وجود دارد. همچنین بین خودپنداره بدنی و خودمراقبتی رابطه معنادار و مستقیم وجود داشت (p<0.05). نتیجه گیری: این مطالعه نشان داد که هر یک از دو متغیر خودپنداره بدنی و خودمراقبتی با افسردگی بیماران دیابتی ارتباط دارند.   2 Diabetes is one of the most common diseases in society and is closely related to living. Physical self-concept and self-care play significant roles in diabetes management. This study aimed to investigate the relationship between depressive symptoms, physical self-concept, and self-care in diabetic patients. This cross-sectional study was conducted in 2014. The sample consisted of 90 patients referred to diabetes clinics in Mashhad health centers, selected through cluster sampling. The research instruments included the Beck Depression Inventory, Diabetes Self-Care questionnaire, and Marsh physical self-description questionnaire. The validity of the instruments was assessed using face and content validity. The reliability of the instruments was calculated using Cronbach’s alpha coefficient. Data were analyzed using SPSS software (version 18), Pearson correlation tests and multivariate regression analysis. The mean age was 51.82±11.378. The results showed that the prevalence of depression was 52.2%. There was a significant negative correlation between depression and physical self-concept (r= -0.420, p≤0.001), and depression and self-care(r= -0.402, p≤0.001). Additionally, there was a significant direct relationship between physical self-concept and self-care (r= 0.365, p≤0.001). This study demonstrated that both physical self-concept and self-care were related to depression in diabetic patients.   1 9 2024/09/19 1403/6/29 2025/02/18 1403/11/30 مرتضی مدرس غروی Morteza Modares Gharavi Department of Psychiatry, School of Medicine, Ebnesina Hospital Mashhad University of Medical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran modaresm@mums.ac.ir عباسعلی عماری Abbasali Ammari Department of psychology, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran AmmariA1@mums.ac.ir فاطمه پورحاجی Fatemeh Pourhaji Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran pourhajif1@thums.ac.ir Diabetes Physical self-concept Self-care Depression دیابت خودپنداره بدنی خودمراقبتی افسردگی References##1.Shahwan M, Alhumaydhi F, Ashraf GM, Hasan PMZ, Shamsi A. Role of polyphenols in combating Type 2 Diabetes and insulin resistance. International Journal of Biological Macromolecules. 2022;206:567-79. doi: https://doi.org/10.1016/j.ijbiomac.2022.03.004.##2.American Diabetes Association Professional Practice C. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45:S17-S38. doi: 10.2337/dc22-s002.##3. Mirsaify Fard L, Moradi K. The role of life skills on mental disorders (anxiety and depression) in type 2 diabetic patients. Medical Journal of Mashhad University of Medical Sciences. 2018;61 1621-52.##4. Mazloomy SS, Mirzaei A, Mohammadi S. Study of Depression Prevalence in the Patients with Type II Diabetes Referring to Yazd Diabetes Research Centers in 2008. TOLOO-E-BEHDASHT. 2008;7:30-6.##5. Ghaedi Heydari F, Toghian Chaharsoghi N. The Effect of Simultaneous Incidence of Diabetes and Depression. Journal of Student Management Committee of Golestan University of Medical Sciences. 2012;14:1-8.##6. Safavi M, Samadi N, Mahmoodi M. The relationship between self-concept and quality of life in patients with type 2 diabetes. MEDICAL SCIENCES JOURNAL. 2013;23:148-53. http://tmuj.iautmu.ac.ir/article-1-682-fa.html.##7. Whitbourne SK, Halgin’s R. Abnormal psychology: ( Clinical perspectives on psychological disorders. 2, editor. Tehran: Ravan 2017. 416 p.##8. Varghese D, Scott JG, Bor W, Williams GM, Najman JM, McGrath JJ. The association between adult attachment style and delusional-like experiences in a community sample of women. The Journal of nervous and mental disease. 2013;201:525-9.##9. Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. Journal of diabetes and metabolic disorders. 2013;12:14-. doi: 10.1186/2251-6581-12-14.##10. Pourhaji F, Delshad MH, Ammari AA, Pourhaji R. Foot-Care Self-efficacy Beliefs, Physical Self-Concept and actual Foot-Care Behavior in People with Diabetes Mellitus. 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Validation and Evaluation of Online an Self-Regulation Questionnaire for Students Using Online Native Learning Management Systems Validation and Evaluation of Online an Self-Regulation Questionnaire for Students Using Online Native Learning Management Systems 2 1 Introduction: Self-regulated learning is an active and self-directed process in that the learner systematically directs, evaluates, and monitors his cognitive, environmental, motivational, and behavioral factors to achieve his learning goals by using special strategies. This research was conducted to validate and evaluate an online self-regulation questionnaire in students using online native learning management systems at Jahrom University of Medical Sciences. . Method: This is a cross-sectional descriptive study that was conducted among the students at Jahrom University of Medical Sciences in the academic year of 2019-2020.  The research tool was a short online self-administered learning questionnaire (OSLQ). 200 students were selected by consensus sampling in 3 fields.  Validity of the questionnaire including translation, content, convergent, and construct validity (exploratory and confirmatory factor analysis) was done. The stability and  Internal consistency of the questionnaire were evaluated by  Cronbach's alpha coefficient. Statistical analyses were performed with IBM SPSS 21 Results: In the exploratory analysis of the questionnaire, 5 areas were identified.  These 5 areas are goals, time management, self-evaluation, environment structure, and support. The high correlation coefficient of components in the learning self-regulation questionnaire was confirmed with the aligned questionnaire. Confirmatory factor analysis led to the confirmation of 5 domains and their items.  The reliability of the questionnaire had acceptable values ​​in checking its internal consistency. Conclusion: In this research, internal consistency, validity, and reliability of a short form of online learning self-regulation questionnaire were confirmed and a short and standardized tool was provided to measure self-regulation of learning in students. This questionnaire can be used in  Iranian research. 2 Self-regulated learning is an active and self-directed process in which the learner systematically directs, evaluates, and monitors their cognitive, environmental, motivational, and behavioral factors to achieve their learning goals by using specific strategies. This aimed conducted to validate and evaluate an online self-regulation questionnaire in students using online native learning management systems at Jahrom University of Medical Sciences. It was a cross-sectional descriptive study conducted among students at Jahrom University of Medical Sciences in the academic year of 2019-2020. The research tool used was a short online self-administered learning questionnaire (OSLQ), and 200 students were selected using consensus sampling in three fields. The validity of the questionnaire including translation, content, convergent, and construct validity (exploratory and confirmatory factor analysis), was assessed. The stability and internal consistency of the questionnaire were evaluated using Cronbach's alpha coefficients, and statistical analyses were performed with IBM SPSS 21. During the exploratory analysis of the questionnaire, five areas were identified: goals, time management, self-evaluation, environment structure, and support. The high correlation coefficient of components in the learning self-regulation questionnaire was confirmed with the aligned questionnaire. Confirmatory factor analysis confirmed the five domains and their items. The reliability of the questionnaire showed acceptable values for internal consistency. Overall, this research confirmed the internal consistency, validity, and reliability of a short form of an online learning self-regulation questionnaire, providing a standardized tool to measure self-regulation of learning in students. This questionnaire can be utilized in Iranian research. 10 22 2024/09/192024/10/9 1403/7/18 2025/02/182025/03/8 1403/12/18 Leili mosalanejad Leili mosalanejad Medical Education Department, Jahrom University of Medical Sciences, Jahrom, Iran mosallanejad@jums.ac.ir Mohsen Keshavarz Mohsen Keshavarz Department of E-Learning in Medical Sciences, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Sajad Ghanateyan Sajad Ghanateyan Jahrom University of Medical Sciences, Jahrom, Iran Sara maghsodzadeh Sara maghsodzadeh Research Center for Neuromodulation and pain, Shiraz, Iran self-regulation online learning Active learning reflection medical education learning self-regulation online self-regulation questionnaire active learning 1-Oprean C, Brumar CI, Canţer M, Bărbat BE. Sustainable development: e-teaching (now) for lifelong e-Learning. Procedia-Social and Behavioral Sciences. 2011 Jan 1; 30:988-92.##2-Al-Gahtani SS. 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Evaluation of epidemiology, clinical signs, and laboratory factors in pregnant patients with COVID-19 admitted to Valiasr Hospital in Birjand from 2020 to 2021 Evaluation of epidemiology, clinical signs, and laboratory factors in pregnant patients with COVID-19 admitted to Valiasr Hospital in Birjand from 2020 to 2021 2 1 Background: Pregnant women are one of the high-risk groups in the coronavirus crisis. Given the maternal physiologic and immune function changes during pregnancy, pregnant women may be at a higher risk of being infected with SARS-CoV-2 and developing more complicated clinical events. Methods: The cross-sectional study was conducted on all pregnant women with COVID-19 who were hospitalized in Valiasr Hospital in Birjand. People were included by census method and the sample size was estimated to be 205 people. The research tool included a researcher-made checklist including demographic characteristics, clinical symptoms, medical examinations, and paraclinical results. Results:. According to the results, the mean age of the mothers was 30.48 ± 5.32 years. The most common underlying diseases were hypothyroidism, gestational diabetes mellitus, hypertension and diabetes mellitus, respectively. Cough, myalgia, shortness of breath, fever, and nausea were the most common clinical symptoms observed in pregnant mothers with COVID-19. The results of inflammatory indices of ESR, and CRP were reported as 14.88 ± 30.52 mm/h, and 27.62 ± 34.30 mg/L, respectively. The mean length of hospitalization due to COVID-19 in pregnant mothers was 3.05 ± 3.17 days. The mortality of COVID-19 among pregnant mothers was only 1 person (0.5%). Conclusions: In conclusion, hypothyroidism was reported as the most common underlying disease in the studied pregnant women, which seems to be necessary to take measures to control this disease and prevent its adverse effects on the mother and the fetus.   2 Pregnant women are considered a high-risk group during the coronavirus crisis. Due to the physiological and immune system changes that occur during pregnancy, they may be more susceptible to SARS-CoV-2 infection and experience more severe clinical outcomes. A cross-sectional study was conducted on all pregnant women with COVID-19 who were hospitalized at Valiasr Hospital in Birjand. Participants were selected through a consus method, with a total sample size of 250 individuals. The research tool consisted of a researcherdeveloped checklist that includ demographic information, clinical symptoms, medical examinations, and paraclinical results. The average age of the mothers was 30.48 ± 5.32 years. The most common underlying conditions were hypothyroidism (12.7%), gestational diabetes mellitus (9.3%), hypertension (2.0%) and diabetes mellitus (1.5%). Common clinical symptoms observed in pregnant women with COVID-19 included cough (39.5%), myalgia (25.9%), shortness of breath (24.4%), fever (21.5%), and nausea (14.6%). Inflammatory markers such as ESR and CRP were reported as 14.88 ± 30.52 mm/h and 27.62 ± 34.30 mg/L, respectively. The average hospitalization duration for pregnant women with COVID-19 was 3.05 ± 3.17 days. The mortality rate among pregnant women with COVID-19 was only 1 person (0.5%). Hypothyroidism was identified as the most prevalent underlying condition among the pregnant women in this study. It is important to implement measures to manage this condition and prevent any negative impacts on both the mother and the fetus.   23 34 2024/09/192024/10/92024/11/28 1403/9/8 2025/02/182025/03/82025/02/3 1403/11/15 Fatemeh Birjandi Fatemeh Birjandi General Practitioner, Birjand University of Medical Sciences, Birjand, Iran Samaneh Bagherian Samaneh Bagherian Department of Operating Room, School of Paramedical, Geriatric Health Research Center, Birjand University of Medical Sciences, Birjand, Iran Masood Ziaee Masood Ziaee Department of Infectious Diseases, School of Medicine, Infectious Diseases Research Center, Birjand University of Medical Science, Birjand, Iran Najmeh Jahani Najmeh Jahani Department of Obstetrics and Gynecology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran njm.jahani@yahoo.com COVID-19 Pregnancy Epidemiology Clinical signs COVID-19 Pregnancy Epidemiology Clinical signs 1. Xu X-W, Wu X-X, Jiang X-G, Xu K-J, Ying L-J, Ma C-L, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. bmj. 2020;368.##2. Arab-Zozani M, Hassanipour S. Features and limitations of LitCovid hub for quick access to literature about COVID-19. Balkan medical journal. 2020;37(4):231.##3. Organization WH. Naming the coronavirus disease (COVID-19) and the virus that causes it. 2020.##4. Li J, Huang DQ, Zou B, Yang H, Hui WZ, Rui F, et al. Epidemiology of COVID‐19: A systematic review and meta‐analysis of clinical characteristics, risk factors, and outcomes. Journal of medical virology. 2021;93(3):1449-58.##5. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet. 2020;395(10229):1054-62.##6. Rahimi G, Habibzadeh S, Fathi A, Ghasemzadeh S, Shahbazzadegan S. Causes of maternal mortality and associated risk factors in Ardebil, Iran, from 2006 to 2016. Journal of health research in community. 2019;4(4):73-83.##7. Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Archives of pathology & laboratory medicine. 2020;144(7):799-805.##8. Díaz CA, Maestro ML, Pumarega MTM, Antón BF, Alonso CRP, editors. Primer caso de infección neonatal por SARS-CoV-2 en España. Anales De Pediatria (Barcelona, Spain: 2003); 2020: Elsevier.##9. Chan JF-W, Yuan S, Kok K-H, To KK-W, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The lancet. 2020;395(10223):514-23.##10. Vale AJM, Fernandes ACL, Guzen FP, Pinheiro FI, de Azevedo EP, Cobucci RN. Susceptibility to COVID-19 in pregnancy, labor, and postpartum period: immune system, vertical transmission, and breastfeeding. Frontiers in Global Women's Health. 2021;2:602572.##11. Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, Seferovic MD, Aski SK, Arian SE, et al. Maternal death due to COVID-19. American journal of obstetrics and gynecology. 2020;223(1):109. e1-. e16.##12. Wang C-L, Wu C-H, Wang C-Y, Wang C-H, Long C-Y. Impact of COVID-19 on Pregnancy. International journal of medical sciences. 2021;18(3):763.##13. Estrada-Chiroque LM, Orostegui-Arenas M, Burgos-Guanilo MDP, Amau-Chiroque JM. Clinical characteristics and maternal perinatal outcome in women with a confirmed diagnosis of COVID-19 in a hospital in Peru. Retrospective cohort study. Revista Colombiana de Obstetricia y Ginecología. 2022;73(1):28-38.##14. Khartabil T, Russcher H, van der Ven A, De Rijke Y. A summary of the diagnostic and prognostic value of hemocytometry markers in COVID-19 patients. 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Relationship between emotional intelligence and health literacy in patients with COVID-19 بررسی رابطه هوش هیجانی با سواد سلامت در بیماران مبتلا به بیماری کرونا ویروس 2 1 مقدمه: در طول همه گیری ، افراد با خطرات مختلف سلامتی روبرو می شوند یکی از عوامل موثر هوش هیجانی می­باشد. عوامل بسیاری برروی هوش هیجانی موثرند یکی از عوامل موثر سواد سلامت می­باشد. روش کار: این پژوهش یک مطالعه توصیفی تحلیلی همبستگی است برروی250 بیمار مبتلا به covid19 در بیمارستان خاتم الانبیا سلماس در سال 1400 که با روش نمونه گیری تصادفی طبقه ای انتخاب شده بودند، صورت گرفت. ابزار پژوهش پرسشنا مه جمعیت شناسی، سواد اطلاعاتی و هوش هیجا نی بود، پرسشنامه اول مربوط به مشخصات فردی بیماران ، پرسشنامه دوم جهت سنجش سواد سلامت عملکردی بزرگسالان(TOFHLA) استفاده شد، پایایی آن با آزمون آلفای کرونباخ بدست آمد. پرسشنامه هوش هیجانی برادبری – گریوز پایایی این پرسشنامه را با استفاده از روش آلفای کرونباخ سنجیده و ضریب پایایی آن را 83/0 بود. داده های جمع آوری شده به کمک نرم افزار و از آمار توصیفی شامل توزیع فراوانی نسبی و مطلق برای توصیف داده ها در افراد مورد مطالعه استفاده شد و جهت بررسی ارتباط بین متغیرها از آزمون کای اسکوئر و همبستگی اسپیرمن استفاده شده است. یافته ها:نتایج نشان داد ارتباط معنا داری بین متغیرهای جنس ، تاهل و تحصیلات با سواد سلامت نشان داد اما بین متغیر درآمد ، سن و سابقه بیماری COVID در خانواده ارتباط معناداری با سواد سلامت دیده نشد.  بین سواد سلامت و هوش هیجانی، همبستگی آماری معنی داری وجود دارد. آزمون همبستگی اسپیرمن  بین سطوح هوش هیجانی و سواد سلامت ارتباط معناداری وجود دارد. ضریب همبستگی اسپیرمن بیشترین همبستگی را در خودآگاهی و کمترین همبستگی را در مدیریت روابط نشان داد. نتیجه گیری: در این مطالعه بین هوش هیجانی وسواد سلامت رابطه وجود دارد. با توجه به اهمیت سوادسلامت برای کنترل بیشتر هوش هیجانی،برنامه هایی در جهت بهبود سوادسلامت و هوش هیجانی، صورت پذیرد. vvvvvمقدمه: در طول همه گیری ، افراد با خطرات مختلف سلامتی روبرو می شوند یکی از عوامل موثر هوش هیجانی می­باشد. عوامل بسیاری برروی هوش هیجانی موثرند یکی از عوامل موثر سواد سلامت می­باشد. روش کار: این پژوهش یک مطالعه توصیفی تحلیلی همبستگی است برروی250 بیمار مبتلا به covid19 در بیمارستان خاتم الانبیا سلماس در سال 1400 که با روش نمونه گیری تصادفی طبقه ای انتخاب شده بودند، صورت گرفت. ابزار پژوهش پرسشنا مه جمعیت شناسی، سواد اطلاعاتی و هوش هیجا نی بود، پرسشنامه اول مربوط به مشخصات فردی بیماران ، پرسشنامه دوم جهت سنجش سواد سلامت عملکردی بزرگسالان(TOFHLA) استفاده شد، پایایی آن با آزمون آلفای کرونباخ بدست آمد. پرسشنامه هوش هیجانی برادبری – گریوز پایایی این پرسشنامه را با استفاده از روش آلفای کرونباخ سنجیده و ضریب پایایی آن را 83/0 بود. داده های جمع آوری شده به کمک نرم افزار و از آمار توصیفی شامل توزیع فراوانی نسبی و مطلق برای توصیف داده ها در افراد مورد مطالعه استفاده شد و جهت بررسی ارتباط بین متغیرها از آزمون کای اسکوئر و همبستگی اسپیرمن استفاده شده است. یافته ها:نتایج نشان داد ارتباط معنا داری بین متغیرهای جنس ، تاهل و تحصیلات با سواد سلامت نشان داد اما بین متغیر درآمد ، سن و سابقه بیماری COVID در خانواده ارتباط معناداری با سواد سلامت دیده نشد.  بین سواد سلامت و هوش هیجانی، همبستگی آماری معنی داری وجود دارد. آزمون همبستگی اسپیرمن  بین سطوح هوش هیجانی و سواد سلامت ارتباط معناداری وجود دارد. ضریب همبستگی اسپیرمن بیشترین همبستگی را در خودآگاهی و کمترین همبستگی را در مدیریت روابط نشان داد. نتیجه گیری: در این مطالعه بین هوش هیجانی وسواد سلامت رابطه وجود دارد. با توجه به اهمیت سوادسلامت برای کنترل بیشتر هوش هیجانی،برنامه هایی در جهت بهبود سوادسلامت و هوش هیجانی، صورت پذیرد. vvمقدمه: در طول همه گیری ، افراد با خطرات مختلف سلامتی روبرو می شوند یکی از عوامل موثر هوش هیجانی می­باشد. عوامل بسیاری برروی هوش هیجانی موثرند یکی از عوامل موثر سواد سلامت می­باشد. روش کار: این پژوهش یک مطالعه توصیفی تحلیلی همبستگی است برروی250 بیمار مبتلا به covid19 در بیمارستان خاتم الانبیا سلماس در سال 1400 که با روش نمونه گیری تصادفی طبقه ای انتخاب شده بودند، صورت گرفت. ابزار پژوهش پرسشنا مه جمعیت شناسی، سواد اطلاعاتی و هوش هیجا نی بود، پرسشنامه اول مربوط به مشخصات فردی بیماران ، پرسشنامه دوم جهت سنجش سواد سلامت عملکردی بزرگسالان(TOFHLA) استفاده شد، پایایی آن با آزمون آلفای کرونباخ بدست آمد. پرسشنامه هوش هیجانی برادبری – گریوز پایایی این پرسشنامه را با استفاده از روش آلفای کرونباخ سنجیده و ضریب پایایی آن را 83/0 بود. داده های جمع آوری شده به کمک نرم افزار و از آمار توصیفی شامل توزیع فراوانی نسبی و مطلق برای توصیف داده ها در افراد مورد مطالعه استفاده شد و جهت بررسی ارتباط بین متغیرها از آزمون کای اسکوئر و همبستگی اسپیرمن استفاده شده است. یافته ها:نتایج نشان داد ارتباط معنا داری بین متغیرهای جنس ، تاهل و تحصیلات با سواد سلامت نشان داد اما بین متغیر درآمد ، سن و سابقه بیماری COVID در خانواده ارتباط معناداری با سواد سلامت دیده نشد.  بین سواد سلامت و هوش هیجانی، همبستگی آماری معنی داری وجود دارد. آزمون همبستگی اسپیرمن  بین سطوح هوش هیجانی و سواد سلامت ارتباط معناداری وجود دارد. ضریب همبستگی اسپیرمن بیشترین همبستگی را در خودآگاهی و کمترین همبستگی را در مدیریت روابط نشان داد. نتیجه گیری: در این مطالعه بین هوش هیجانی وسواد سلامت رابطه وجود دارد. با توجه به اهمیت سوادسلامت برای کنترل بیشتر هوش هیجانی،برنامه هایی در جهت بهبود سوادسلامت و هوش هیجانی، صورت پذیرد.   2 During the epidemic, individuals face various health risks that impact their personal lives and workplaces, and this is one of the key factors of emotional intelligence. Many factors influence emotional intelligence with health literacy being a significant one. This study aims to explore the relationship between two factors that affect the recovery process of patients with coronavirus. This descriptive-analytical correlational study involved 250 COVID-19 patients at Imam Khomeini Hospital of Urmia in 2020 selected through stratified random sampling. The research utilized a demographic questionnaire, health literacy, and emotional intelligence assessments. Data analysis was conducted using SPSS software, with descriptive statistics such as relative and absolute frequency distributions employed to describe the data. The chi-square test and Spearman correlation were used to assess the relationship between variables. The findings indicated a significant relationship between gender, material status, and education level with health literacy (p-value < 0.05), while no significant relationship was found between income, age, or family history of COVID-19 and health literacy(p-value > 0.05). There was a statistically significant correlation between health literacy and emotional intelligence (p-value < 0.05), as evidenced by the Spearman correlation test revealing a significant relationship between levels of emotional intelligence and health literacy (p-value < 0.05). This study, highlights the connection between emotional intelligence and health literacy. Given the importance of health in enhancing emotional intelligence, interventions to enhance both health literacy and emotional intelligence should be implemented. 35 40 2024/09/192024/10/92024/11/282024/11/29 1403/9/9 2025/02/182025/03/82025/02/32025/01/19 1403/10/30 Leila Heidarzadeh Leila Heidarzadeh School of Nursing and Midwifery of Urmia, Urmia, Iran leilaheydare63@yahoo.com Monir Rezaee Monir Rezaee Department of Midwifery, Urmia Branch, Islamic Azad University, Urmia, Iran monir.rezaee@yahoo.co.uk Nasrin Heidarzadeh Nasrin Heidarzadeh Department of Midwifery, Urmia Branch, Islamic Azad University, Urmia, Iran nasrin.hy9597@gmail.com Leyla Alilu Leyla Alilu School of Nursing and Midwifery of Urmia, Urmia, Iran emotional intelligence health literacy COVID-19 سواد سلامت. هوش هیجانی. بیماری کرونا 1. Li G, Fan Y, Lai Y, Han T, Li Z, Zhou P, et al. Coronavirus infections and immune responses. Journal of medical virology. 2020;92(4):424-32.##2. Update C. 120,126,411 cases and 2,661,042 deaths from COVID-19 virus pandemic—worldometer nd https://www. worldometers. info/coronavirus. Accessed Mar. 2021;14.##3. Sharp G, Bourke L, Rickard MJ. Review of emotional intelligence in health care: an introduction to emotional intelligence for surgeons. ANZ journal of surgery. 2020;90(4):433-40.##4. Fteiha M, Awwad N. Emotional intelligence and its relationship with stress coping style. Health psychology open. 2020;7(2):2055102920970416.##5. Safarian Hamedani S, Zameni F, Moghaddam Z, Behnampour N, Sayed Ghasemi NS, Torbatinezhad F. Relationship between Information Literacy with Emotional Intelligence students of Golestan University of Medical Sciences. Health Information Management. 2014;11(4):443-53.##6. Sajjadi H, Hosseinpour N, Sharifian Sani M, Mahmoodi Z. Association between health literacy and life style in married rural women in Izeh, Iran. Journal of health. 2016;7(4):479-89.##7. Ganji H, Mirhashemi M, Sabet M. Bradberry-Greaves’ emotional intelligence test: preliminary norming-process. J Thought Behav. 2006;1(2):23-35.##8. Zysberg L, Zisberg A. Days of worry: Emotional intelligence and social support mediate worry in the COVID-19 pandemic. Journal of Health Psychology. 2022;27(2):268-77.##9. Soto-Rubio A, Giménez-Espert MDC, Prado-Gascó V. Effect of emotional intelligence and psychosocial risks on burnout, job satisfaction, and nurses’ health during the covid-19 pandemic. International journal of environmental research and public health. 2020;17(21):7998.##10. Alonazi WB. The impact of emotional intelligence on job performance during COVID-19 crisis: A cross-sectional analysis. Psychology Research and Behavior Management. 2020:749-57.##11. Miller TA. Health literacy and adherence to medical treatment in chronic and acute illness: a meta-analysis. Patient education and counseling. 2016;99(7):1079-86.##12. Okan O, Bollweg TM, Berens E-M, Hurrelmann K, Bauer U, Schaeffer D. Coronavirus-related health literacy: a cross-sectional study in adults during the COVID-19 infodemic in Germany. International Journal of Environmental Research and public health. 2020;17(15):5503.##13. Sentell T, Vamos S, Okan O. Interdisciplinary perspectives on health literacy research around the world: more important than ever in a time of COVID-19. MDPI; 2020. p. 3010.## ##

Comparison of serologic and sonographic findings in patients with HBV/HDV and HBV/HCV Infections مقایسه یافته‌های سرولوژیک و سونوگرافیک در بیماران مبتلا به عفونت HBV/HDV و HBV/HCV 2 1 زمینه: ویروس هپاتیت B (HBV) و ویروس هپاتیت C (HCV) چالش‌های قابل توجهی برای سلامت عمومی در سطح جهانی به شمار می‌روند و از عوامل اصلی ایجاد هپاتیت مزمن، سیروز و کارسینومای هپاتوسلولار (HCC) هستند. عفونت‌های همزمان HBV با HCV یا HDV می‌توانند یافته‌های سونوگرافیک و سرولوژیک خاصی را ارائه دهند که برای تشخیص ارزشمند هستند. اهداف: این مطالعه به مقایسه یافته‌های سونوگرافیک و سرولوژیک در بیماران مبتلا به عفونت‌های HBV/HCV و HBV/HDV می‌پردازد. روش‌ها: این مطالعه شامل 300 بیمار مبتلا به هپاتیت B مزمن در بیرجند، بود که تحت آزمایش‌های خون و سونوگرافی کبد قرار گرفتند و با استفاده از روش‌های آماری مانند K-score، آزمون دقیق فیشر، ANOVA و آزمون کرسکال-والیس تحلیل شدند. نتایج: بررسی 300 بیمار نشان داد که بیماران مبتلا به عفونت همزمان HBV/HDV به طور معناداری سطوح بالاتری از AST، ALT، بیلی روبین توتال، بیلی روبین دایرکت و  پروترومبین تایم، نسبت به بیماران مبتلا به عفونت HBV/HCV داشتند که نشان‌دهنده آسیب شدیدتر کبدی در گروه اول است (P = 0.01). همچنین مطالعه هیچ تفاوت معناداری در سطوح آلفا-فتوپروتئین بین بیماران HBV/HDV و HBV/HCV پیدا نکرد و تفاوت معناداری در شرایط کبدی، فیبروز، آسیت یا سیروز بین دو گروه مشاهده نشد. نتیجه گیری نهایی: به طور کلی، سطوح آنزیم‌های کبدی و پروترومبین تایم در بیماران با عفونت‌های همزمان HBV و HDV نسبت به بیماران با عفونت‌های همزمان HBV و HCV به طور معناداری افزایش یافته بود. علاوه بر این، گروه اول یافته‌های سونوگرافیک معناداری را نشان دادند که نشان‌دهنده پیشرفت بیماری و پیش‌آگهی بدتر است. 2 Hepatitis B virus (HBV) and hepatitis C virus (HCV) pose significant public health challenges globally, being primary contributors to chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). Co-infections of HBV with HCV or HDV can present distinct sonographic and serologic findings that are valuable for diagnosis. This study compares sonographic and serologic findings in patients with HBV/HCV and HBV/HDV infections. The study involved 300 chronic hepatitis B patients, aged 13, in Birjand, Iran, who underwent blood tests and liver sonography. Statistical methods like Chi-square, Fisher's exact test, ANOVA, and Kruskal-Wallis tests were used for analysis. A study involving 300 patients found that those with HBV/HDV co-infection exhibited significantly higher average levels of AST, ALT, total bilirubin, direct bilirubin, and prothrombin time compared to patients with HBV/HCV co-infection. This indicates more severe liver impairment in the HBV/HDV group (P = 0.01). The study found no significant difference in alpha-fetoprotein levels between HBV/HDV and HBV/HCV patients, and no significant differences in liver conditions, fibrosis, ascites, or cirrhosis among the two groups. Overall, liver enzyme levels and prothrombin time were significantly elevated in patients with dual HBV and HDV infections compared to those with dual HBV and HCV infections. Furthermore, the former group exhibited significant sonographic findings indicative of disease progression and a poorer prognosis 41 46 2024/09/192024/10/92024/11/282024/11/292024/12/1 1403/9/11 2025/02/182025/03/82025/02/32025/01/192025/01/22 1403/11/3 Azadeh Ebrahimzadeh Azadeh Ebrahimzadeh Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran Effat Alemzadeh Effat Alemzadeh Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran Mahyar Mohammadifard Mahyar Mohammadifard Department of Radiology, Division of Neuroradiology, Imam Reza Hospital of Birjand, Birjand, Iran Parvin Askari Parvin Askari Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran parvin.askari.90@gmail.com Hepatitis B Hepatitis D Hepatitis C Liver Enzymes Serologic changes Sonographic findings. هپاتیت B هپاتیت D هپاتیت C آنزیم های کبدی تغییرات سرولوژیک یافته های سونوگرافی. 1. Tassopoulos N, Purcell R, Theodoropoulos G, Sjogren MH, Engle R. Serological markers of hepatitis B virus and hepatitis D virus infections in Greek adults with primary hepatocellular carcinoma. Infection. 1989;17(1):17-9.##2. Bakhshipour A, Mashhadi M, Mohammadi M, Nezam SK. Seroprevalence and risk factors of hepatitis delta virus in chronic hepatitis B virus infection in Zahedan. Acta Medica Iranica. 2013:260-4.##3. Ayele AG, Gebre-Selassie S. Prevalence and risk factors of hepatitis B and hepatitis C virus infections among patients with chronic liver diseases in public hospitals in Addis Ababa, Ethiopia. International Scholarly Research Notices. 2013;2013.##4. Kew MC. Hepatitis B virus/human immunodeficiency virus co-infection and its hepatocarcinogenic potential in Sub-Saharan Black Africans. Hepatitis monthly. 2012;12(10 HCC).##5. Saravanan S, Velu V, Nandakumar S, Madhavan V, Shanmugasundaram U, Murugavel KG, et al. Hepatitis B virus and hepatitis C virus dual infection among patients with chronic liver disease. Journal of Microbiology, Immunology, and Infection. 2009;42(2):122-8.##6. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison's principles of internal medicine 18E Vol 2 EB: McGraw Hill Professional; 2012.##7. Gish RG, Yi DH, Kane S, Clark M, Mangahas M, Baqai S, et al. Coinfection with hepatitis B and D: Epidemiology, prevalence and disease in patients in N orthern C alifornia. Journal of gastroenterology and hepatology. 2013;28(9):1521-5.##8. Tahaei SME, Mohebbi SR, Azimzadeh P, Behelgardi A, Sanati A, Mohammadi P, et al. Prevalence of hepatitis D virus in hepatitis B virus infected patients referred to Taleghani hospital, Tehran, Iran. Gastroenterology and hepatology from bed to bench. 2014;7(3):144.##9. Mendy M, Welzel T, Lesi O, Hainaut P, Hall A, Kuniholm M, et al. Hepatitis B viral load and risk for liver cirrhosis and hepatocellular carcinoma in The Gambia, West Africa. Journal of viral hepatitis. 2010;17(2):115-22.##10. Baig S, Siddiqui AA, Ahmed WU, Qureshi H, Arif A. Frequency of hepatitis C and D super infection in patients with hepatitis B related complex liver disorders. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 2009;19(11):699-703.##11. Xiao G, Yang J, Yan L. Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis‐4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: a systemic review and meta‐analysis. Hepatology. 2015;61(1):292-302.##12. Tsochatzis E, Papatheodoridis G, Manesis E, Chrysanthos N, Kafiri G, Archimandritis A. Hepatic steatosis in chronic hepatitis B develops due to host metabolic factors: a comparative approach with genotype 1 chronic hepatitis C. Digestive and liver disease. 2007;39(10):936-42.##13. Foupouapouognigni Y, Noah DN, Sartre MT, Njouom R. High prevalence and predominance of hepatitis delta virus genotype 1 infection in Cameroon. Journal of clinical microbiology. 2011;49(3):1162-4.##14. Gordon A, McLean CA, Pedersen JS, Bailey MJ, Roberts SK. Hepatic steatosis in chronic hepatitis B and C: predictors, distribution and effect on fibrosis. Journal of hepatology. 2005;43(1):38-44.## ##

COVID-19 Vaccination Promotion Program Based on COM-B Model: an App-Based Educational Program in Northern Iraq برنامه ترویج واکسیناسیون کووید-19 بر اساس مدل COM-B: برنامه آموزشی مبتنی بر اپلیکیشن در شمال عراق 2 2 Vaccines have effectively reduced the spread of the COVID-19 pandemic. This study aimed to evaluate a program promoting COVID-19 vaccination for Kurdish individuals in Said Sadiq, northern Iraq, using the COM-B model. A total of 150 adults over 18 years old in the city of Said Sadiq participated as the intervention and control group. This was a quasi-experimental study to implement a behavior modification-based intervention to promote of COVID-19 vaccine uptake. The authors developed an organized and innovative educational application program to improve determinants related to COVID-19 vaccine uptake among adults over 18 years old in Said Sadiq. The mobile application consisted of eight educational lessons. Independent t-tests and paired sample t-tests were employed to determine the comparability of the intervention compared to the control group. The effect size was estimated as "small" for social opportunity, “medium" for physical capability, psychological capability, physical opportunity, and reflective motivation, and “large" for automatic motivation. Our findings showed a significant increase in the rate of COVID-19 vaccine uptake among participants in the intervention group compared to the control group (P= 0.033) after the program implementation. This study utilized the COM-B model to provide useful guidance for understanding the adult population in Iraqi Kurdistan to increase COVID-19 vaccine uptake. The study demonstrates the ability to use the COM-B model in the development of an m-health intervention to promote COVID-19 vaccine uptake in northern Iraq. Although our intervention was brief, it showed promising findings. Our findings have valuable implications as they demonstrate that a short, inexpensive, and convenient intervention can effectively educate and empower people during the COVID-19 pandemic. 47 58 2024/09/192024/10/92024/11/282024/11/292024/12/12024/12/1 1403/9/11 2025/02/182025/03/82025/02/32025/01/192025/01/222025/02/19 1403/12/1 Mehdi Mirzaei-Alavijeh Mehdi Mirzaei-Alavijeh Social Development and Health Promotion Research Center, Health Policy and Promotion Research Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran mehdimirzaiea@yahoo.com Ismail Ali Faraj Ismail Ali Faraj Department of Health Education and Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. farajismail253@gmail.com Farzad Jalilian Farzad Jalilian Clinical Research Development Center, Motazedi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran f_jalilian@yahoo.com COVID-19 Vaccine Behavior Change COM-B model Education m-health 1. Beladiya J, Kumar A, Vasava Y, Parmar K, Patel D, Patel S, Dholakia S, Sheth D, Boddu SH, Patel C. Safety and efficacy of COVID‐19 vaccines: A systematic review and meta‐analysis of controlled and randomized clinical trials. Reviews in Medical Virology. 2024; 34(1):e2507.##2. Novaes TE, Lara DM, da Silva SG. Severe acute respiratory syndrome (SARS) in the context of the COVID-19 pandemic among indigenous peoples of Brazil: epidemiology and risk factors associated with death. Journal of Racial and Ethnic Health Disparities. 2024; 11(4):1908-17.##3. Diniz LM, Dias CS, Oliveira MC, Simões e Silva AC, Colosimo EA, Mak RH, Pinhati CC, Galante SC, Yan IO, Martelli-Júnior H, Oliveira EA. Outcomes of SARS-CoV-2 and seasonal viruses among 2 million adults hospitalized for severe acute respiratory infection during the COVID-19 pandemic in Brazil. The Journal of Infectious Diseases. 2024: jiae295##4. Agampodi S, Mogeni OD, Chandler R, Pansuriya M, Kim JH, Excler JL. Global pandemic preparedness: learning from the COVID-19 vaccine development and distribution. Expert Review of Vaccines. 2024; 23(1):761-72.##5. Martin R, Maleche A, Gay J, Fatima H. Lessons learnt from COVID-19 to reduce mortality and morbidity in the Global South: addressing global vaccine equity for future pandemics. BMJ Global Health. 2024; 9(1):e013680.##6. Ali S, Ashraf J, Ghufran M, Xiaobao P, Zhiying L. Innovation sharing a remedial measure: the case of Covid-19 pandemic. European Journal of Innovation Management. 2024; 27(5):1624-42.##7. Abate BB, Tilahun BD, Yayeh BM. Global COVID-19 vaccine acceptance level and its determinants: an umbrella review. BMC Public Health. 2024; 24(1):5.##8. Mwiinde AM, Kaonga P, Jacobs C, Zulu JM, Fwemba I. Determinants of COVID-19 vaccine acceptance and hesitancy among adolescents and youths aged 10-35 years in sub-Saharan African countries: A systematic review and meta-analysis. PloS one. 2024; 19(10):e0310827.##9. Al-Abdulla O, Alaref M, Kallström A, Kauhanen J. Individual and social determinants of COVID-19 vaccine hesitancy and uptake in Northwest Syria. BMC Health Services Research. 2024; 24(1):265.##10. Al-Mohaithef M, Padhi BK. Determinants of COVID-19 vaccine acceptance in Saudi Arabia: a web-based national survey. Journal of multidisciplinary healthcare. 2020; 13:1657##11. Casselman-Hontalas A, Adams-Santos D, Watkins-Hayes C. Discourses of Distrust: How Lack of Trust in the US Health-Care System Shaped COVID-19 Vaccine Hesitancy. RSF: The Russell Sage Foundation Journal of the Social Sciences. 2024; 10(4):154-72.##12. Pelletier C, Gagnon D, Dubé E. “It’s not that I don’t trust vaccines, I just don’t think I need them”: Perspectives on COVID-19 vaccination. Plos one. 2024; 19(2):e0293643.##13. Cenat JM, Noorishad PG, Moshirian Farahi SM, Darius WP, Mesbahi El Aouame A, Onesi O, Broussard C, Furyk SE, Yaya S, Caulley L, Chomienne MH. Prevalence and factors related to COVID‐19 vaccine hesitancy and unwillingness in Canada: A systematic review and meta‐analysis. Journal of Medical Virology. 2023; 95(1):e28156.##14. Pandher R, Bilszta JL. Novel COVID-19 vaccine hesitancy and acceptance, and associated factors, amongst medical students: a scoping review. Medical education online. 2023; 28(1):2175620.##15. Dinga JN, Kabakama S, Njimoh DL, Chia JE, Morhason-Bello I, Lumu I. Quantitative synthesis of factors associated with COVID-19 vaccine acceptance and vaccine hesitancy in 185 countries. Vaccines. 2023; 12(1):34.##16. Yin F, Wu Z, Xia X, Ji M, Wang Y, Hu Z. Unfolding the Determinants of COVID-19 Vaccine Acceptance in China. Journal of medical Internet research. 2021; 23(1):e26089.##17. Harapan H, Wagner AL, Yufika A, Winardi W, Anwar S, Gan AK, Setiawan AM, Rajamoorthy Y, Sofyan H, Vo TQ, Hadisoemarto PF. Willingness-to-pay for a COVID-19 vaccine and its associated determinants in Indonesia. Human vaccines & immunotherapeutics. 2020; 16(12):3074-80.##18. Howard MC, Davis MM. The mediating role of vaccine hesitancy in the relations of COVID-19 conspiracy beliefs and vaccination outcomes: Which dimensions matter?. Journal of Health Psychology. 2023; 28(3):241-50.##19. Evans WD, Bingenheimer JB, Long M, Ndiaye K, Donati D, Rao NM, Akaba S, Hoglin B. Development and Evaluation of an Index to Measure the Ability to Get Vaccinated for COVID-19. Vaccines. 2023; 11(2):342.##20. Anagaw TF, Tiruneh MG, Fenta ET. Application of behavioral change theory and models on COVID-19 preventive behaviors, worldwide: A systematic review. SAGE Open Medicine. 2023; 11:20503121231159750.##21. Jama A, Appelqvist E, Kulane A, Karregård S, Rubin J, Nejat S, et al. Design and implementation of tailored intervention to increase vaccine acceptance in a Somali community in Stockholm, Sweden-based on the Tailoring Immunization Programmes approach. Public Health in Practice. 2022; 4:100305.##22. Michie S, Van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implementation Science. 2011; 6(1):1-2.##23. Vallis M, Bacon S, Corace K, Joyal-Desmarais K, Sheinfeld Gorin S, Paduano S, Presseau J, Rash J, Mengistu Yohannes A, Lavoie K. Ending the pandemic: How behavioural science can help optimize global COVID-19 vaccine uptake. Vaccines. 2021; 10(1):7.##24. Bregenzer A, Wagner-Hartl V, Jiménez P. Who uses apps in health promotion? A target group analysis of leaders. Health Informatics Journal. 2019; 25(3):1038-52.##25. Mirzaei-Alavijeh M, Ali Faraj I, Keshavarzi A, Jalilian F. Use of the Capability, Opportunity, and Motivation Behaviour Model to Predict COVID-19 Vaccine Uptake in the Kurdistan Region, Iraq. Avicenna Journal of Neuro Psycho Physiology. 2024; 11(1):1-6.##26. Kok G, Schaalma H, Ruiter RA, Van Empelen P, Brug J. 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Improving The Quality of Life of Caregivers of Patients With Multiple Sclerosis بهبود کیفیت زندگی مراقبان بیماران مبتلا به مولتیپل اسکلروزیس 2 1 زمینه:مراقبین بیماران مبتلا به مولتیپل اسکلروزیس (MS) به دلیل پیامدهای جسمی و استرس زای بیماران، کیفیت زندگی نامناسبی دارند. الگوی خودمراقبتی اورم از جمله الگوهایی است که رویکرد خاصی به انسان و مسائل مراقبت سلامت داشته استالگوی خودمراقبتی اورم از جمله الگوهایی است که رویکرد خاصی به انسان و مسائل مراقبت سلامت داشته است بنابراین مطالعه حاضربا هدف بهبود کیفیت زندگی مراقبان بیماران مبتلا به ام اس انجام گردید. اهداف: هدف از مطالعه حاضر تعیین میزان ارتقای کیفیت زندگی مراقبین بیماران مبتلا به مولتیپل اسکلروزیس بود. روش: مطالعه نیمه تجربی حاضر با طرح پیش آزمون، پس آزمون و با گروه کنترل روی 76 نفر از اعضای اصلی خانواده مراقبت کننده از بیماران دچار مولتیپل اسکلروزیس در بندرعباس صورت گرفت. واحدها به روش تصادفی انتخاب و به دو گروه کنترل و مداخله تقسیم شدند. گروه مداخله مطابق با برنامه آموزشی اورم در بیماران ام­اس در طول 7 جلسه 40 دقیقه­ایی تحت آموزش قرار گرفتند. به منظور بررسی کیفیت­زندگی مراقبت­کنندگان از پرسشنامه SF-36 استفاده و پرسشنامه قبل و بعد از مداخله در هر دو گروه تکمیل شد. نتایج پژوهش با نسخه 26 نرم­افزار SPSS و آزمون­های آمار توصیفی و تحلیلی مورد تجزیه و تحلیل قرار گرفت. یافته ها: یافته ها نشان داد که میانگین سنی مراقبین در گروه مداخله 11.34±39.74 و در گروه کنترل 11.32±38.94 سال بود. میانگین نمره کلی کیفیت زندگی در گروه مداخله و کنترل قبل از مطالعه به ترتیب8.47±52.31 و 14.01±57.04 و بعد از مداخله 12.8±61.10 و 10.20±55.23 بود که در گروه مداخله از نظر آماری معنی دار بود (05/0<p). نتیجه گیری: پرستاران می توانند به مراقبین کمک کنند تا توانایی های خود را ارتقا دهند و با پیامدهای این بیماری های مزمن سازگار شوند. برنامه های آموزشی می توانند نقش مهمی در افزایش کیفیت زندگی مراقبین بیماران مبتلا به مولتیپل اسکلروزیس در طول دوره طولانی مراقبت داشته باشند.   </p). 2 Caregivers of patients with Multiple Sclerosis (MS) often experience a decreased quality of life due to the physical and emotional strain of caring for these patients. Orem’s self-care model offers a unique approach to addressing the needs of both patients and caregivers in the health care setting. This study aimed to assess the impact of an educational program based on Orem’s self-care model on improving the quality of life of caregivers of MS patients. This quasi-experimental study included 76 primary family caregivers of MS patients in Bandar Abbas, who were randomly assigned to either a control or intervention group. The intervention group participated in a 7- sessions educational program based on Orem’s self-care model, each lasting 40 minutes. The quality of life of caregivers was assessed using the SF-36 questionnaire before and after the intervention in both groups. Data analysis was conducted using SPSS-26 software, including statistical tests such as chi- square, t-test and covariance analysis, with a significance level set at less than 0.05. The mean age of caregivers in the intervention group was 39.74±11.34 and 38.94±11.32 in the control group. The overall mean quality of life score in the intervention group increased from 52.31±8.47 before the study to 61.10±12.8 after the intervention, while in the control group it changed from 57.04±14.01 to 55.23±10.20. These differences were statistically significant (P<0.05) in the intervention group. Nurses can play a vital role in supporting caregivers of MS patients by enhancing their abilities to cope with the challenges of this chronic disease. Educational programs based on models like Orem’s self-care model can significantly improve the quality of life of caregivers of MS patients overtime. 59 68 2024/09/192024/10/92024/11/282024/11/292024/12/12024/12/12024/12/3 1403/9/13 2025/02/182025/03/82025/02/32025/01/192025/01/222025/02/192025/02/3 1403/11/15 Nadieh Dehghan Nadieh Dehghan Student Research Committee, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Elham Imani Elham Imani Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran eimani@hums.ac.ir Ahmad Agha Neghi Ahmad Agha Neghi Neurology and Internal Medicine Department, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Saeed Hosseini Tashnizi Saeed Hosseini Tashnizi Biostatistics Department, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Caregiver Orem’s self-care model Multiple sclerosis مراقب الگوی خودمراقبتی اورم مولتیپل اسکلروزیس 1. Mahdizadeh A, Lokzadeh S, Riyahi A, Hosseini SA, Jalili N. The Investigation of Factors Affecting the Gait of the Patients Suffering From Multiple Sclerosis. Archives of Rehabilitation 2019;20(1):64-73.[Persian] doi: 10.32598/rj.20.1.64##2. Khodaveisi M, Rahmati M, Gholamhosein. The Effect of Orem’s Self Care Model on Physical Quality Of Life in Patients with Multiple Sclerosis. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2018;3(4):24-35. [Persian] doi: 10.29252/sjnmp.3.4.24##3. Özmen S, Yurttaş A. Determination of care burden of caregivers of patients with multiple sclerosis in Turkey. Behavioural neurology. 2018:7205046. doi: 10.1155/2018/7205046. ##4. Dahmardeh H, Vagharseyyedin SA. Effect of self-care educational program based on Orem’s Theory on hope in patients with Multiple Sclerosis. Medical - Surgical Nursing Journal. 2015;4(2):57-63. [Persian]##5. Dahmardeh H, Vagharseyyedin SA, Rahimi H, Amirifard H, Akbari O, Sharifzadeh G. Effect of a program based on the orem self-care model on sleep quality of patients with multiple sclerosis. Jundishapur Journal of Chronic Disease Care. 2016;5(3):736-764. [Persian] doi: 10.17795/jjcdc-36764##6. Masoudi R, Mohammadi E, Ahmadi F, Hasanpour-Dehkordi A. The effect of self-care program education based on Orem’s theory on mental aspect of quality of life in multiple sclerosis patients. Iran Journal of Nursing. 2009;22(60):53-64. [Persian]##7. Seyedoshohadaee M, Bozorgi Matin M, Haghani H. Association of Death Anxiety and Quality of Life in the Caregivers of Patients with Multiple Sclerosis. Iran Journal of Nursing. 2019;32(120):1-12. [Persian] doi: 10.29252/ijn.32.120.1##8. Buchanan R, Huang C. Health-related quality of life among informal caregivers assisting people with multiple sclerosis. Disability and rehabilitation. 2011;33(2):113-121. doi: 10.3109/09638288.2010.486467##9. Buhse M, Della Ratta C, Galiczewski J, Eckardt P. Caregivers of older persons with multiple sclerosis: determinants of health-related quality of life. Journal of Neuroscience Nursing. 2015;47(2):2-12.doi: 10.1097/jnn.0000000000000117##10. Buhse M. Assessment of caregiver burden in families of persons with multiple sclerosis. Journal of Neuroscience Nursing. 2008;40(1):25-31. doi: 10.1097/01376517-200802000-00005##11. Jahanbakhsian N. A study on the effectiveness of caregivers’ group supportive-training intervention on the mental health of MS patients. Razi Journal of Medical Sciences. 2016;23(144):19-29. [Persian]##12. Hinkle J.L , Cheever K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing 2021, 15th edition. Philadelphia, Lippincott Williams & Wilkins Co, 2352 pages.##13. Madmoli Y. Does ORM's Self-Care Model Affect the Physical Health of People with Major β Thalassemia? 2019;5(3):29-42. [Persian]##14. Mohammadi S, Roshanzadeh M. The Effect of Educatonal Interventon Based on Orem Self-Care Model on Family Caregiver's Burden of Patents with Spinal Cord Injuries.2016;17(1):54-63. [Persian] doi: 10.20286/jrehab-170152##15. Rivera-Navarro J, Benito-León J, Oreja-Guevara C, Pardo J, Bowakim Dib W, Orts E, et al. Burden and health-related quality of life of Spanish caregivers of persons with multiple sclerosis. Multiple Sclerosis Journal. 2009; 15(11): 1347-1355. doi:10.1177/1352458509345917##16. McMillan SC, Small BJ, Weitzner M, Schonwetter R, Tittle M, Moody L, et al. Impact of coping skills intervention with family caregivers of hospice patients with cancer: a randomized clinical trial. Cancer. 2006;106(1):214-222. doi: 10.1002/cncr.21567##17. Alshubaili AF, Ohaeri JU, Awadalla AW, Mabrouk AA. Family caregiver quality of life in multiple sclerosis among Kuwaitis: a controlled study. BMC health services research. 2008;8(1):1-9. doi: 10.1186/1472-6963-8-206##18. 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Non-pharmacological Techniques to Control Pain and Anxiety during Medical Procedures in Children under 15 Years: A Systematic Review تکنیک‌های غیردارویی برای کنترل درد و اضطراب در حین انجام درمان های پزشکی در کودکان زیر 15 سال: مروری سیستماتیک 2 1 زمینه و هدف: یکی از راههای کنترل درد و اضطراب در انواع فرآیندهای پزشکی در کودکان، تکنیک حواس پرتی غیردارویی است. بنابراین، پژوهش حاضر با هدف بررسی چنین تکنیک هایی انجام شد. روش‌ها: در این مرور سیستماتیک، PubMed، Scopus، Web of Science و Google Scholar در بازه زمانی 2015 تا 2023 با استفاده از کلیدواژه‌های خاص حواس‌پرتی، تکنیک غیردارویی، درمان های پزشکی و کودکان جستجو شدند. پس از تکمیل جستجو، غربالگری و ارزیابی مقالات، 42 مقاله اصلی و 21 مقاله مروری در پژوهش حاضر انجام شد. یافته ها: 21.4 درصد از اقدامات پزشکی و درمانی مربوط به دندانپزشکی، 21.42 درصد مربوط به وریدی، 14.28 درصد مربوط به واکسیناسیون، 9.52 درصد مربوط به مداخلات دردناک، 7.14 درصد مربوط به خونگیری، 7.14 درصد مربوط به جراحی، 4.76 درصد مربوط به بخیه زدن می باشد.  راه حل های غیردارویی ارائه شده در این مقالات شامل فناوری رباتیک (14.28%)، تماشای کارتون (11.9%)، فیلم آموزشی (7.14%)، حضور مادر، شیر دادن به مادر و صدای مادر (7.14%)، ابزارهای سمعی و بصری (7.14%) بود. 4.76 درصد، موسیقی درمانی و تکنیک فشار (7.14 درصد) و بقیه راه حل های دیگر هستند. نتیجه‌گیری: با توجه به عوارض کمتر تکنیک‌های غیردارویی و همچنین حساسیت این گروه سنی به دوز و عوارض داروها و کم هزینه بودن و اثربخشی بالای این تکنیک‌ها، استفاده از آنها ارجحیت دارد. 2 One way to control pain and anxiety in a variety of medical procedures in children is through the use of nonpharmacological distraction techniques. Therefore, the present research aimed to investigate the effectiveness of such techniques. In this systematic review, PubMed, Scopus, Web of Science, and Google Scholar were searched for articles published between 2015 and 2022 using specific keywords such as distraction, non-pharmacological techniques, procedural therapy, and children. Following the search, a total of 42 original articles and 21 review articles were screened and evaluated for inclusion in the study. The distribution of medical and therapeutic procedures in the articles reviewed was as follows: 21.4% were related to dentistry, 21.42% to IV procedures, 14.28% to vaccinations, 9.52% to painful interventions, 7.14% to blood sampling, 7.14% to surgeries, 4.76% to stitches, and 14.28% to other procedures. Non-pharmacological solutions mentioned in the articles included robotic technology (14.28%), watching cartoons (11.9%), training videos (7.14%), mother's presence, breastfeeding and mother's voice (7.14%), audio-visual tools (4.76%), music therapy and pressure technique (7.14%) and various other solutions. Given the lower risk of complications associated with non-pharmacological techniques, the sensitivity of children to drug dosage and side effects, and the cost-effectiveness of these techniques, their use is preferred in pediatric medical procedures. 69 81 2024/09/192024/10/92024/11/282024/11/292024/12/12024/12/12024/12/32024/12/2 1403/9/12 2025/02/182025/03/82025/02/32025/01/192025/01/222025/02/192025/02/32025/02/15 1403/11/27 Sara Golmakani Sara Golmakani Student Research Committee, Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand, Iran sara.golmakani1077@gmail.com Ali Taheri Ali Taheri Department of clinical psychology, faculty of human science, Shahed University , Tehran, Iran alitaheri1412@gmail.com Reza Chambari Reza Chambari Student Research Committee, Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand, Iran rezachambari80@gmail.com Fariborz Jamshidi Fariborz Jamshidi Student Research Committee, Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand, Iran fariborzboron@gmail.com Masoomeh RabaniRad Masoomeh RabaniRad Student Research Committee, Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand, Iran m.r99161013@gmail.com Behnam Barzegar Behnam Barzegar 1 Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran Hadi Ahmadi Chenari Hadi Ahmadi Chenari Department of Nursing, Ferdows Faculty of Medical Sciences, Birjand University of Medical Sciences, Birjand, Iran ahmadi.h@bums.ac.ir Distraction Children Medical procedures Non-pharmacological technique حواس‌پرتی تکنیک غیردارویی درمان های پزشکی و کودکان 1. Sarbijan, S. S., Rabori, R. M., & Nouhi, E. (2021). The Effect of Balloon Inflating Distraction on Pain Intensity During Venous Blood Sampling in Children: A Randomized Controlled Trial.‌ https://doi.org/10.21203/rs.3.rs-711305/v1.##2. Francischinelli AGB, Almeida FdA, Femandes DMSO. Routine use of therapeutic play in the care of hospitalized children: nurses’ perceptions. Acta Paul Enferm.2012;25(1):18-23. https://doi.org/10.1590/s0103-21002012000100004.##3. LI WH, Chung JOK, Ho KY, Kwok BMC. Play interventions to reduce anxiety and negative emotion in hospitalized children. BMC pediatrics. 2016;16(1):36. https://doi.org/10.1186/s12887-016-0570-5.##4. Yazdanparast E., Davoudi M., Ghorbani S. H., Akbarian A., Chenari H. A. (2022). Investigating the relationship between moral sensitivity and attitude towards euthanasia in nursing students of Birjand University of Medical Sciences. Clinical Ethics, 17(2), 205–210. https://doi.org/10.1177/14777509211016294##5. Atzori, B., Lauro Grotto, R., Giugni, A., Calabrò, M., Alhalabi, W., & Hoffman, H. G. (2018). Virtual reality analgesia for pediatric dental patients. Frontiers in psychology, 9, 2265.‌ https://doi.org/10.3389/fpsyg.2018.02265. ##6. Shureshi P, Ahmadi Chenari H, Ahmadi M, Jesmi A A. Effect of Education by Lecture and Pamphlet Methods on Soldiers Knowledge about Meningitis Disease. J Mil Med 2015; 17 (3) :181-186##7. Slifer KJ, Tucker CL, Dahlquist LM: Helping children and caregivers cope with repeated invasive procedures: How are we doing? Journal of Clinical Psychology in Medical Settings. 2002, 9:131–152. https://doi.org/10.1023/A:1014944110697.##8. National Institutes of Health: Integration of behavioral and relaxation approaches into the treatment of chronic pain and insomnia. Journal of the American Medical Association. 1996, 276:313–318. https://doi.org/10.1001/jama.1996.03540040057033##9. Eccleston C, Crombez G: Pain demands attention: A cognitive-affective model of the interrumptive function of pain. Psychological Bulletin. 1999, 125:356–366. https://doi.org/10.1037/0033-2909.125.3.356.##10. Matthew J. Page1* , Joanne E. McKenzie1, Patrick M. Bossuyt2, Isabelle Boutron3, Tammy C. Hoffmann4, Cynthia D. Mulrow5, Larissa Shamseer6, Jennifer M. Tetzlaff7, Elie A. Akl8, Sue E. Brennan1, Roger Chou9, Julie Glanville10, Jeremy M. Grimshaw11, Asbjørn Hróbjartsson12, Manoj M. Lalu13, Tianjing Li14, Elizabeth W. Loder15, Evan Mayo-Wilson16, Steve McDonald1 , Luke A. McGuinness17, Lesley A. Stewart18, James Thomas19, Andrea C. Tricco20, Vivian A. Welch21, Penny Whiting17 and David Moher22. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Page, M. J., et a. 2021.10:89. (1-11). https://doi.org/10.1371/journal.pmed.1003583.##11. Aditya, P.V.A., et al., Comparison of effectiveness of three distraction techniques to allay dental anxiety during inferior alveolar nerve block in children: A randomized controlled clinical trial. Heliyon, 2021. 7(9). https://doi.org/10.1016/j.heliyon.2021.e08092.##12. Dixit, U.B. and L. Moorthy, The use of interactive distraction technique to manage gagging during impression taking in children: a single-blind, randomised controlled trial. European Archives of Paediatric Dentistry, 2021. 22(2): p. 219-225. https://doi.org/10.1007/s40368-020-00582-2##13. Garrocho-Rangel, A., et al., A video eyeglasses/ earphones system as distracting method during dental treatment in children: A crossover randomised and controlled clinical trial. European Journal of Paediatric Dentistry, 2018. 19(1): p. 74-79. https://doi.org/10.23804/ejpd.2018.19.01.14.##14. Ghaderi, F. and N. Solhjou, The effects of lavender aromatherapy on stress and pain perception in children during dental treatment: A randomized clinical trial. Complementary Therapies in Clinical Practice, 2020. 40. https://doi.org/10.1016/j.ctcp.2020.101182.##15. Ghadimi, S., et al., Effect of visual distraction on children's anxiety during dental treatment: a crossover randomized clinical trial. Eur Arch Paediatr Dent, 2018. 19(4): p. 239-244. https://doi.org/10.1007/s40368-018-0352-x.##16. Gümüş, H. and M. Aydinbelge, Evaluation of effect of warm local anesthetics on pain perception during dental injections in children: a split-mouth randomized clinical trial. Clinical Oral Investigations, 2020. 24(7): p. 2315-2319. https://doi.org/10.1007/s00784-019-03086-6.##17. Kasimoglu, Y., et al., Robotic approach to the reduction of dental anxiety in children. Acta Odontologica Scandinavica, 2020. 78(6): p. 474-480. https://doi.org/10.1080/00016357.2020.1800084.##18. Kharouba, J., B. Peretz, and S. Blumer, The effect of television distraction versus Tell-Show-Do as behavioral management techniques in children undergoing dental treatments. Quintessence Int, 2020. 51(6): p. 486-494. https://doi.org/10.3290/j.qi.a44366.##19. Shekhar, S., et al., Effect of active and passive distraction techniques while administering local anaesthesia on the dental anxiety, behaviour and pain levels of children: a randomised controlled trial. European Archives of Paediatric Dentistry, 2022. 23(3): p. 417-427. https://doi.org/10.1007/s40368-022-00698-7.##20. Aykanat Girgin, B. and İ. Göl, Reducing Pain and Fear in Children During Venipuncture: A Randomized Controlled Study. Pain Management Nursing, 2020. 21(3): p. 276-282. https://doi.org/10.1016/j.pmn.2019.07.006.##21. Canbulat Şahiner, N., A.S. Türkmen, and D. Şahin, Effect of using vacutainers with cartoon characters on the pain and fear levels of preschoolers during bloodletting. Journal of Paediatrics and Child Health, 2022. https://doi.org/10.1111/jpc.16042.##22. Inal, S. and M. Kelleci, The Effect of External Thermomechanical Stimulation and Distraction on Reducing Pain Experienced by Children during Blood Drawing. Pediatric Emergency Care, 2020. 36(2): p. 66-69. https://doi.org/10.1097/PEC.0000000000001264.##23. Koç Özkan, T. and S. Balcı, The Effect of Acupressure on Acute Pain During Venipuncture in Children: Implications for Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 2020. 17(3): p. 221-228. https://doi.org/10.1111/wvn.12437.##24. Alireza Momenabadi, Maryam Radmehr, Narges Sadeghi. Effect of two Methods of Acupressure in Hugo Point and Music on Severity of Pain During IV Insertion in Children. P J M H S. 2021. 14(2);697-700. ##25. Ali, S., et al., A randomized trial of iPad distraction to reduce children's pain and distress during intravenous cannulation in the paediatric emergency department. Paediatrics and Child Health (Canada), 2021. 26(5): p. 287-293. https://doi.org/10.1093/pch/pxaa089.##26. Ortiz GS, OʼConnor T, Carey J, et al. Impact of a Child Life and Music Therapy Procedural Support Intervention on Parental Perception of Their Child's Distress During Intravenous Placement. Pediatr Emerg Care. 2019;35(7):498-505. https://doi.org/10.1097/PEC.0000000000001065##27. Chavan, S. and P. Naregal, Effectiveness of cartoon animation video on pain during venepuncture among 3-6 year old children. Sri Lanka Journal of Child Health, 2021. 50(2): p. 299-305. http://dx.doi.org/10.4038/sljch.v50i2.9577.##28. Suleman, S.K., A. Atrushi, and K. Enskär, Effectiveness of art-based distraction on reducing pediatric patients' pain and anxiety during venipuncture: A randomized controlled trial. Complementary Therapies in Clinical Practice, 2022. 48. https://doi.org/10.1016/j.ctcp.2022.101597.##29. 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