Investigation of Knowledge, Attitude and Practice of Pregnant Women regarding Nutrition during Pregnancy in Yazd City بررسی آگاهی، نگرش و عملکرد زنان باردار در زمینه تغذیه در دوران بارداری در شهر یزد 2 1 مقدمه :بارداری یکی از مهم ترین مراحل زندگی مادر و جنین میباشد که نیاز مادر به انرژی و مواد غذایی در این دوران به دلیل تغییرات فیزیولوژیک افزایش یافته و در نتیجه وضعیت تغذیه ای مادر تاثیر چشمگیری بر سلامت او ، جنین ، پیامدهای بارداری و نهایتا جامعه دارد. مطالعات انجام شده حاکی از آن است که آگاهی و نگرش تغذیه ای بر وضع تغذیه موثر میباشند ، لذا بررسی حاضر به منظور تعیین آگاهی،نگرش و عملکرد (KAP) زنان باردار شهر یزد در خصوص تغذیه دوران بارداری انجام گرفت. روش کار: این مطالعه یک پژوهش توصیفی- مقطعی است که بر روی 120 نفر از زنان باردار شهر یزد انجام گردید. پرسشنامه های مورد بررسی در این پژوهش محقق ساخته بوده و شامل متغیر های دموگرافیک، آگاهی، نگرش و عملکرد زنان باردار می باشد. در نهایت داده های جمع آوری شده با استفاده از نرم افزار SPSS (نسخه18) مورد تجزیه و تحلیل قرار گرفته است. یافته ها: نتایج نشان داد که آگاهی در3/33% زنان باردار ضعیف،2/64 % متوسط و 5/2 % خوب بود. نگرش اغلب افراد (2/98 %) در خصوص تغذیه مناسب دوران بارداری مثبت بود. عملکرد 70% از افراد در خصوص تغذیه مناسب دوران بارداری در محدوده متوسط قرار داشت. نتیجه گیری: مطابق با نتایج به دست آمده از مطالعه حاضر ، آگاهی و عملکرد اکثر افراد در زمینه تغذیه دوران بارداری در محدوده متوسط قرار داشت همچنین نگرش اکثر افراد نسبت به تغذیه دوران بارداری مثبت بود. لذا باید برنامه های آموزشی جهت بهبود آگاهی و عملکرد زنان باردار توسط مراقبین دوران بارداری اجرا گردد. 2 Introduction: Pregnancy is one of the most important stages in maternal and fetal life, in which mother's need for energy and food during this period increases due to physiological changes. As a result, mother's nutritional status has a significant impact on her health, her fetus, pregnancy outcomes and ultimately the community. Studies have shown that nutritional knowledge and attitudes affect nutrition effectively. Therefore, this study was conducted with the aim of determining the knowledge, attitude and practice (KAP) of pregnant women regarding nutrition during pregnancy in Yazd. Methods: This cross-sectional descriptive study was performed on 120 pregnant women in Yazd health center during summer 1396. The questionnaires in this study were researcher-made including demographic variables, knowledge, attitude and practice of pregnant women. Finally, data were analyzed using descriptive statistics and coloration in SPSS version 18. Results: The results showed that knowledge in 33.3% of pregnant women was poor, 64.2% moderate and 2.5% good. The attitude of most people (98.2%) was positive towards proper nutrition during pregnancy. The performance of 70% of people was moderate about nutrition during pregnancy. Conclusion: According to the results of this study, the knowledge and practice of most people in the field of nutrition during pregnancy was in the medium range. Furthermore, the attitude of most people was positive towards nutrition. Therefore, educational programs to improve the knowledge and practice of pregnant women should be implemented by pregnant care providers. 134 139 2018/06/10 1397/3/20 2018/09/26 1397/7/4 سید سعید مظلومی محمودآباد Seyed Saeed Mazloomy Mahmoodabad Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran مرضیه تفتیان Marziye Taftiyan Department of Public Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran حسن مظفری خسروی Hassan Mozaffari- Khosravi Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran نوشین یوشنی Nooshin Yoshany Department of Health Education and Health Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran nooshin.yoshany@yahoo.com معصومه گودرزی خویگانی Masoomeh Goodarzi-Khoigani Social Determinants of Health Research Center, School of public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Health Knowledge Attitudes Practice Pregnancy Nutritional Status آگاهی نگرش عملکرد بارداری وضعیت تغذیه ای 1. Ahmadpoor H, Maheri A, Shojaizadeh D. Effectiveness of nutrition education based on health belief model during pregnancy on knowledge and attitude of women referred to health centers of Gonbad Kavoos city. Journal of Neshabur University of Medical Sciences. 2015; 3(2): 52-60. [Persian]##2. Sajadi P, Bakhtiari A, Hajahmadi M. Assessment of nutritional knowledge level of pregnant women referred to health and therapeutic centers of Babol. Journal of Babol University of Medical Sciences. 2008; 9(5): 50-54. [Persian]##3. Fallah F, Pourabbas A, Delpisheh A, et al. Effects of nutrition education on levels of nutritional awareness of pregnant women in Western Iran. International Journal of Endocrinology and Metabolism. 2013; 11(3): 175-178.##4. Ludvigsson JF, Ludvigsson J. Milk consumption during pregnancy and infant birthweight. Acta Paediatrica. 2004; 93(11): 1474-1478.##5. Baghianimoghadam M, Sharifi E, Mozafari-Khosravie H, et a l. The study of knowledge, attitude and practice of pregnant moders abut consumption of milk and dairy products in Yazd. Toloo-e-behdasht. 2014;13(2): 58-71. ##6. Goodarzi-Khoigani M, Mahmoodabad SSM, Moghadam MHB, et al. Prevention of insulin resistance by dietary intervention among pregnant mothers: A randomized controlled trial. International Journal of Preventive Medicine. 2017; 8: 85.##7. Zadeh MD, Ebrahimi H, Haghighi NB, et al. Surveying pregnant women's nutritional status and some factors affecting it in cases referring to Shahrood health-care centers. Journal of Birjand University of Medical Sciences. 2006; 13(4): 42-49. [Persian] ##8. Karimy M, Taher M, Fayazi N, et al. Beliefs effective on nutritional practice s of pregnant women in health centers of Saveh, Iran. Journal of Education and Community Health. 2015; 2(3): 28-35. [Persian]##9. Khajavishojaii K , Parsay S , Fallah N. Assessment of nutritional knowledge, attitude and practice s in pregnant women in university hospitals of Tehran. Journal of Gorgan University of Medical Sciences. 2001; 3(2): 70-75. [Persian]##10. Johnson K. A16. A study of nutritional knowledge and supplement use in pregnant women. Journal of Human Nutrition and Dietetics. 2000; 13(5): 363-371.##11. Mugyia ASN, Tanya ANK, Njotang PN, et al. Knowledge and attitudes of pregnant mothers towards maternal dietary practice s during pregnancy at the Etoug-Ebe Baptist Hospital Yaounde. Health Sciences and Diseases. 2016; 17(2).##12. Farivar F, Heshmat R, Azemati B, et al. Understanding knowledge about, general attitudes toward and practice of nutrition behavior in the Iranian population. Iranian Journal of Epidemiology. 2009; 5(2): 11-8. [Persian]##13. Mansourian M, Saliminezhad M, Behnampoor N. The effect of educational intervention on knowledge and attitude of pregnant women about nutrition in pregnancy. Mendish. 2012; 1(1). [Persian]##14. Bashirian S, Jalily M, Barati M. Nutritional behaviors status and its related factors among pregnant women in Tabriz: A cross-sectional study. Pajouhan Scientific Journal. 2016; 14(2): 34-43.## ##

Path Analysis to Determine the Relationship Between Marital Dissatisfaction, Premenstrual Syndrome and Emotional Dimension of Quality of Life in Women آنالیز مسیر برای تعیین رابطه بین نارضایتی زناشویی، سندرم پیش از قاعدگی و بعد عاطفی کیفیت زندگی در زنان 2 1 چکیده زمینه و هدف: رضایت زناشویی به عنوان ارزیابی ذهنی افراد از کیفیت ازدواج آنها تعریف شده است. کیفیت زندگی (QOL) یک مفهوم چند بعدی است و شامل تمام جنبه های زندگی افراد است. سندرم پیش از قاعدگی (PMS) با طیف گسترده ای از علائم عاطفی و جسمی و تغییرات رفتاری مشخص می شود. هدف از این مطالعه تعیین نقش نارضایتی زناشویی و سندرم پیش از قاعدگی در ابعاد عاطفی کیفیت زندگی است. روش: این مطالعه مقطعی بود. 246 زن مراجعه کننده به مراکز بهداشتی حاشیه شهر یزد، به طور داوطلبانه و تصادفی به مطالعه دعوت شدند. ابزار جمع آوری داده ها، پرسشنامه کیفیت زندگی SF36، ابزار غربالگری سندرم پیش از قاعدگی و شاخص رضایت زناشویی (QOL & PSST & IMS) بود. داده ها جمع آوری شده با استفاده از نرم افزار SPSS18 و با آزمون آنالیز مسیر مورد تجزیه و تحلیل قرار گرفت. یافته ها: نارضایتی زناشویی(021/0p=) و سندرم قبل از قاعدگی(001/0p=) به طور مستقیم تاثیر منفی بر بعد عاطفی کیفیت زندگی دارند و در این بین شدت سندرم قبل از قاعدگی تاثیر قوی تری دارد. همچنین نارضایتی زناشویی با تاثیر بر شدت سندرم قبل از قاعدگی(001/0p=) به طور غیر مستقیم بر بعد عاطفی کیفیت زندگی موثر است. نتیجه گیری: یافته های این مطالعه تاکید دارد که زنان مبتلا به سندرم قبل از قاعدگی و نارضایتی زناشویی در بعد عاطفی کیفیت زندگی خود دچار مشکل هستند، در نتیجه باید به زنان آموزش داد که برای اینکه از نظر روانی زندگی بهتری داشته باشند، با فائق آمدن بر ناملایمات زندگی زناشویی و شناخت علایم سندرم قبل از قاعدگی و راهکارهای بهبود آن، کنترل بیشتری بر این عوامل داشته و کیفیت زندگی خود را افزایش دهند. 2 Introduction: Marital satisfaction was defined as individuals’ global subjective evaluation of the quality of their marriage. Quality of life (QOL) is a multidimensional concept and includes all aspects of individuals’ lives. Premenstrual syndrome (PMS) is characterized by a wide variety of emotional and physical symptoms and behavioral changes. The purpose of this study was to determine the role of marital dissatisfaction and premenstrual syndrome in the emotional dimension of quality of life. Methods: This study was analytical cross-sectional. 246 women referred to health centers in the border Yazd city, were recruited, voluntarily or accidentally. Tools for data collection were Quality of life questionnaire SF36, Premenstrual Syndrome Screening Tool and Index of Marital Satisfaction(QOL &PSST & IMS). Data collected was coded by SPSS18, descriptive statistics were used to summarize and organize the data and analyzed with path analyze Test. Results: Marital dissatisfaction (p = 0.021) and premenstrual syndrome (p = 0.001) have a direct negative effect on the quality of life's emotional dimension, and the severity of premenstrual syndrome has a stronger effect. Also, marital dissatisfaction with the effect on the severity of premenstrual syndrome (p = 0.001) indirectly affects the quality of life's emotional dimension. Conclusions: The findings of this study emphasize that women with premenstrual syndrome and marital dissatisfaction have a problem in their emotional dimension, so women should be taught that, in order to have a better mental health, to overcome Complications of marital life and recognizing the symptoms of premenstrual syndrome and its improvement strategies will further control these factors and increase their quality of life. 140 146 2018/06/102018/03/25 1397/1/5 2018/09/262018/09/26 1397/7/4 زهره کریمیان کاکولکی Zohreh Karimian Kakolaki Department of Health, Faculty of Nursing and Midwifery, Shahrekord Branch, Islamic Azad University, Shahrekord,Iran Iran zohrehkarimian68@yahoo.com سید سعید مظلومی محمودآباد seyed saeed Mazloomy mohmoodabad Research Centre on Social Determinants of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran zohre_116@yahoo.com سکینه گرایلو Sakineh Gerayllo Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran gerayllo65@yahoo.com فاطمه حیدری Fatemeh Heidari Critical Care Nursing, School Of Nursing, Gerash University of Medical Sciences, Gerash, Iran Iran heidari.f20@gmail.com بهاره متقی Bahareh Motaghi Department of Midwifery, Shahrekord University of Medical Sciences, Sharekord, Iran Iran b.motaghi14@gmail.com فیروزه شریفی Firoozeh Sharifi Department of Public Health, School of Public Health, Isfahan University of Medical sciences, Isfahan, Iran Iran firoozehsharifi100@yahoo.com Quality of Life Marital Satisfaction Premenstrual Syndrome کیفیت زندگی رضایت زناشویی سندرم قبل از قاعدگی 1. Ganji AA, Navabinezhad D. The Relationship between Locus of Control and Marital Satisfaction of Couples. Life Science Journal. 2012; 9(4): 294-298.##2. Ofovwe C, Ofili A, Ojetu O, et al. Marital satisfaction, job satisfaction and psychological health of secondary school teachers in Nigeria. Health. 2013; 5(4): 663-668.##3. Nagaraja A, Rajamma NM, Reddy SV. Effect of parents’ marital satisfaction, marital life period and type of family on their children mental health status. Journal of Psychology. 2012; 3(2): 65-70.##4. Morowatisharifabad M, Karimiankakolaki Z, Bokaie M, et al. Frequency of marital dissatisfaction in couples with wives who suffer from premenstrual syndrome in the city of Yazd. Journal of Health System Research. 2014; 10(2): 315-325. [Persian]##5. Sahin S, Ozdemir K, Unsal A. Evaluation of premenstrual syndrome and quality of life in university students. Journal of Pakistan Medical Association. 2014; 64(8): 915-922.##6. Rostami A, Ghazinour M, Nygren L, et al. Health-related quality of life, marital satisfaction, and social support in medical staff in Iran. Applied Research in Quality of Life. 2012; 8(3): 385-402.##7. Morowatisharifabad M, Karimiankakolaki Z, Bokaie M, et al. The effects of training married men about premenstrual syndrome by pamphlets and short messages on marital satisfaction. Health Education Research. 2014; 29(6): 1005–1014.##8. Kianiasiabar A, Heydari M, Mohamaditabar S, et al. The prevalence, signs, symptoms and risk factors of premenstrual syndrome in women. Journal Daneshvar. 2009; 16(81): 45-54. [Persian]##9. Maleki F, Pourshahbaz A, Asadi A, et al. The impact of premenstrual disorders on health-related quality of life (HRQOL). Practice in Clinical Psychology. 2014; 2(2): 77-84.##10. Zarei Z, Bazzazian S. The relationship between premenstrual syndrome disorder, stress and quality of life in female students. Iranian Journal of Psychiatric Nursing. 2015; 2(4): 49-58.##11. RezaSoltani P, Ghanbari Khanghah A, Moridi M. Comparison of health related quality of life in dormitory and non-dormitory students. Journal of Holistic Nursing and Midwifery. 2014; 24(74): 38-45. [Persian]##12. Hoga LAK, Vulcano MA, Miranda CM, et al. Male behavior in front of women with Premenstrual Syndrome: narratives of women. Acta Paulista de Enfermagem. 2010; 23(3): 372-378.##13. Morowatisharifabad M, Zareipour M, Movahed E, et al. The relationship between marital satisfaction andmen,s awareness and practice towards PMS among couples in Kerman. Journal of Health in the Field. 2017; 5(1): 13-23. [Persian]##14. Dean BB, Borenstein JE, Knight K, et al. Evaluating the criteria used for identification of PMS. Journal of Women's Health. 2006; 15(5): 546-555.##15. Delara M, Ghofranipour F, Azadfallah P, et al. Health related quality of life among adolescents with premenstrual disorders: a cross sectional study. Health and Quality of Life Outcomes. 2012; 10(1): 1-5.##16. Munro BH. Statistical methods for health care research. lippincott williams & wilkins; 2005.##17. Seedhom AE, Mohammed ES, Mahfouz EM. Life style factors associated with premenstrual syndrome among El-Minia university students, Egypt. ISRN Public Health. 2013; (Article ID 617123): 1-6.##18. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): conceptual framework and item selection. Medical Care. 1992; 30(6): 473-483.##19. Montazeri A, Goshtasebi A, Vahdaninia M, et al. The short form health survey (SF-36): translation and validation study of the Iranian version. Quality of Life Research. 2005; 14(3): 875-882.##20. Cheug PP, Hudson WW. Assessment of marital discord in social work practice: A revalidation of the index of marital satisfaction. Journal of Social Service Research. 1982; 5(1-2): 101-118.##21. Siahbazi S, Hariri F, Montazeri A, et al. Standardization of premenstrual symptoms screening questionnairePSST: translation and psychometric Iranian species. 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An Investigation of Predictive Marital Adjustment Base of Attachment Styles in Married Women پیش بینی سازگاری زناشویی برپایه سبکهای دلبستگی 2 1 مقدمه: ارقام فعلی نشان می دهد که بسیاری از ازدواج ها در ایران در 20 سال اخیر با جدایی و طلاق پایان می یابد. با توجه به اثرات مخرب روحی و جسمی بر زوجین و همچنین فرزندانشان، برای محققان و متخصصان تلاش درجهت درک این پدیده مضر و اقدامات پیشگیرانه برای مقابله با این فاجعه مدرن، بسیار مهم است. سازگاری زناشویی یک هدف عالی در تحقق یک خانواده مطلوب است و به عنوان یک عامل اساسی در سلامت و توسعه اعضای خانواده عمل می کند. یکی از مهم ترین عوامل موثر بر سازگاری زناشویی، سبک دلبستگی است. این مطالعه با هدف تعیین رابطه سبک دلبستگی و سازگاری زناشویی در زنان انجام شد. روش: این مطالعه مقطعی بر روی 220 زن مراجعه کننده به مشاوره یزد در سال 1396انجام شد. شرکت کنندگان از طریق نمونه گیری در دسترس انتخاب شدند. ابزار جمع آوری داده ها شامل پرسشنامه های سازگاری زناشویی و سبک های دلبستگی بزرگسالان است. داده ها با استفاده از نرم افزار SPSS (نسخه 19) با استفاده از ضریب همبستگی پیرسون و تحلیل رگرسیون گام به گام تجزیه و تحلیل شدند. یافته ها: سبک دلبستگی پیش بینی کننده سازگاری زناشویی بود. همبستگی منفی معناداری بین سازگاری زناشویی و سبک دلبستگی اضطرابی و اجتنابی وجود داشت، همچنین همبستگی سازگاری زناشویی و سبک دلبستگی ایمن به طور معناداری مثبت بود. نتیجه گیری: با توجه به اینکه سبک های دلبستگی با سازگاری زناشویی ارتباط دارند، مشاوران می توانند با رویکرد زوج درمانی در اصلاح سبک های دلبستگی تاثیرگذار باشند تا بتوانند به حل اختلافات آنها قبل و بعد از ازدواج بپردازند. 2 Introduction: Current figures indicate that many of first marriages in the Iran will end in separation or divorce and due to many problems, one of the causing this phenomenon is marital adjustment. Marital adjustment denotes emotional stability, intellectual efficiency and social effectiveness people and acts as a fundamental contributor to the health and development of family members. One of the most important factors influencing marital adjustment is attachment styles. This study aimed to determine the relationship between attachment styles and marital adjustment in women. Methods: This cross-sectional study was conducted on 220 women referring to health centers of yazd city in 2016. The participants were selected via available sampling. The data collection instruments consisted of the standardized Questionnaires include Spanier ’s marital adjustment (1976) and Collins and Read’s Adult Attachment Style Scale. The data were analyzed in SPSS software (version 19) using descriptive statistics and Pearson correlation coefficient, and stepwise regression analysis, regression equation. Results: The attachment styles were predictors of marital adjustment. There was a significant negative correlation between marital adjustment and anxious and avoidant attachment styles while the correlation between marital adjustment and securate attachment style was significantly positive. Conclusion: 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. As attachment styles are contributory to marital adjustment, counselors can build on couple therapy approach to have an effective role in modifying attachment styles of the couple and solving their conflicts both before and after marriage. 147 154 2018/06/102018/03/252018/05/11 1397/2/21 2018/09/262018/09/262018/09/26 1397/7/4 سیده فاطمه حسینی حسین آباد Seyede Fateme Hoseini Hoseinabad Department of Psychology, Faculty of Psychology, Islamic Azad university Karaj Branch, Karaj, Iran Iran باقر غباری بناب Bagher Ghobari Banab Department of Psychology, Faculty of Psychology & Education, Tehran University, Tehran, Iran Iran مریم مشایخ Maryam Mashayekh Department of Psychology, Faculty of Psychology, Islamic Azad university Karaj Branch, Karaj, Iran Iran m.mashayekh.@kuia.ac.ir شیدا سوداگر Sheyda Sodagar Department of Psychology, Faculty of Psychology, Islamic Azad university Karaj Branch, Karaj, Iran Iran نورعلی فرخی Noorali Farrokhi Department of Educational Psychology, Faculty of Psychology & Educational Sciences, Allameh Tabataba'i University, Tehran, Iran Iran Attachment Styles Marital Adjustment Women سبکهای دلبستگی سازگاری زناشویی زنان 1. Namvaran Germi K, Farzad V, Zahrakar K. Identifying the dimensions of marital adjustment in Iranian couples: a qualitative study. Journal of Health and Care. 2017; 19 (3): 182-194. [Persian] ##2. Strohschein L, Ram U. Gender, marital status, and mental health: A test of the sex role hypothesis in India. Journal of Family Issues. 2016; 38(13): 1899-1922.##3. Rao SL. Marital adjustment and depression among couples. The International Journal of Indian Psychology. 2017; 4(2): 34-42.##4. Greeff AP, De Bruyne T. Conflict management style and marital satisfaction. Journal of Sex and Marital Therapy. 2000; 26(4): 321-334.##5. Bayrami M, Fahimi S, Akbari E, et al. Predicting marital satisfaction on the basis of attachment styles and differentiation components. Journal of Fundamentals of Mental Health. 2012; 14(1): 64-77. [Persian] ##6. Jahangir P. Comparison of family functioning and marital satisfaction in married women working and non-working (housewife) in Tehran. Educational Administration Research Quarterly. 2012; 3(4): 176-192. [Persian]##7. Hamidi F. A study on the relationship between attachment styles and marital satisfaction in married students of teacher training university. Journal of Family Research. 2007; 3(9): 443-453. [Persian]##8. Asfichi AT, Lavasani MQ, Bakhshayesh A. Predicting marital satisfaction on the basis of attachment styles and differentiation of self. Journal of Family Research. 2013; 8(4): 441-463. [Persian] ##9. Moradi Siahafshadi M, Amiri S, Molavi H, et al. The relationship between attachment and subjective well-being: the mediating role of emotion regulation skill. International Journal of Psychology. 2018; 12(1): 118-135. ##10. SHahsiah M, Bahrami F, Etemadi O, et al. Effect of sex education on improving couples marital satisfaction in Isfahan. Health System Research. 2011; 6(4): 690-697. [Persian]##11. Beyranvand H, Azizi A, Dehghan Manshadi SM, et al. Relationship between attachment styles and spiritual intelligence and marital satisfaction in married female teachers. Journal of Mazandaran University of Medical Sciences. 2016; 26(135): 149-152. [Persian] ##12. Mikulincer M, Florian V. The relationship between adult attachment styles and emotional and cognitive reactions to stressful events. In: Simpson JA , Rholes WS, editors. Attachment theory and close relationships. New York: The Guilford Press; 1998; 143-165. ##13. Bogaerts S, Daalder AL, Van Der Knaap LM, et al. Critical incident, adult attachment style, and posttraumatic stress disorder: A comparison of three groups of security workers. Social Behavior and Personality: An International Journal. 2008; 36(8): 1063-1072. ##14. Wearden A, Peters I, Berry K, et al. Adult attachment, parenting experiences, and core beliefs about self and others. Personality and Individual Differences. 2008; 44(5): 1246-1257. ##15. Eidi R, Khanjani Z. 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Awareness of Risk Factors and Complications of Hypertension in Southern Tanzania Awareness of risk factors, complications and prevention of complications of hypertension among hypertensive patients in Southern Tanzania 2 1 فاقد چکیده فارسی می باشد. 2 Introduction: To assess patient’s awareness on the risk factors, complications and prevention of complications of hypertension. Methods: This cross-sectional study was carried out on a random sample of hypertensive patients attending Songea Regional Referral Hospital, Tanzania using an interview based questionnaire. Data entry and analysis was performed using SPSS v 14. Results are expressed as Mean ± SD for continuous data and proportions for categorical data. Logistic regression was performed to assess the association between variables and patients’ awareness on risk factors, complications and prevention of complications of hypertension. Results: Four hundred and fifty hypertensive patients with mean age 57.00±12.60 years were enrolled in the study. Females accounted for 52.90% of the study population. More than one-third (35.60%) of patients had low level of awareness on the risk factors, complications and preventive measures of complication of hypertension. Having higher education level, duration with hypertension of more than 5 years, and a positive family history of hypertension were all associated with high level of awareness among hypertensive patients. Conclusions: The findings show a considerable number of hypertensive patients are not aware of the risk factors, complications and preventive measures of hypertension. Assessing patients’ awareness of risk factors and complications of hypertension during follow-up visits may improve patients’ control of blood pressure and slow down progression to complications. 155 163 2018/06/102018/03/252018/05/112018/05/21 1397/2/31 2018/09/262018/09/262018/09/262018/09/26 1397/7/4 Kanuda Mandago Kanuda Mandago Department of Community Medicine, Faculty of Medicine, Archbishop James University College, St. Augustine University of Tanzania, Songea, Tanzania Tanzania kanudamandago8@gmail.com Fabian P. Mghanga Fabian P. Mghanga Department of Internal Medicine, Faculty of Medicine, Archbishop James University College, St. Augustine University of Tanzania, Songea, Tanzania Tanzania fpmghanga@ajuco.ac.tz Awareness Risk Factors Hypertension Awareness risk factors complications hypertension 1. World Health Organization. Global status report on non-communicable diseases 2010.Available at: http://www.who.int/nmh/publications/ncd_report_full_en.pdf. Accessed Sep 10, 2018.##2. Mathers C, Stevens G, Mascarenhas M. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, Switzerland: World Health Organization; 2009.##3. Chockalingam A, Campbell NR, Fodor JG. Worldwide epidemic of hypertension. The Canadian Journal of Cardiology. 2006; 22(7): 553–555.##4. Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF. 2016. Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2015-16. Dar es Salaam, Tanzania, and Rockville, Maryland, USA: MoHCDGEC, MoH, NBS, OCGS, and ICF. Available at: https://dhsprogram.com/pubs/pdf/fr321/fr321.pdf. Accessed Sep 10, 2018.##5. Kjellgren KI, Svensson S, Ahlner J, et al. Hypertensive patients’ knowledge of high blood pressure. Scandinavian Journal of Primary Health Care.1997; 15(4): 188-192.##6. Saengsuwan J, Suangpho P,Tiamkao S. Knowledge of stroke risk factors and warning signs in patients with recurrent stroke or recurrent transient ischaemic attack in Thailand. Hindawi Neurology Research International. 2017; (Article ID 8215726):1-7.##7. Kumar CA, Sasi Sekhar TVD, Sahithi B, et al. Hypertension – the silent killer, awareness of the risk factors and complications of hypertension among hypertensives. International Journal of Advanced Research. 2006; 4(6): 1277-1281.##8. Costa JS, Barcellos FC, Sclowitz ML, et al. Hypertension prevalence and its associated risk factors in adults: a population-based study in Pelotas. Arquivos Brasileiros De Cardiologia. 2007; 88(1): 59-65.##9. El Bcheraoui C, Memish ZA, Tuffaha M, et al. Hypertension and its associated risk factors in the kingdom of Saudi Arabia, 2013: A national survey. International Journal of Hypertension. 2014;(Article ID 564679): 1-8.##10. Kish L. Survey sampling. New York: John Wiley and Sons, Inc; 1965. P: 78-94.##11. Jolles EP, Padwal RS, Clark AM, et al. A qualitative study of patient perspectives about hypertension. ISRN Hypertension. 2013; (Article ID 671691): 1-10.##12. Dorobantu M, Darabont RO, Badila E, et al. Prevalence, awareness, treatment and control of hypertension in Romania: Results of SEPHAR Study. International Journal of Hypertension.2010; (Article ID 970694): 1-6.##13. Ashfaq T, Anjum Q, Siddiqui H, et al. Awareness of hypertension among patients attending primary heath care centre and outpatient department of tertiary care hospital of Karachi. Journal of the Pakistan Medical Association.2007; 57: 396-399##14. Eve-MerikeSooväli, PiretSimm, LiinaAnimägi. Awareness of risk factor management, complications, and prevention among adult patients with recently diagnosed hypertension. National Environmental Research Program.2015; 5(1): 2-10##15. Tan EK, Chung WL, Lew YJ, et al. Characteristics, and disease control and complications of hypertensive patients in primary-care – a community-based study in Singapore. Annals Academy of Medicine Singapore. 2009; 38(10): 850-856.##16. Kirkland S, MacLean D, Langille D, et al. Knowledge and awareness of risk factors for cardiovascular disease among Canadians 55 to 74 years of age: results from the Canadian Heart Health Surveys, 1986-1992. Canadian Medical Association Journal. 1999; 161(8): S10-S16.##17. Meredith PA, Ostergren J. From hypertension to heart failure – are there better primary prevention stratergies?. Journal of the Renin-Angiotensin-Aldosterone System. 2006; 7(2): 64-73.##18. Oliveria SA, Chen RS, McCarthy BD, et al. Hypertension knowledge, awareness, and attitudes in a hypertensive population. Journal of General Internal Medicine. 2005; 20(3): 219-225.##19. Taylor C, Ward A. Patients’ views of high blood pressure, its treatment and risks. Australian Family Physician. 2003; 32(4): 278-282.## ##

Knowledge, Attitudes and Practice of Health Care Workers in Oncology, Hemodialysis and Transplantation Towards Influenza Vaccination in Isfahan, Iran آگاهی، نگرش و عملکرد کارکنان مراقبت های بهداشتی شاغل در بخش های انکولوژی، همودیالیز و پیوند بیمارستانهای اصفهان در خصوص واکسیناسیون آنفلوآنزا 2 1 مقدمه: آنفلوآنزا یک بیماری ویروسی است که در افراد با ایمنی سالم معمولا خود محدود شونده است اما در بیماران با نقص ایمنی می تواند خطرناک باشد و باعث عفونت های شدید با خود ویروس یا بصورت ثانویه با باکتریها بشود . اغلب این عفونت ها در ریه متمرکز می شود و در بعضی مواقع میتواند باعث مرگ بیمار بشود. لذا جلوگیری از سرایت این بیماری به این گونه بیماران از اهمیت خاصی برخوردار است و در این راستا رفتار مراقبان این بیماران اهمیت خود را داراست. این مطالعه در جهت بررسی آگاهی، نگرش و عملکرد پزشکان، پرستاران و سایر کارکنان مراقبت های بهداشتی شاغل در بخش های انکولوژی ، همودیالیز و پیوند بیمارستانهای اصفهان در سال 1396 انجام پذیرفت. روش : در این مطالعه ی توصیفی، مقطعی پرسشنامه ای شامل بخش اطلاعات دموگرافیک و 34 سوال تنظیم شده برای ارزیابی آگاهی، نگرش وعملکرد بود، که روایی و پایایی آن در حد مطلوب تعیین شد. سپس این پرسشنامه، به 110 نفر از کارکنان بهداشتی تحویل داده شد و از آنان خواسته شد که آن را تکمیل کنند و پس از تکمیل مورد بررسی قرار گرفت و آگاهی ،نگرش و عملکرد کارکنان برآورد شد و با کمک نرم افزار SPSS اطلاعات دسته بندی و تحلیل گردید. نتایج: از بین 110 نفر شرکت کننده در مطالعه 72 نفر (5/65 %) زن و 38 نفر (5/34 %) مرد بودند میانگین سنی افراد مطالعه شده 7 7/32 سال برآورد گردید و میانگین سابقه کار آنها 8/6 49/8 سال بود. از این تعداد بیشترین افراد یعنی 74 نفر (3/67 %) پرستار بودند. میانگین نمره آگاهی افراد 55/4 ± 75/14 محاسبه گردید و نگرش افراد در خصوص واکسن آنفلوآنزا خوب بود. بر اساس بررسی انجام شده فقط 58 نفر از کل 110 نفر مطالعه شده (7/52 %) واکسن را تلقیح کرده اند نتیجه گیری: با توجه به آگاهی مطلوب شرکت کنندگان و نگرش نسبتا مثبت شرکت کنندگان و نسبت پایین واکسیناسیون در آنها به نظر می رسد که با الگو برداری از کشورها و مناطقی که نسبت واکسیناسیون بهتری دارند اقدامات لازم درخصوص بهبود نگرش و در نهایت عملکرد پرسنل بهداشتی انجام شود. 2 Introduction: Influenza is a viral disease which is self-limited in immunocompetent patients but it can be dangerous in immunocompromised patients. In these patients it may lead to sever viral and/or bacterial infection that often may lead to death. Therefor prevention of influenza in immunocompromised patients is very important and thus health care workers’ belief is important too. This study is evaluation of knowledge, attitude and practices of health care workers in oncology, hemodialysis and transplantation wards in hospitals of Isfahan in 2017. Methods: In this descriptive cross-sectional study selected health care workers filled a questionnaire which has 2 sections. In first section we asked about demographic characterization of them and in second section we asked the questions about their knowledge, attitude and practices. At the end we evaluate and analyze the data by SPSS software. Results: We evaluate 110 units and they were 72 (65.5%) female and 38 (34.5%) were male. Mean age of individuals was 32.7±7 years and mean time of their working acquaintance was 8.49±6.8 years. Attitude of the health care workers was well but only 58 units from 110 (52.7%) had been vaccinated. Conclusion: By attention to the knowledge and attitude of the participants and low proportion of vaccination in them it seems that we should have program for improving the vaccination in health care workers in our country. We should take modeling from the countries which have better vaccination coverage in their health care workers. 164 172 2018/06/102018/03/252018/05/112018/05/212018/09/9 1397/6/18 2018/09/262018/09/262018/09/262018/09/262018/09/9 1397/6/18 محسن میدانی Mohsen Meidani Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran محمدرضا یزدانی Mohammad Reza Yazdani Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Iran علی نظری ندوشن Ali Nazari Nodoushan School of Medicine , Isfahan University of Medical Science ,Isfahan ,Iran Iran آوات فیضی Awat Feizi Department of Biostatics and Epidemiology ,School of health , Isfahan University of Medical Science, Isfahan ,Iran Iran مرتضی پوراحمد Morteza Pourahmad Nosocomial Infection Research Center, Isfahan, University of Medical Sciences, Isfahan, Iran Iran mortezapourahmad@yahoo.com Influenza Human Vaccination Health Personnel knowledge Attitude آنفلوآنزا واکسیناسیون کارکنان بهداشتی آگاهی نگرش 1. World Health Organization. Influenza vaccines. WHO position paper. Weekly epidemiological record. 2005; 80 (33): 279-287. Available at: URL: http://www.who.int/wer/2005/wer8033.pdf?ua=1. Accessed 22 Sep, 2018.##2. World Health Organization. Vaccines against influenza WHO position paper November 2012. Weekly Epidemiological Record. 2012; 87(47): 461–476. Available at: URL: http://www.who.int/wer/2012/wer8747.pdf?ua=1. Accessed 22 Sep, 2018.##3. Sobhanian S, Pourahmad M, Jafarzadeh A, et al. The prophylactic effect of honey on common cold. Quran and Medicine. 2014; 3(1). ##4. Loeb M, Singh PK, Fox J, et al. Longitudinal study of influenza molecular viral shedding in Hutterite communities. The Journal of Infectious Diseases. 2012; 206(7): 1078-1084.##5. Killingley B, Nguyen-Van-Tam J. Routes of influenza transmission. Influenza and Other Respiratory Viruses. 2013; 7(s2): 42-51.##6. Haworth E, Barasheed O, Memish ZA, et al. Prevention of influenza at Hajj: applications for mass gatherings. Journal of the Royal Society of Medicine. 2013; 106(6): 215-223.##7. Cooksley CD, Avritscher EB, Bekele BN, et al. Epidemiology and outcomes of serious influenza related infections in the cancer population. Cancer: Interdisciplinary International Journal of the American Cancer Society. 2005; 104(3): 618-628.##8. Salgado CD, Farr BM, Hall KK, et al. Influenza in the acute hospital setting. The Lancet Infectious Diseases. 2002; 2(3): 145-155.##9. Noah DL, Noah JW. Adapting global influenza management strategies to address emerging viruses. American Journal of Physiology-Lung Cellular and Molecular Physiology. 2013; 305(2): L108-L17.##10. Meidani M, Rostami M, Dehghani F. Why coverage of influenza vaccine is not enough in patients receiving chemotherapy?. International Journal of Preventive Medicine. 2011; 2(3): 186-187.##11. Honarvar B, Sara A, Karam TB. Influenza immunization status of public hospitals' staff in Shiraz,Southern Iran. Iran Occupational Health Journal. 2012 9(1):37-44.[Persian]##12. Askarian M, Khazaeipour Z, McLaws M-L. Facilitators for influenza vaccination uptake in nurses at the Shiraz University of Medical Sciences. Public Health. 2011;125(8):512-517.##13. Hofmann F, Ferracin C, Marsh G, et al. Influenza vaccination of healthcare workers: a literature review of attitudes and beliefs. Infection. 2006; 34(3): 142-147.##14. Darvishi. M, Hajiparvaneh R, Mohammadi M, et al. Barriers and motivators factors effecting influenza vaccination uptake among healthcare workers. Medical Sciences. 2017; 27 (3): 217-221.##15. Canning HS, Phillips J, Allsup S. Health care worker beliefs about influenza vaccine and reasons for non-vaccination-a cross-sectional survey. Journal of Clinical Nursing. 2005; 14(8): 922-925.##16. Clark SJ, Cowan AE, Wortley PM. Influenza vaccination attitudes and practices among US registered nurses. American Journal of Infection Control. 2009; 37(7): 551-556.##17. Lee PH, Cowling BJ, Yang L. Seasonal influenza vaccination among Chinese health care workers. American Journal of Infection Control. 2017; 45(5): 575-578.##18. Zhang J, While A, Norman I. Seasonal influenza vaccination knowledge, risk perception, health beliefs and vaccination behaviours of nurses. Epidemiology & Infection. 2012; 140(9): 1569-1577.##19. Cihan FG, Durmaz FG, Odabas D, et al. Attitudes toward and factors affecting influenza vaccination among physicians and nurses of a tertiary-care hospital in the Central Anatolia region of Turkey. Postgraduate Medicine. 2013; 124(6): 117-123.##20. Black CL, Yue X, Ball SW, et al. Influenza vaccination coverage among health care personnel-United States, 2014-15 influenza season. Morbidity and Mortality Weekly Report. 2015; 64(36): 993-999.##21. Imtiaz MA, Budnick LD, Berman AR. Influenza immunization among resident physicians in an urban teaching hospital. American Journal of Infection Control. 2016; 44(4): 491-493.##22. Khazaeipour Z, Ranjbarnovin N, Hoseini N. Influenza immunization rates, knowledge, attitudes and practices of health care workers in Iran. The Journal of Infection in Developing Countries. 2010; 4(10): 636-644.## ##

The Impact of Emotion-focused Therapy on Anxiety and Depression among Female-Headed Households in Imam Khomeini Relief Committee تاثیر درمان هیجان مدار بر اضطراب و افسردگی زنان سرپرست خانوار تحت پوشش کمیته امداد امام خمینی (ره) شهرستان یزد در سال 1395 2 1 مقدمه:زن سرپرست خانوار، یک واقعیت اجتماعی است که امروز در تمام جوامع به چشم می خورد و به دلایل مختلف به وجود می آید. این زنان، از آسیب پذیرترین افراد جامعه هستند و از آنجا که این قشر درجاتی از پریشانی هیجانی، نشانه های عمومی اضطراب و افسردگی را تجربه می کنند، این مطالعه با هدف اثربخشی درمان هیجان مدار بر اضطراب و افسردگی زنان سرپرست خانوار انجام شد. روش تحقیق: این مطالعه یک پژوهش نیمه تجربی و با طرح پیش آزمون- پس آزمون و گروه آزمایش و کنترل است که بر روی 30 نفر از زنان سرپرست خانوار تحت پوشش کمیته امداد شهرستان یزد بصورت تصادفی در سال 1395 انجام گردید. پرسشنامه های مورد بررسی در این پژوهش شامل اضطراب و افسردگی بک می باشد. در نهایت، داده های جمع اوری شده با استفاده از نرم افزار spss (نسخه 20) مورد تجزیه و تحلیل قرار گرفته است. یافته ها: نتایج نشان داد که روش درمان هیجان مدار توانسته است میزان اضطراب زنان سرپرست خانوار را کاهش دهد. همچنین اندازه اثر برابر با 522/0 گزارش شده که نشان میدهد 52 درصد از تغییرات واریانس ناشی از متغیر مستقل می باشد. همچنین روش درمان هیجان مدار توانسته است میزان افسردگی زنان سرپرست خانوار را کاهش دهد. همچنین اندازه اثر برابر با 734/0 گزارش شده که نشان میدهد 73 درصد از تغییرات واریانس ناشی از متغیر مستقل می باشد. بنابراین می توان نشان داد که روش درمانی هیجان مدار بر اضطراب و افسردگی زنان سرپرست اثر معناداری دارد. (001/0>p) نتیجه گیری: مطابق با نتایج به دست آمده از مطالعه حاضر، مدل چند متغیری تحلیل کوواریانس پژوهش حاضر بیانگر آن است که تغییرات ایجاد شده در گروه ها می تواند در اثر مداخله ی ایجاد شده باشد. از این رو می توان نتیجه گرفت که روش درمانی هیجان مدار بر اضطراب و افسردگی زنان سرپرست موثر بود. بنابراین روش درمانی هیجان مدار می تواند بر کاهش اضطراب و افسردگی زن سرپرست خانوار مورد استفاده قرار گیرد. 2 Introduction: The female-headed householdsare the most vulnerable members of society and since this population statum experiences a degree of emotional distress, the common signs and symptoms of anxiety and depression, Emotion-focused therapy, an empirically supported, neo-humanistic approach that integrates and updates person-centered, Gestalt, and existential therapy with a focus on emotional processing processes, has received condiferable ecperimental support. Methods: the aim of this study was to investigate the effect of emotion-focused therapy on the anxiety and depression of female-headed households. Results: The results indicated that the emotion-focused therapy was effective on anxiety and depression among female- headed households (P <0.001). It was also observed that emotion-focused therapy can be used to reduce anxiety and depression. Conclusion: research was carried out by adopting a semi-experimental method and was administered through a pre-test post-test control group design. The statistical population consisted of all female-headed households in Imam Khomeini Relief Committee of Yazd in 2016. Among women who agreed to participate in the study (ranging from 25 to 50 years old), a number of women who gained a high score in the Beck Anxiety and Depression Inventory were selected by convenient sampling method. Then, 30 subjects were selected randomly and were assigned into two experimental groups (n=15) and a control group (n=15). This study employed instrument along with sociological information of subjects. The data were analyzed using covariance analysis. 173 182 2018/06/102018/03/252018/05/112018/05/212018/09/92017/11/11 1396/8/20 2018/09/262018/09/262018/09/262018/09/262018/09/92018/03/26 1397/1/6 مرجان خسروی اصل Marjan Khosravi Asl Clinical Psychology, Islamic Azad University, Yazd Branch, Yazd, Iran Iran ma58.kh@gmail.com منصوره نصیریان Mansoureh Nasirian Psychiatrist Researcher of Department of Pscychiatry Shahid Sadoughi Medical University, Yazd, Iran Iran علیرضا بخشایش Alireza Bakhshayesh Clinical Psychology, Faculty of Psychology and Educational Sciences, Yazd University, Yazd, Iran Iran Emotion-Focused Ttherapy Anxiety Depression Family Characteristics درمان هیجان مدار اضطراب افسردگی خصوصیات خانوادگی 1. Shafiabadi A, GholamhossinGhashghayi F. Effectiveness of reality group counseling therapy and feminist therapy on the identity of woman households. Quarterly Woman in Development and Politics. 2011; 9(4): 93-113. [Persian]##2. Khosravi Z. Social psychological trauma of female-headed households. Journal of Human Sciences, Alzahra University. 2001; 24(39): 71-94. [ Persian]##3. Saberi MJ. Take a look at the Government's approach towards female-headed households - are supported by sponsors who need. Available at: URL: http://www.persianpersia.com/social/sdetails.php? articleid= 2503 & parentid = 132 &catid=135, Accessed Sep 15, 2018. [ Persian]##4. Frozan Setare A. Indicators of human poverty in female-headed households receiving service plans from the State Welfare Organization. Tehran Welfare Organization. 2000##5. Khosravi Z. Problems, emotional, mental, social and women headed households. Center for Women's Participation presidency.1999. [Persian]##6. Bakhtiari A, Mohebi S. Government and female-headed households. Journal of Women's Cultural and Social Council. 2006; (34); 67-110. [Persian]##7. Elliott R, Greenberg LS. The essence of process-experiential emotions- focused therapy. American Journal of Psychotherapy. 2007; 61(3): 241-254.##8. Greenberg LS, Korman LM, Paivio SC. Emotion in humanistic psychotherapy. In: Cain DJ, editor. Humanistic psychotherapies: Handbook of research and practice. Washington, DC, US: American Psychological Association, xxviii; 2002: 499-530.##9. Watson JC, Goldman RN, Greenberg LS. Case studies in emotion -focused treatment of depression: A comparison of good and poor outcome. Washington DC: American Psychological Association; 2007.##10. Pascual-Leone J, Johnson J. Affect, self-motivation, and cognitive development: A dialectical constructivist view. In: Dai DY, Sternberg RJ, editors. Motivation, emotion, and cognition: Integrative perspectives on intellectual functioning and development. Mahwah, New Jersey: Erlbaum Associates; 2004: 197-236. ##11. Paivio SC. Essential processes in emotion – focused therapy. Psychotherapy. 2013; 50(3): 341-345.##12. Bargh JA, Williams LE. On the non-conscious of emotion regulation. In: Gross JJ, editor. Emotion regulation. New York: The Guilford Press; 2007: 429-445. ##13. Bylsma LM, Taylor-Clift A, Rottenberg J. Emotion reactivity to daily events in major and minor depression. Journal of Abnormal Psychology. 2011; 120(1): 155-167.##14. Angus LE, Kagan F. Assessing client self-narrative change in emotion focused therapy of depression: An intensive single case an14alysis. Psychotherapy. 2013; 50(4): 525-534.##15. Kaviani H, Mousavi AS. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran University Medical Journal TUMS Publications. 2008; 66 (2): 136-140.##16. Beck AT, Steer RA. Relationship between the beck anxiety inventory and the hamilton anxiety rating scale with anxious outpatients. Journal of Anxiety Disorders. 1991; 5(3): 213-223.##17. Dabsoon K, Mohammadkhani P. Psychometric characteristics of depression inventory of beck- people with major depression. Journal of Rehabilitation, Special Issue of Mental Illnesses. 2005; 8(29): 80-86. [Persian]##18. Greenberg L, Watson J. Experiential therapy of depression: Differential effects of client-centered relationship conditions and process experiential interventions. Psychotherapy Research. 1998; 8(2): 210-224.##19. Greenberg LJ, Warwar SH, Malcolm WM. Differential effects of emotion-focused therapy and psycho education in facilitating forgiveness and letting go of emotional injuries. Journal of Counseling Psychology. 2008; 55(2):185-196.##20. Angus LE, Greenberg LS. Working with narrative in emotion-focused therapy: Changing stories, healing lives. Washington, DC, US: American Psychological Association; 2011.## ##

Epidemiological Status of Brucellosis in Abadeh County, Fars Province, Iran in 2011-2017 بررسی وضعیت اپیدمیولوژیک تب مالت در شهرستان آباده استان فارس-ایران در فاصله سالهای 1390 تا 1396 2 1 مقدمه:بروسلوزیس یکی از شایعترین بیماریهای زئونوز می باشد که در بسیاری از نقاط جهان، بهداشت و سلامت عمومی و اقتصاد دامی را با مشکلاتی مواجه کرده است. این مطالعه با هدف بررسی وضعیت اپیدمیولوژیک بیماری تب مالت در شهرستان آباده فارس انجام شده است. روش : در این مطالعه مقطعی، اطلاعات دموگرافیک و اپیدمیولوژیک 985 فرد مبتلا به تب مالت که در فاصله سالهای 1390 تا 1396 به مراکز بهداشتی درمانی و مطب های شهرستان آباده مراجعه کرده بودند، مورد بررسی قرار گرفت. برای تجزیه و تحلیل از مدل های آماری توزیع فراوانی، کای دو و تی مستقل با استفاده از نرم افزار SPSS نسخه 25 استفاده شد. میزان معنی داری آزمون ها 0.05 در نظر گرفته شد. نتایج: میزان بروز بیماری در فاصله سالهای 90-96 ، 128.78 در صدهزار نفر جمعیت بود. بیشترین موارد بیماری در بهار و تابستان گزارش شده بود. بیشترین تعداد مبتلایان به ترتیب زنان خانه دار(28.7%)، دامداران(25.4%) و دانش آموزان و دانشجویان (17.8%) بودند. 56 % مبتلایان روستایی بودند. 62.6% مبتلایان سابقه تماس با دام داشتند و پنیر غیرپاستوریزه در 50.2 % مبتلایان، منبع انتقال عفونت به انسان بود. میانگین سنی مبتلایان (19.35)+34.3 سال بود وگروه سنی 34-25 سال، بیشترین تعداد مبتلایان (20.9%) را به خود اختصاص داده است. نسبت ابتلای مردان به زنان یک ونیم برابر بود. نتیجه گیری: با توجه به شیوع بالای بیماری تب مالت در شهرستان آباده باید به گروههای مختلف جمعیت بخصوص افراد در معرض خطر در مورد راههای انتقال بیماری آموزش لازم داده شود. 2 Introduction: Brucellosis is one of the most common zoonotic diseases in many parts of the world, which has made problems for the public health and the livestock economics. The aim of this study was to investigate the epidemiological status of brucellosis disease in Abadeh county, Fars province, Iran. Methods: In this cross-sectional study, the demographic and epidemiologic data of 985 patients with brucellosis who referred to the health centers and clinics of Abadeh county from 2011 to 2017 were evaluated. In order to analyze the data, the frequency distribution, Chi-Square and independent t-test statistical models were used through the SPSS version 25. A significant level of 0.05 was considered. Results: The incidence of the disease in 2011-2017 was 128.78 per 100,000 population. Most cases of the disease were reported in the spring and summer. The highest number of people with the brucellosis consisted of housewives (28.7%), ranchers (25.4%), and students and pupil (17.8%). In addition, 56 percent of the patients were the rural inhabitants. We found that 62.6 percent of the patients had a history of contact with the livestock and non-pasteurized cheese was the source of infection transmission to humans in 50.2 percent of the cases. The mean age of the patients was 34.3 ± (19.35) years and the age group of 25-34 years had the highest number of patients (20.9). which is the prevalence of the disease in men was one and a half times higher than this rate in women. Conclusion: Regarding the high prevalence of brucellosis disease in Abadeh city, training about the ways of disease transmission should be provided to various population groups, especially the individuals who are at risk. 183 191 2018/06/102018/03/252018/05/112018/05/212018/09/92017/11/112018/06/4 1397/3/14 2018/09/262018/09/262018/09/262018/09/262018/09/92018/03/262018/09/26 1397/7/4 احمد کریمی Ahmad karimi Department Biostatics & Epidemiology, School of Public Health, ShahidSadoughi University Of Medical sciences,Yazd, Iran Iran elsavan97@gmail.com بهنام کریمی Behnam karimi Department of Rescue, Abadeh Red Crescent Society, Fars Red Crescent Society, Fars, Iran Iran behnamam84@gmail.com Brucellosis Epidemiology Public Health Incidence Abadeh بروسلوز اپیدمیولوژی بهداشت عمومی بروز آباده 1. Mamani M, Majzoobi MM, Keramat F, et al. Seroprevalence of brucellosis in butchers, veterinarians and slaughterhouse workers in Hamadan, Western Iran. Journal of Research in Health Sciences. 2018; 18(1): 1-5.##2. Singh B, Dhand NK, Gill J. Economic losses occurring due to brucellosis in indian livestock populations. Preventive Veterinary Medicine. 2015; 119(3-4): 211-215.##3. Ebrahimpour S, Youssefi MR, Karimi N, et al. The prevalence of human Brucellosis in Mazandaran province, Iran. African Journal of Microbiology Research. 2012; 6(19): 4090-4094.##4. Atluri VL, Xavier MN, De Jong MF, et al. Interactions of the human pathogenic Brucella species with their hosts. Annual Review of Microbiology. 2011; 65: 523-541.##5. Azizi F, Hatami H, Janghorbani M. Epidemiology and control of common diseases in Iran. 4th. Tehran: Khosravi Publications; 2010. ##6. Shakurnia A, Ghasemzadeh A, Afra M, et al. The seroprevalence of brucellosis among blood donors referred to blood centers of Khuzestan province. Scientific Journal of Iranian Blood Transfusion Organization. 2014; 11(3): 180-189.##7. Hashemi Tabar GH, Jafari A. Preventive and control programs for brucellosis in human and animals. Journal of Zoonoses. 2014; 1(1): 9-30.##8. N Xavier M, A Paixao T, B den Hartigh A, et al. Pathogenesis of brucella spp. The Open Veterinary Science Journal. 2010; 4(1): 109-118.##9. Alavi SM, Motlagh ME. A review of epidemiology, diagnosis and management of brucellosis for general physicians working in the Iranian health network. Jundishapur Journal of Microbiology. 2012; 5(2): 384-387.##10. Zeinali M, Shirzadi M, Hajrasoliha H. A guide to combat Brucellosis. 2th ed. Tehran: Raz Nahan Publications; 2012. p: 50.##11. Pappas G. The changing Brucella ecology: novel reservoirs, new threats. International Journal of Antimicrobial Agents. 2010; 36(Suppl 1): S8-S11.##12. B Lopes L, Nicolino R, PA Haddad J. Brucellosis-risk factors and prevalence: a review. The Open Veterinary Science Journal. 2010; 4(1): 72-84.##13. Gooya MM, Nabavi M, Zeinali M, et al. National guideline for Brucellosis control. Ministry of Health and Medical Education of Iran. 2012.##14. Dubie T, Adugna M, Sisay T, et al. The economic and public health significance of brucellosis. Global Research Journal of Public Health and Epidemiology. 2014; 1(7): 054-64.##15. Haileselassie M, Kalayou S, Kyule M, et al. Effect of Brucella infection on reproduction conditions of female breeding cattle and its public health significance in Western Tigray, northern Ethiopia. Veterinary Medicine International. 2011; 354943:1-7.##16. Seleem MN, Boyle SM, Sriranganathan N. Brucellosis: a re-emerging zoonosis. Veterinary Microbiology. 2010; 140(3-4): 392-398.##17. Rubach MP, Halliday JE, Cleaveland S, et al. Brucellosis in low-income and middle-income countries. Current Opinion in Infectious Diseases. 2013; 26(5): 404.##18. Dean AS, Crump L, Greter H, et al. Global burden of human brucellosis: a systematic review of disease frequency. PLoS Neglected Tropical Diseases. 2012; 6(10): e1865.##19. Pappas G, Papadimitriou P, Akritidis N, et al. The new global map of human brucellosis. The Lancet Infectious Diseases. 2006; 6(2): 91-99.##20. Farahani S, Shahmohamadi S, Navidi I, et al. An investigation of the epidemiology of brucellosis in Arak City, Iran,(2001-2010). Arak Medical University Journal. 2012; 14(6): 40-48.##21. Akhvlediani T, Clark DV, Chubabria G, et al. The changing pattern of human brucellosis: clinical manifestations, epidemiology, and treatment outcomes over three decades in Georgia. BMC Infectious Diseases. 2010; 10(1): 346.##22. Kassiri H, Amani H, Lotfi M. Epidemiological, laboratory, diagnostic and public health aspects of human Brucellosis in Western Iran. Asian Pacific Journal of Tropical Biomedicine. 2013; 3(8): 589-594.##23. Hadadi A, Rasoulinezhad M, Afhami S, et al. Epidemiological, clinical, para clinical aspects of brucellosis in Imam Khomeini and Sina Hospital of Tehran (1998-2005). Journal of Kermanshah University of Medical Sciences. 2006; 10(3): 242-251.##24. Bosilkovski M, Krteva L, Dimzova M, et al. Human brucellosis in Macedonia–10 years of clinical experience in endemic region. Croatian Medical Journal. 2010; 51(4): 327-336.##25. Khazaei S, Shojaeian M, Zamani R, et al. Epidemiology and risk factors of childhood brucellosis in West of Iran. International Journal of Pediatrics. 2016; 4(7): 2099-2104.##26. Makita K, Fèvre EM, Waiswa C, et al. Spatial epidemiology of hospital-diagnosed brucellosis in Kampala, Uganda. International Journal of Health Geographics. 2011; 10(1): 52.##27. Ayatollahi J, Dehghanpour Farashah A, Vakili M, et al. Frequency of seropositive people for brucellosis in Yazd. Infection, Epidemiology and Microbiology. 2017; 3(1): 16-18.##28. Hamzavi Y, Khademi N, Zadeh MMG, et al. Epidemiology of malt fever in Kermanshah province in 2011. Journal of Kermanshah University of Medical Sciences. 2014; 18(2): 114-121.##29. Moradi G, Kanani S, Majidpour M, et al. Epidemiological status survey of 3880 case of brucellosis in Kurdistan. Iranian Journal of Infectious Diseases and Tropical Medicine. 2006; 11(33): 27-33. [Persian]##30. Alsoghair MI. Epidemiological characteristics of human brucellosis in Al-Qassim region, Saudi Arabia, between 2010 and 2014. International Journal of Community Medicine and Public Health. 2017; 3(2): 397-402.##31. Ramezani Avval Riabi H, Razmara H. Epidemiological feature of the human brucellosis prevalence in people in southern cities of Khorasan Razavi, Iran. Zahedan Journal of Research in Medical Sciences. 2017; 19(4): e7911.##32. Abdelkader A, Reda BA, Karima G. Prevalence of human brucellosis in the southern Zone of Sidi-Bel-Abbes, Algeria. Archives of Clinical and Medical Case Reports. 2018; 2(2): 56-64.##33. Pakzad R, Barati M, Moludi J, et al. Epidemiology of brucellosis in the North and North-West Iran. Paramedical Sciences and Military Health. 2016; 11(1): 17-23.## ##

The Effectiveness of Problem-Focused Coping Strategies Training on Quality of Life in Pregnant Women with Genetic Risk of Fetal Abnormalities اثربخشی آموزش مقابله مسئله‌مدار بر کیفیت زندگی زنان باردار دارای ریسک نابهنجاری‌های ژنتیکی بر جنین 2 1 مقدمه: ناهنجاری ها و اختلالات ژنتیکی در جنین از مهمترین رویداد های آسیب زا برای مادران می باشد که موجب ناراحتی و استرس بسیار زیادی می گردد. پژوهش حاضر با هدف تعیین اثربخشی آموزش مقابله مسئله مدار بر کیفیت زندگی زنان باردار دارای ریسک ناهنجاریهای ژنتیکی در جنین صورت گرفته است. روش: تحقیق حاضر از لحاظ روش ، آزمایشی از نوع کارآزمایی بالینی با طرح پیش آزمون پس آزمون با گروه کنترل است. بعد از انتخاب تصادفیِ 30 نفر از زنان باردار دارایِ ریسک ناهنجاری های ژنتیکیِ جنین و اجراء پیش آزمون کیفیت زندگی،این افراد به طور تصادفی به دو گروه آزمایش و کنترل تقسیم شدند، سپس گروه آزمایش، طی دوازده جلسه( هفته ای یکبار،به مدت 60 دقیقه ) تحت آموزش مقابله مسئله مدار قرار گرفت و پس از اتمام آموزش، از هردوگروه، پس آزمون کیفیت زندگی به عمل آمد و تجزیه و تحلیل داده ها با استفاده از شاخص آمار توصیفی و آزمون تحلیل کوواریانس انجام شد. یافته ها: یافته ها حاکی از آن بود که نمرات کیفیت زندگی مادران در پس آزمون نسبت به پیش آزمون افزایش داشته و به طور معنی داری متفاوت است. بعد از مداخله، افزایش معنی داری در ابعاد مختلف کیفیت زندگی شامل عملکرد جسمانی، محدودیت جسمانی، کارکرد اجتماعی، تحمل درد، سرزندگی و نشاط، محدودیت عاطفی و هیجانی، سلامت عمومی و سلامت روان در گروه آزمایش نسبت به گروه کنترل بوده است (F=67.48, P<0.01). نتیجه گیری: می توان نتیجه گرفت که آموزش مقابله مسئله مدار بر کیفیت زندگی زنان باردار دارای ریسک ناهنجاری های ژنتیکی جنین از لحاظ آماری موثر است. علاوه بر این، می توان نتیجه گرفت که آموزش مقابله مسئله مدار می تواند به عنوان یک رویکرد آموزشی موثر برای جلوگیری از خطرات استرس در زنان باردار دارای ریسک ناهنجاریهای ژنتیکی در جنین به کار رود. 2 Introduction: Abnormalities and genetic disorders in the fetus are one of the most important traumatic events for mothers, which can cause discomfort and stress. This study aimed to determine the effectiveness of training based on problem-focused coping strategies on quality of life (QOL) in pregnant women with genetic risk of fetal abnormality. Methods: The current study is a semi-experimental method with a pretest-posttest design with a control group. After randomly selected of 30 pregnant women with genetic risk of fetal abnormalities, a pretest of the quality of life Questionnaire was done and they randomly divided into two groups (experimental and control). Then the experimental group during the 12th sessions (once a week, for 60 minutes) were trained coping strategies and after completion of training, from both groups, QOL post-test was performed and analyzing the data using the descriptive statistical index and covariance analysis test. Results: Results showed that Mothers' QOL scores increased significantly in post-test compared to pre-test, and significantly different. After the intervention, there was a significant decrease in various dimensions of QOL including anxiety, depression and physical signs and an improvement of social function and mental health in the intervention group compared to the control (F=67.48, P<0.01). Conclusion: It can be concluded that coping strategies training on QOL pregnant women with genetic risk of fetal abnormality is statistically significant effectiveness. In addition, it can be deduced that training of problem-focused coping strategies can serve as an effective instructive approach to prevent risks of stress among pregnant women with genetic risk of fetal abnormality. 192 199 2018/06/102018/03/252018/05/112018/05/212018/09/92017/11/112018/06/42018/04/30 1397/2/10 2018/09/262018/09/262018/09/262018/09/262018/09/92018/03/262018/09/262018/09/26 1397/7/4 سحر جعفرزاده راستین Sahar Jafarzadeh Rastin Department of Psychology, School of Humanities, Islamic Azad University, Tehran, Iran Iran saharrastin49@gmail.com الهه خوشنویس Elaheh Khoshnevis Department of Psychology, School of Humanities, Islamic Azad University, Tehran, Iran Iran elaheh.khoshnevis@gmail.com سید محمود میرزمانی بافقی Seyed Mahmood Mirzamani Bafghi Department of Psychology, School of Humanities, Islamic Azad University, Tehran, Iran Iran Mirzamani2003@gmail.com Congenital Abnormalities Pregnant Women Problem-Focused Coping Strategies Quality of Life مقابله مسئله مدار کیفیت زندگی زنان باردار ناهنجاری های ژنتیکی 1. Ghorbani M, Dolatian M, Shams J, et al. Anxiety, post-traumatic stress disorder and social supports among parents of premature and full-term infants. Iranian Red Crescent Medical Journal. 2014; 16(3): e13461.##2. Alagheband M, Aghayousefi AR, Kamali M, et al. Effect of coping-therapy on mental health of mothers with genetic and non-genetic mentally retarded children. Journal of Shahid Sadoughi University of Medical Sciences. 2011; 19(1): 104-113. [Persian]##3. Geraedts J. Healthy children without fear: Reproductive options for patients or couples carrying inherited diseases. EMBO reports. 2017; 18(5): 666-669.##4. Nazmiye F, Sheikhha M, Kamali Zarch M. The effects of coping therapy on general health of pregnant women with high risk of genetic abnormalities in their fetus. Journal of Shahid Sadoughi University of Medical Sciences. 2016; 24(8): 607-617. [Persian]##5. Turnpenny P, Ellard S. Emery's elements of medical genetics. 15th ed. Philadelphia: Elsevier/Churchill Livingstone; 2017.##6. Mahdieh N, Rabbani B. An overview of mutation detection methods in genetic Disorders. Iranian Journal of Pediatrics. 2013; 23(4): 375-388.##7. Faramarzi S, Homaie R, Izadi R. Efficacy of cognitive behavioral group training of life skills on mental health of women with handicapped spouses. Social Welfare Quarterly. 2011; 11(40): 217-235. [Persian]##8. Santa Cruz J. Why a growing number of U.S. mothers are turning to midwives, rather than physicians, for prenatal care, labor, and delivery. Available at: URL: https://www.theatlantic.com/health/archive/2015/06/midwives-are-making-a-comeback/395456/. Accessed Sep 16, 2018.##9. Hinton L, Locock L, Knight M. Support for mothers and their families after life-threatening illness in pregnancy and childbirth: a qualitative study in primary care. The British Journal of General Practice. 2015; 65(638), e563–e569##10. Campbell-sills L, Cohan SL, Stein MB. 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