Application of e-health in the Corona virus's (COVID-19) pandemic کاربرد سلامت الکترونیک در بیماری همه گیر ویروس کرونا ((COVID-19 2 1 چکیده ندارد. 2 there is no abstract 66 68 2020/06/6 1399/3/17 2020/06/20 1399/3/31 الهام حسینی Elham Hoseini 1. Department of Health Technology Assessment, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran فروزان زارع Forouzan Zare 1. Department of Health Technology Assessment, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Keshvardoost S, Bahaadinbeigy K, Fatehi F. Role of telehealth in the management of COVID-19: lessons learned from previous SARS, MERS, and Ebola outbreaks. Telemedicine and e-Health. 2020.##Yin X, Wang J, Feng J, et al. The Impact of the Corona Virus Disease 2019 Outbreak on Chinese Residents' Mental Health. Available at SSRN 3556680. 2020.##Mabillard, S. COVID-19: HOW DIGITAL HELPS TO COUNTER THE EPIDEMIC? ; Available at URL: https://www. alpict. com/ coronavirus- how- digital- helps- to- counter- the-epidemic/.##ERNs and COVID-19. Available at: URL:. https://ec.europa.eu/health/ehealth/covid-19_en.##eHealth and COVID-19. Available at:URL: https://ec.europa.eu/health/ehealth/covid-19_en##Eysenbach G. What is e-Health? Journal of Medical Internet Research. 2001; 3(2): e20.##Krausz, M., et al., Emergency Response to COVID-19 in Canada: Platform Development and Implementation for eHealth in Crisis Management. JMIR Public Health and Surveillance. 2020; 6(2): e18995.##eHealth Network, Mobile applications to support contact tracing in the EU's fight against COVID-19 Common EU Toolbox for Member States.2020 .Available at:URL:https://ec.europa.eu/ health/ sites/ health/ files/ehealth/docs/covid19_apps_ en. pdf.##Keshvardoost S, Bahaadinbeigy K, Fatehi F. Role of telehealth in the management of COVID-19: lessons learned from previous SARS, MERS, and Ebola outbreaks. Telemedicine and e-Health. 2020.##Yin X, Wang J, Feng J, et al. The Impact of the Corona Virus Disease 2019 Outbreak on Chinese Residents' Mental Health. Available at SSRN 3556680. 2020.##Mabillard, S. COVID-19: HOW DIGITAL HELPS TO COUNTER THE EPIDEMIC? ; Available at URL: https://www. alpict. com/ coronavirus- how- digital- helps- to- counter- the-epidemic/.##ERNs and COVID-19. Available at: URL:. https://ec.europa.eu/health/ehealth/covid-19_en.##eHealth and COVID-19. Available at:URL: https://ec.europa.eu/health/ehealth/covid-19_en##Eysenbach G. What is e-Health? Journal of Medical Internet Research. 2001; 3(2): e20.##Krausz, M., et al., Emergency Response to COVID-19 in Canada: Platform Development and Implementation for eHealth in Crisis Management. JMIR Public Health and Surveillance. 2020; 6(2): e18995.##eHealth Network, Mobile applications to support contact tracing in the EU's fight against COVID-19 Common EU Toolbox for Member States.2020 .Available at:URL:https://ec.europa.eu/ health/ sites/ health/ files/ehealth/docs/covid19_apps_ en. pdf.##Keshvardoost S, Bahaadinbeigy K, Fatehi F. Role of telehealth in the management of COVID-19: lessons learned from previous SARS, MERS, and Ebola outbreaks. Telemedicine and e-Health. 2020.##Yin X, Wang J, Feng J, et al. The Impact of the Corona Virus Disease 2019 Outbreak on Chinese Residents' Mental Health. Available at SSRN 3556680. 2020.##Mabillard, S. COVID-19: HOW DIGITAL HELPS TO COUNTER THE EPIDEMIC? ; Available at URL: https://www. alpict. com/ coronavirus- how- digital- helps- to- counter- the-epidemic/.##ERNs and COVID-19. Available at: URL:. https://ec.europa.eu/health/ehealth/covid-19_en.##eHealth and COVID-19. Available at:URL: https://ec.europa.eu/health/ehealth/covid-19_en##Eysenbach G. What is e-Health? Journal of Medical Internet Research. 2001; 3(2): e20.##Krausz, M., et al., Emergency Response to COVID-19 in Canada: Platform Development and Implementation for eHealth in Crisis Management. JMIR Public Health and Surveillance. 2020; 6(2): e18995.##eHealth Network, Mobile applications to support contact tracing in the EU's fight against COVID-19 Common EU Toolbox for Member States.2020 .Available at:URL:https://ec.europa.eu/ health/ sites/ health/ files/ehealth/docs/covid19_apps_ en. pdf.## ##

Osteoporosis Risk Prediction Using Data Mining Algorithms پیش بینی خطر ابتلا به پوکی استخوان با استفاده از روش الگوریتم های داده کاوی 2 1 چکیده: مقدمه: پوکی استخوان بیماری است که با کاهش تراکم استخوان و از دست رفتن کیفیت ریزساختار استخوان شناخته می شود که خود منجر به افزایش خطر شکستگی می گردد. این بیماری یکی از دلایل مهم ناتوانی و مرگ در افراد مسن است. هدف این تحقیق تعیین عوامل تاثیرگذار در بروز پوکی استخوان و نیز ارائه مدل پیش بینی کننده ای برای تشخیص این بیماری، به منظور افزایش سرعت تشخیص و نیز کاهش هزینه های تشخیصی می باشد. روش:اطلاعات فردی شامل اطلاعات شخصی ، شیوه زندگی و اطلاعات بیماری مورد بررسی قرار گرفت. یک مدل جدید بر اساس فرآیند استاندارد صنعت متقابل(CRISP) ارائه شده است. در این مقاله از الگوریتم های ماشین بردار پشتیبان یا (SVM)Support vector machines و بیزین ساده درخت افزودنی یا Tree Augmented Naive Bayes (TAN) استفاده شده است.Clementine12 ابزار داده کاوی مورد استفاده در این تحقیق است. نتایج: برخی از ویژگی ها موثر بر این بیماری شناسایی شدند. قوانینی استخراج گردید که می توانند به عنوان الگویی برای پیش بینی وضعیت بیماران استفاده شوند. دقت طبقه بندی برای ماشین بردار پشتیبان 88/39 درصد و برای بیزین ساده درخت افزودنی 91/29 درصد می باشد. دقت الگوریتم TAN در مقایسه با سایر روشها از دقت بالاتری برخوردار بوده است. نتیجه گیری: بیشترین عوامل تاثیرگذار بر پوکی استخوان شناسایی شده اند و می توان با توجه به عوامل به دست آمده برای یک نمونه ی جدید با ویژگی های مشخص احتمال ابتلای فرد به پوکی استخوان را پیش بینی کرد. 2 Abstract Introduction: Osteoporosis is a disease that reduces bone density and loses the quality of bone microstructure leading to an increased risk of fractures. It is one of the major causes of inability and death in elderly people. The current study aims at determining the factors influencing the incidence of osteoporosis and providing a predictive model for the disease diagnosis to increase the diagnostic speed and reduce diagnostic costs. Methods: An Individual's data including personal information, lifestyle, and disease information were reviewed. A new model has been presented based on the Cross-Industry Standard Process CRISP methodology. Besides, Support Vector Machine (SVM) and Bayes methods (Tree Augmented Naïve Bayes (TAN)) and Clementine12 have been used as data mining tools. Results: Some features have been detected to affect this disease. The rules have been extracted that can be used as a pattern for the prediction of the patients' status. Classification precision was calculated to be 88.39% for SVM, and 91.29% for (TAN) when the precision of TAN is higher comparing to other methods. Conclusion: The most effective factors concerning osteoporosis are detected and can be used for a new sample with defined characteristics to predict the possibility of osteoporosis in a person. 69 80 2020/06/62019/02/16 1397/11/27 2020/06/202020/06/29 1399/4/9 عفت جبارپور efat jabarpour 1. Department of Industrial Engineering, School of Engineering, Payame Noor University, Tehran Shomal Branch, Tehran,Iran Iran ejabarpoor@yahoo.com امین عابدینی amin Abedini 2. Department of Computer Engineering, School of Electrical and Computer, Engineering Islamic Azad University, Qazvin Branch, Iran Iran aminabedini.ai@gmail.com عباسعلی کشتکار abbasali keshtkar 3. Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Iran abkeshtkar@gmail.com Osteoporosis Data mining Support vector machine Bayes network پوکی استخوان روش بردار ماشین روش بیزین داده کاوی Camacho PM, Petak SM, Binkley N, et al. 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Relationship between Demographic Characteristics, Depression and Insomnia with Restless Legs Syndrome: a Case-Control Study of Adults Aged 17-70 Years in Yazd ارتباط ویژگی‌های جمعیت شناختی، افسردگی و بی‌خوابی با سندرم پاهای بی‌قرار: یک مطالعۀ مورد-شاهدی از بزرگسالان 17 تا 70 سال یزد 2 1 مقدمه: سندرم پاهای بیقرار یک اختلال حرکتی- نرولوژیک است که اغلب بیماران در طول خواب تمایل شدیدی به تکان دادن پاهای خود داشته و آن را احساس ناخوشایندی توصیف میکنند. هدف از این پژوهش تعیین شیوع سندرم پاهای بیقرار، ارتباط آن با ویژگیهای جمعیت شناختی، افسردگی و بیخوابی و مقایسه متغیرهای نامبرده در دو گروه با و بدون سندرم پاهای بیقرار بود. روش: این پژوهش یک مطالعۀ مورد-شاهدی تحلیلی بود. نمونۀ پژوهش شامل 429 بزرگسال 17 تا 70 ساله بود که به کلنیکهای روانپزشکی و عصب روانشناختی یزد (ایران) در سال 1398 مراجعه کرده بودند. شرکت کنندگان با روش نمونه گیری خوشه ای انتخاب شدند. ابزار پژوهش شامل فرم جمعیت شناختی، پرسشنامه افسردگی بک (BDI-II)، شاخص شدت بیخوابی (ISI) و پرسشنامۀ بینالمللی سندرم پاهای بیقرار (IRLSQ) بود. داده ها نیز با استفاده از نرم افزار SPSS-21 و روش آماری خی دو، ضریب همبستگی پیرسون، آزمون t مستقل و رگرسیون خطی مورد تحلیل قرار گرفته شدند. سطح معناداری در حد 0.05 بود. یافته ها: میانگین و انحراف استاندارد سنی افراد شرکتکننده در پژوهش 10.82± 34.43 بود. همچنین میانگین و انحراف استاندارد سنی گروه دارای سندرم پاهای بیقرار 10/95±36/07 و گروه بدون سندرم پاهای بیقرار 10.75±33.92 بود. میزان شیوع سندرم پاهای بیقرار در بزرگسالان 23.5% (101=n) بود که میزان شیوع در زنان 32% (66=n) و در مردان 28.7% (35=n) بود. نتایج t-test نشان داد بیماران سندرم پاهای بیقرار از میزان افسردگی و بیخوابی شدیدتری نسبت به افراد بدون سندرم پاهای بیقرار برخوردار هستند (0.05> p). رگرسیون خطی چندگانه نشان داد که متغیرهای بیخوابی (0.36=β)، سن (0.13=β) و افسردگی (0.15=β) بیشترین توان پیشبینی سندرم پاهای بیقرار را دارند. نتیجه گیری: نسبت شیوع سندرم پاهای بیقرار در بزرگسالان ایرانی بالا است. بیخوابی شدید، داشتن خلق افسرده و سن بالا در پیشبینی این بیماری جزو عوامل مهمی در نظر گرفته میشوند. این موضوع توجه به تشخیص زودهنگام، پیشگیری و درمان این اختلال را در بزرگسالان الزام میدارد. 2 Introduction: Restless legs syndrome (RLS) is a neurological-motor disorder in which most patients tend to shake their legs during sleep and describe it as an unpleasant feeling. The aims of this study were to determine the prevalence of RLS, its relationship with demographic characteristics, depression, and insomnia and comparison of the mentioned variables in the group with and without RLS. Methods: This was a case-control analytic study. The sample consisted of 429 adults aged 17-70 years who had referred all the psychiatric and neurological clinics of Yazd (center of Iran) in 2019. Participants were selected by cluster sampling method. Research tools included a demographic questionnaire, the Beck Depression Inventory (BDI-II), Insomnia Severity Index (ISI), and an International Restless Legs Syndrome Questionnaire (IRLSQ). The data were analyzed by SPSS-21, chi-square, Pearson correlation coefficient, independent t-test, and linear regression. Significant level was considered 0.05. Results: The mean and standard deviation of the age of participants was 34.43± 10.82. Furthermore, the mean and standard deviation of the age group with RLS was 36.07± 10.95 while in group without RLS was 33.92± 10.75. Prevalence of RLS in adults was 23.5% (n= 101), in women was 32% (n= 66) and in men was 28.7% (n= 35). The t-test showed patients with RLS had a higher degree of depression and insomnia than those without RLS (p<0.05). Multiple linear regression also showed that insomnia (β= 0.36), age (β= 0.13), and depression (β= 0.15) had a significant effect on RLS score. Conclusion: The prevalence of RLS among adults in Yazd is high. Severe insomnia, depressed mood, and aging are considered as important factors in predicting this disease. According to what was mentioned early detection, prevention, and treatment of this disorder in adults is necessary. 81 89 2020/06/62019/02/162019/12/26 1398/10/5 2020/06/202020/06/292020/06/29 1399/4/9 محمد حسین سربی Mohammad Hossein Sorbi Faculty of Humanities, Urmia University, Urmia, Iran Iran sorbih@gmail.com علی عیسی زادگان Ali Issazadegan Faculty of Humanities, Urmia University, Urmia, Iran Iran a.esazade@gmail.com اسماعیل سلیمانی Esmaeil Soleimani Faculty of Humanities, Urmia University, Urmia, Iran Iran soleymany.psy@gmail.com حمید میرحسینی Hamid Mirhosseini Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical sciences, Yazd, Iran Iran mirhoseini.h@gmail.com Restless legs syndrome Depression Insomnia Age distribution Body Mass Index سندرم پاهای بی قرار افسردگی بی‌خوابی توزیع سنی شاخص تودۀ بدنی 1. Alidosti M, Hemate Z, Reisi M. 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Investigating the association between Restless Leg Syndrome and depression in elderly. Iranian Journal of Rehabilitation Research in Nursing. 2016;2(3):18-26.[Persian]##Mucsi I, Molnar MZ, Ambrus C, et al. Restless legs syndrome, insomnia and quality of life in patients on maintenance dialysis. Nephrology Dialysis Transplantation. 2005; 20(3):571-577.##Al-Arabi S. Quality of life: subjective descriptions of challenges to patients with end stage renal disease. Nephrology Nursing Journal. 2006;33(3):285-93.##Terzi H, Terzi R, Zeybek B, et al. Restless legs syndrome is related to obstructive sleep apnea symptoms during pregnancy. Sleep and Breathing. 2015;19(1):73-78.##Gheshlagh RG, Farajzadeh M, Zarei M, et al. The prevalence of restless legs syndrome in patients undergoing hemodialysis: a systematic review and meta-analysis study. Basic and Clinical Neuroscience. 2017;8(2):105-112.##Hosseini H, Safavi M, Fesharaki M. Relationship between Hypertension and Restless Legs Syndrome in Patients with Cardiovascular Diseases. Iranian Journal of Rehabilitation Research in Nursing. 2018;4(3):47-53.##Amiri MH, Bidaki R, Avazbakhsh MH, et al. Prevalence and correlates of restless legs syndrome in chronic renal failure patients undergoing hemodialysis. Koomesh. 2019;21(3):493-498.[Persian]##Jamalnia S. Investigating restless leg syndrome and its severity in nursing students. Nursing development in health. 2018;8(2):25-30.##Hemmati Z, Alidosti M. Frequency of Restless Legs Syndrome in Hemodialysis Patients Referring to Chaharmahal and Bakhtiari Province Hospitals. Journal of Health And Care. 2012;14(4):28-34.[Persian]##Rajabi G, Karjo-Kasmai S. Psychometric properties of a Persian-language version of the beck depression inventory-second edition (BDI-II-Persian). Training Measurement. 2013;3(10):139-157.[Persian]##Chahoud M, Chahine R, Salameh P, et al. Reliability, factor analysis and internal consistency calculation of the Insomnia Severity Index (ISI) in French and in English among Lebanese adolescents. eNeurologicalSci. 2017;7:9-14##Fereshtehnejad SM, Rahmani A, Shafieesabet M, et al. Prevalence and associated comorbidities of restless legs syndrome (RLS): Data from a large population-based door-to-door survey on 19176 adults in Tehran, Iran. PLoS One. 2017;12(2):e0172593.##Koo BB. Restless leg syndrome across the globe: epidemiology of the restless legs syndrome/Willis-Ekbom disease. Sleep Medicine Clinics. 2015;10(3):189-205.##Yilmaz O, Şengül Y, Şengül HS, et al. Investigation of alexithymia and levels of anxiety and depression among patients with restless legs syndrome. Neuropsychiatric Disease and Treatment. 2018;14: 2207-2214.##Theorell-Haglöw J, Miller CB, Bartlett DJ, et al. Gender differences in obstructive sleep apnoea, insomnia and restless legs syndrome in adults-What do we know? A clinical update. Sleep Medicine Reviews. 2018;38:28-38.##Batool-Anwar S, Li Y, De Vito K, et al. Lifestyle factors and risk of restless legs syndrome: prospective cohort study. Journal of Clinical Sleep Medicine. 2016;12(2):187-194.##Ohayon MM, O'Hara R, Vitiello MV. Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep medicine reviews. 2012;16(4):283-295.##Innes KE, Selfe TK, Agarwal P. Prevalence of restless legs syndrome in North American and Western European populations: a systematic review. Sleep Medicine. 2011;12(7):623-634.##Habibzadeh H, Lazari N, Ghanei GR. Relationship between restless legs syndrome and sleep quality in hemodialysis patients. Iranian Journal of Medical - Surgical Nursing. 2013;2(1-2):57-62.[Persian]##Association D-AP. Diagnostic and statistical manual of mental disorders. Arlington: American Psychiatric Publishing. 2013.##Saraji NZ, Hami M, Boostani R, et al. Restless leg syndrome in chronic hemodialysis patients in Mashhad hemodialysis centers. Journal of Renal Injury Prevention. 2017;6(2):137-141.##Abedi P, Bagheri R, Qorbani M, et al. Is there a relationship between restless legs syndrome and medical problems in pregnant women? A cross-sectional study in Iran. Acta Neurologica Belgica. 2018:1-6.##1. Alidosti M, Hemate Z, Reisi M. Relationship between the quality of sleep and restless legs syndrome among the hemodialysis patients admitted to dialysis centers in Chaharmahal and Bakhtiari during 2011. Feyz Journal of Kashan University of Medical Sciences. 2013;17(1):85-90.[Persian]##Leschziner GD. Restless legs syndrome. InSleep Disorders in Psychiatric Patients. 2018: 175-188.##Lee HB, Ramsey CM, Spira AP, et al. Comparison of cognitive functioning among individuals with treated restless legs syndrome (RLS), untreated RLS, and no RLS. The Journal of Neuropsychiatry and Clinical Neurosciences. 2014;26(1):87-91.##Comella CL. Treatment of restless legs syndrome. Neurotherapeutics. 2014;11(1):177-187.##Gheshlagh RG, Farajzadeh M, Zarei M, et al. The prevalence of restless legs syndrome in patients undergoing hemodialysis: a systematic review and meta-analysis study. Basic and Clinical Neuroscience. 2017;8(2):105-112.##Farajzadeh M, Hosseini M, Ghanei-Gheshlagh R, et al. Investigating the association between Restless Leg Syndrome and depression in elderly. Iranian Journal of Rehabilitation Research in Nursing. 2016;2(3):18-26.[Persian]##Mucsi I, Molnar MZ, Ambrus C, et al. Restless legs syndrome, insomnia and quality of life in patients on maintenance dialysis. Nephrology Dialysis Transplantation. 2005; 20(3):571-577.##Al-Arabi S. Quality of life: subjective descriptions of challenges to patients with end stage renal disease. Nephrology Nursing Journal. 2006;33(3):285-93.##Terzi H, Terzi R, Zeybek B, et al. Restless legs syndrome is related to obstructive sleep apnea symptoms during pregnancy. Sleep and Breathing. 2015;19(1):73-78.##Gheshlagh RG, Farajzadeh M, Zarei M, et al. The prevalence of restless legs syndrome in patients undergoing hemodialysis: a systematic review and meta-analysis study. Basic and Clinical Neuroscience. 2017;8(2):105-112.##Hosseini H, Safavi M, Fesharaki M. Relationship between Hypertension and Restless Legs Syndrome in Patients with Cardiovascular Diseases. Iranian Journal of Rehabilitation Research in Nursing. 2018;4(3):47-53.##Amiri MH, Bidaki R, Avazbakhsh MH, et al. Prevalence and correlates of restless legs syndrome in chronic renal failure patients undergoing hemodialysis. Koomesh. 2019;21(3):493-498.[Persian]##Jamalnia S. Investigating restless leg syndrome and its severity in nursing students. Nursing development in health. 2018;8(2):25-30.##Hemmati Z, Alidosti M. Frequency of Restless Legs Syndrome in Hemodialysis Patients Referring to Chaharmahal and Bakhtiari Province Hospitals. Journal of Health And Care. 2012;14(4):28-34.[Persian]##Rajabi G, Karjo-Kasmai S. Psychometric properties of a Persian-language version of the beck depression inventory-second edition (BDI-II-Persian). Training Measurement. 2013;3(10):139-157.[Persian]##Chahoud M, Chahine R, Salameh P, et al. Reliability, factor analysis and internal consistency calculation of the Insomnia Severity Index (ISI) in French and in English among Lebanese adolescents. eNeurologicalSci. 2017;7:9-14##Fereshtehnejad SM, Rahmani A, Shafieesabet M, et al. Prevalence and associated comorbidities of restless legs syndrome (RLS): Data from a large population-based door-to-door survey on 19176 adults in Tehran, Iran. PLoS One. 2017;12(2):e0172593.##Koo BB. Restless leg syndrome across the globe: epidemiology of the restless legs syndrome/Willis-Ekbom disease. Sleep Medicine Clinics. 2015;10(3):189-205.##Yilmaz O, Şengül Y, Şengül HS, et al. Investigation of alexithymia and levels of anxiety and depression among patients with restless legs syndrome. Neuropsychiatric Disease and Treatment. 2018;14: 2207-2214.##Theorell-Haglöw J, Miller CB, Bartlett DJ, et al. Gender differences in obstructive sleep apnoea, insomnia and restless legs syndrome in adults-What do we know? A clinical update. Sleep Medicine Reviews. 2018;38:28-38.##Batool-Anwar S, Li Y, De Vito K, et al. Lifestyle factors and risk of restless legs syndrome: prospective cohort study. Journal of Clinical Sleep Medicine. 2016;12(2):187-194.##Ohayon MM, O'Hara R, Vitiello MV. Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep medicine reviews. 2012;16(4):283-295.##Innes KE, Selfe TK, Agarwal P. Prevalence of restless legs syndrome in North American and Western European populations: a systematic review. Sleep Medicine. 2011;12(7):623-634.##Habibzadeh H, Lazari N, Ghanei GR. Relationship between restless legs syndrome and sleep quality in hemodialysis patients. Iranian Journal of Medical - Surgical Nursing. 2013;2(1-2):57-62.[Persian]##Association D-AP. Diagnostic and statistical manual of mental disorders. Arlington: American Psychiatric Publishing. 2013.##Saraji NZ, Hami M, Boostani R, et al. Restless leg syndrome in chronic hemodialysis patients in Mashhad hemodialysis centers. Journal of Renal Injury Prevention. 2017;6(2):137-141.##Abedi P, Bagheri R, Qorbani M, et al. Is there a relationship between restless legs syndrome and medical problems in pregnant women? A cross-sectional study in Iran. Acta Neurologica Belgica. 2018:1-6.## ##

Analysis of Occupational Accidents in the Manufacturing Sector in Semnan Province during 2013-2015 تجزیه و تحلیل حوادث شغلی شرکتهای تولیدی استان سمنان در سال های 1394-1392 2 1 مقدمه: حوادث و آسیب های ناشی ‌از ‌کار از عوامل مهم منجر به مرگ در جهان محسوب می‌شوند. تجزیه و تحلیل حوادث شغلی نقش کلیدی در اقدام های پیشگیرانه دارد. مطالعه حاضر با هدف تعیین فراوانی, انواع و علل حوادث و آسیب های شغلی در صنایع استان سمنان اجرا شده است. مواد و روش ها: طرح مطالعه حاضر پیمایشی و در مقطع زمانی 1394-1392 است. گزارش 721 حادثه در طی بازه مذکور از منابع داده های سازمان تأمین اجتماعی بررسی شده است. در این پژوهش میزان شیوع حوادث در محیط کار تعیین و همچنین ارتباط بین صدمات شغلی با عوامل فردی و عوامل مرتبط با کار بررسی گردید. یافته‌ها: میزان تکرار حوادث سمنان در سال‌های 1392، 1393 و 1394 به ترتیب 1.46 ، 1.54 و 1.40 است. اکثر حوادث سمنان در گروه مردان متأهل با رده‌سنی 45-24 سال و سطح تحصیلات دیپلم و پایین‌تر در نوبت‌کاری صبح به وقوع پیوسته است. بیشترین آمار ثبت‌شده در مورد نوع حادثه، نوع جراحت ایجاد شده و عضو حادثه‌دیده به ترتیب برخورد با اجسام تیز و موانع (%25)، ضربدیدگی (%30 ) و اندام حرکتی فوقانی (%44) است. نتایج نشان می‌دهد که ارتباط معناداری میان نوبت‌کاری و حوادث‌شغلی و همچنین بین نوع حوادث و آسیب های ایجاد شده وجود دارد (0.05>p). نتیجه گیری: اقدامات‌پیشگیرانه حوادث‌شغلی باید بر سنجه‌های نوع و علل‌حوادث وآسیب‌ها متمرکز شود. در این راستا آموزش های لازم برای کارشناسان ایمنی و بهداشت کار با هدف اجرای فرایند تحقیق حادثه در محیط‌کار، گزارش دهی و چگونگی تجزیه و تحلیل حوادث پیشنهاد می گردد. 2 Introduction: Occupational accidents have been regarded as the third cause of mortality around the world. This study examined the rates, types, and causes of occupational accidents in industrial sites. Methods: In a cross-sectional design, 721 accident reports were examined in the manufacturing sites in Semnan which is located in the central part of Iran from 2013 to 2015. This study used the Social Security Organization database on workplace accident investigation reports. Frequency and percentage were used for the prevalence, whereas Chi-Squarewere used to identify the predictors of occupational accidents. SPSS version 21 was used for data analysis and 0.01 was considered as a cutoff for the significant level. Results: Accident Frequency Rates were 1.46, 1.54, and 1.40 in 2013, 2014, and 2015, respectively. Also, the Safe T-score was calculated between +3 and -3. The majority of accidents occurred in males in the age group 24-45, having the educational level of high school diploma or lower. Furthermore, most accidents occurred during the morning shift. Unsafe actions were determined as the major cause of accidents. The maximum reported statistics related to the type of accidents, injuries, and injured organs of the body were hitting sharp edges or obstacles (25%), bruising (30%), and upper limbs (44%). The results indicated a statistically significant relationship between shift work, accident type, inured organs, and injury type ( p =0.001). Conclusion: This study revealed that workers’ behavior as a main contribution to accidents and injuries in the industry. Health and safety training should be designed according to worker duties. 90 99 2020/06/62019/02/162019/12/262020/01/19 1398/10/29 2020/06/202020/06/292020/06/292020/06/29 1399/4/9 فرین فاطمی Farin Fatemi Department of Health in Disasters and Emergencies, Semnan University of Medical Sciences, Semnan, Iran Iran farin.fatemi@gmail.com علیرضا دهدشتی Alireza Dehdashti Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran Iran dehdasht@yahoo.com بشارت زاده عباس Besharat Zadehabbas Department of Occupational Health, Semnan University of Medical Sciences, Semnan, Iran. Iran besharatabbas@gmail.com حسین کاشانی Hossein Kashani Department of Occupational Health , Hamadan University of Medical Sciences, Hamadan, Iran Iran hosseinkashani@gmail.com Occupational accidents Unsafe act Unsafe condition Manufacturing sector Safety indices حوادث شغلی اعمال ناایمن شرایط ناایمن بخش تولید شاخص های ایمنی Melchior C, Zanini RR. Mortality per work accident: A literature mapping. Safety Science. 2019; 114: 72-78.##Ghasempouri SKH, Pourhossein M, Mirmohammadi SM, et al. The Frequency and Pattern of Injuries in Occupational Accident Victims Referred to Sari Legal Medicine Center During Year 2012. Iranian Journal of Forensic Medicine. 2014; 20(3): 127-132. [persian]##Hosseini SSH. Check organizational factors in reducing work-related accidents in the workplace. Business and Society Magazine. 2012; 140: 80-91.[persian].##Nowrouzi-Kia B, Nadesar N, Casole J. Systematic review: Factors related to injuries in small- and medium-sized enterprises. International journal of critical illness and injury science. 2019; 9(2): 57-63.##Cagno E, Micheli GJL, Jacinto C, et al. An interpretive model of occupational safety performance for Small- and Medium-sized Enterprises. International Journal of Industrial Ergonomics. 2014; 44(1): 60-74.##Alali H, Abdel Wahab M, Van Hecke T, et al. Work accident victims: a comparison between non-standard and standard workers in Belgium. International Journal of Occupational and Environmental Health. 2016; 22(2): 99-106.##Van der Klauw M, Hengel KO, Roozeboom MB, et al. Occupational accidents in the Netherlands: incidence, mental harm, and their relationship with psychosocial factors at work. International Journal of Injury Control and Safety Promotion. 2016; 23(1): 79-84.##Lund J, Bjerkedal T. Permanent impairments, disabilities and disability pensions related to accidents in Norway. Accident Analysis and Prevention. 2001; 33(1): 19-30.##Sabeti motlagh S, Panahi M, Mansouri NA. Economic assessment of damages and injuries due to occupational accidents amoungQazvin workers using DALY in period of 2011 to 2013. Human and Environmental Quarterly. 2015; 13(2): 1-15. [persian]##Aaltonen M, Oinonen K, Kitinoja JP, et al. Costs of occupational accidents-Effects of occupational safety on company business a research and development project.Scientific. 2006: 47-51 .##Macedo AC, Silva IL. Analysis of occupational accidents in Portugal between 1992 and 2001. Safety Science. 2005; 43(5-6): 269-286.##Hämäläinen P, Takala J, Saarela KL. Global estimates of occupational accidents. Safety Science. 2006; 44(2): 137-156.##Hämäläinen P. The effect of globalization on occupational accidents.Safety Science. 2009; 47(6): 733-742.##Gholamnia R. Introduction to occupational accidents and analyze. Tehran: Sobhan; 2015. [Persian]##Cioni M, Savioli M. Safety at the workplace: accidents and illnesses. Work, employment and society. 2016; 30(5): 858-875.##Unsar S, Sut N. General assessment of the occupational accidents that occurred in Turkey between the years 2000 and 2005. Safety Science. 2009; 47(5): 614-619.##Jeong BY, Shin DS. Characteristics of Occupational Accidents in Korean, Chinese, Japanese and Western Cuisine Restaurants. Human Factors and Ergonomics in Manufacturing & Service Industries. 2016; 26(3): 316-322.##Halvani G, Jafarinodoushan R, Mirmohammadi S, et al. A survey on occupational accidents among construction industry workers in Yazd city: Applying Time Series 2006-2011. Journal of Occupational Health & Epidemiology. 2012; 1(1): 1-8.##AkboĞA Ö, Baradan S. Safety in ready mixed concrete industry: descriptive analysis of injuries and development of preventive measures. Industrial Health. 2017; 55(1): 54-66.##Gulhan B, Ilhan MN, Civil EF. Occupational accidents and affecting factors of metal industry in a factory in Ankara. Turkish Journal of Public Health. 2012; 10(2): 76-85.##Bakhtiyari M, Delpisheh A, Riahi SM, et al. Epidemiology of occupational accidents among Iranian insured workers. Safety Science. 2012; 50(7): 1480-1484.##Mohammadfam I, Fatemi F. Evaluation of the relationship between unsafe acts and occupational accidents in a vehicle manufacturing. Iran Occupational Health Journal. 2008; 5(3): 44-50.[persian].##Nævestad TO, Phillips RO, Størkersen KV, et al. Safety culture in maritime transport in Norway and Greece: Exploring national, sectorial and organizational influences on unsafe behaviours and work accidents. Marine Policy. 2019; 99: 1-13.##Gomes SC, Caldas AD. Incidence of work accidents involving exposure to biological materials among healthcare workers in Brazil, 2010-2016. Revista Brasileira de Medicina do Trabalho. 2019; 17(2): 188-200.##Khodabandeh F, Kabir-Mokamelkhah E, Kahani M. Factors associated with the severity of fatal accidents in construction workers. Medical journal of the Islamic Republic of Iran. 2016; 30: 469.##Mehrdad R, Seifmanesh S, Chavoshi F, Aminian O, Izadi N. Epidemiology of occupational accidents in iran based on social security organization database. Iranian Red Crescent medical journal. 2014; 16: e10359.##Betsis S, Kalogirou M, Aretoulis G, et al. Work accidents correlation analysis for construction projects in northern Greece 2003-2007: A retrospective study. Safety. 2019; 5(2): 33.##Ghods AA, Alhani F, Anosheh M, et al. Epidemiology of occupational accidents in Semnan (2002-2006). koomesh Journal. 2009; 10(2): 95-99. [Persian]##Laal F, Pouyakian M, Madvari RF, et al. Investigating the Impact of Establishing Integrated Management Systems on Accidents and Safety Performance Indices: A Case Study. Safety and Health at Work. 2019; 10(1): 54-60.##Heras-Saizarbitoria I, Boiral O, Arana G, et al. OHSAS 18001 certification and work accidents: Shedding Light on the connection. Journal of Safety Research. 2019; 68: 33-40.##Melchior C, Zanini RR. Mortality per work accident: A literature mapping. Safety Science. 2019; 114: 72-78.##Ghasempouri SKH, Pourhossein M, Mirmohammadi SM, et al. The Frequency and Pattern of Injuries in Occupational Accident Victims Referred to Sari Legal Medicine Center During Year 2012. Iranian Journal of Forensic Medicine. 2014; 20(3): 127-132. [persian]##Hosseini SSH. Check organizational factors in reducing work-related accidents in the workplace. Business and Society Magazine. 2012; 140: 80-91.[persian].##Nowrouzi-Kia B, Nadesar N, Casole J. Systematic review: Factors related to injuries in small- and medium-sized enterprises. International journal of critical illness and injury science. 2019; 9(2): 57-63.##Cagno E, Micheli GJL, Jacinto C, et al. An interpretive model of occupational safety performance for Small- and Medium-sized Enterprises. International Journal of Industrial Ergonomics. 2014; 44(1): 60-74.##Alali H, Abdel Wahab M, Van Hecke T, et al. Work accident victims: a comparison between non-standard and standard workers in Belgium. International Journal of Occupational and Environmental Health. 2016; 22(2): 99-106.##Van der Klauw M, Hengel KO, Roozeboom MB, et al. Occupational accidents in the Netherlands: incidence, mental harm, and their relationship with psychosocial factors at work. International Journal of Injury Control and Safety Promotion. 2016; 23(1): 79-84.##Lund J, Bjerkedal T. Permanent impairments, disabilities and disability pensions related to accidents in Norway. Accident Analysis and Prevention. 2001; 33(1): 19-30.##Sabeti motlagh S, Panahi M, Mansouri NA. Economic assessment of damages and injuries due to occupational accidents amoungQazvin workers using DALY in period of 2011 to 2013. Human and Environmental Quarterly. 2015; 13(2): 1-15. [persian]##Aaltonen M, Oinonen K, Kitinoja JP, et al. Costs of occupational accidents-Effects of occupational safety on company business a research and development project.Scientific. 2006: 47-51 .##Macedo AC, Silva IL. Analysis of occupational accidents in Portugal between 1992 and 2001. Safety Science. 2005; 43(5-6): 269-286.##Hämäläinen P, Takala J, Saarela KL. Global estimates of occupational accidents. Safety Science. 2006; 44(2): 137-156.##Hämäläinen P. The effect of globalization on occupational accidents.Safety Science. 2009; 47(6): 733-742.##Gholamnia R. Introduction to occupational accidents and analyze. Tehran: Sobhan; 2015. [Persian]##Cioni M, Savioli M. Safety at the workplace: accidents and illnesses. Work, employment and society. 2016; 30(5): 858-875.##Unsar S, Sut N. General assessment of the occupational accidents that occurred in Turkey between the years 2000 and 2005. Safety Science. 2009; 47(5): 614-619.##Jeong BY, Shin DS. Characteristics of Occupational Accidents in Korean, Chinese, Japanese and Western Cuisine Restaurants. Human Factors and Ergonomics in Manufacturing & Service Industries. 2016; 26(3): 316-322.##Halvani G, Jafarinodoushan R, Mirmohammadi S, et al. A survey on occupational accidents among construction industry workers in Yazd city: Applying Time Series 2006-2011. Journal of Occupational Health & Epidemiology. 2012; 1(1): 1-8.##AkboĞA Ö, Baradan S. Safety in ready mixed concrete industry: descriptive analysis of injuries and development of preventive measures. Industrial Health. 2017; 55(1): 54-66.##Gulhan B, Ilhan MN, Civil EF. Occupational accidents and affecting factors of metal industry in a factory in Ankara. Turkish Journal of Public Health. 2012; 10(2): 76-85.##Bakhtiyari M, Delpisheh A, Riahi SM, et al. Epidemiology of occupational accidents among Iranian insured workers. Safety Science. 2012; 50(7): 1480-1484.##Mohammadfam I, Fatemi F. Evaluation of the relationship between unsafe acts and occupational accidents in a vehicle manufacturing. Iran Occupational Health Journal. 2008; 5(3): 44-50.[persian].##Nævestad TO, Phillips RO, Størkersen KV, et al. Safety culture in maritime transport in Norway and Greece: Exploring national, sectorial and organizational influences on unsafe behaviours and work accidents. Marine Policy. 2019; 99: 1-13.##Gomes SC, Caldas AD. Incidence of work accidents involving exposure to biological materials among healthcare workers in Brazil, 2010-2016. Revista Brasileira de Medicina do Trabalho. 2019; 17(2): 188-200.##Khodabandeh F, Kabir-Mokamelkhah E, Kahani M. Factors associated with the severity of fatal accidents in construction workers. Medical journal of the Islamic Republic of Iran. 2016; 30: 469.##Mehrdad R, Seifmanesh S, Chavoshi F, Aminian O, Izadi N. Epidemiology of occupational accidents in iran based on social security organization database. Iranian Red Crescent medical journal. 2014; 16: e10359.##Betsis S, Kalogirou M, Aretoulis G, et al. Work accidents correlation analysis for construction projects in northern Greece 2003-2007: A retrospective study. Safety. 2019; 5(2): 33.##Ghods AA, Alhani F, Anosheh M, et al. Epidemiology of occupational accidents in Semnan (2002-2006). koomesh Journal. 2009; 10(2): 95-99. [Persian]##Laal F, Pouyakian M, Madvari RF, et al. Investigating the Impact of Establishing Integrated Management Systems on Accidents and Safety Performance Indices: A Case Study. Safety and Health at Work. 2019; 10(1): 54-60.##Heras-Saizarbitoria I, Boiral O, Arana G, et al. OHSAS 18001 certification and work accidents: Shedding Light on the connection. Journal of Safety Research. 2019; 68: 33-40.## ##

Investigating the Relationship between Job Compatibility and Controlling Job Stress with Nurses' Performance: A Case Study on Shiraz State Hospitals 2020 بررسی رابطه بین سازگاری و کنترل استرس کاری با عملکرد پرستاران، مطالعه موردی :پرستاران بیمارستان های دولتی شیراز 1398 2 1 چکیده مقدمه: عملکرد معیار پیش بینی شده برای قضاوت در مورد اثر بخشی افراد، گروه ها و سازمانها می باشد این پژوهش با هدف بررسی رابطه بین سازگاری شغلی و کنترل استرس کاری با عملکرد پرستاران در سال 1398 انجام شده است. روش‌‌ها: پژوهش حاضر به روش توصیفی ـ همبستگی با ماهیت کاربردی در سال 1398 انجام شده است .جامعه اماری شامل پرستاران شاغل در بیمارستان های دولتی شیراز می باشد .حجم نمونه طبق فرمول کوکران 196 نفر ازپرستاران محاسبه و روش نمونه‌گیری به صورت طبقه ای انجام شده است. در این پژوهش، از پرسشنامه خود ساخته محقق با سه بخش اصلی و 13 سوال استفاده گردید. ضـریب آلفـای کرونبـاخ پایایی پرسشنامه77/4 محاسبه شده و روایی ان نیز با استفاده از نظر متخصصان بدست امده است . آنالیزهای آماری با استفاده از نرم‌افزار spss22 ، آزمون اسپیرمن و مدل رگرسیونی در سطح اطمینان0/95 استفاده شده است. یافته‌ها: طبق تحلیل های اماری انجام شده میانگین وانحراف معیارمتغیر سازگاری شغلی 3/368 و 1/15 ، کنترل استرس‌کاری 3/084 ، 1/17 و عملکرد پرستاران 3/408 و1/02 بود. بین سازگاری شغلی و عملکرد (0/731 = r ، p <0/001)و همچنین بین کنترل استرس شغلی و عملکرد (0/651 = r ، p <0.001)رابطه معنی داری وجود داشت. نتیجه‌گیری: سازگاری شغلی منجر به اجرای موثر وظایف افراد و نگرش مثبت به سوی نقش کاری جدید می گردد واسترس زیاد، سطح بهره‌وری را کاهش داده و از لحاظ جسمی و روانی صدماتی به همراه دارد 2 Introduction: Performance is the criterion for judging the effectiveness of individuals, groups, and organizations. The aim of this study was to investigate the relationship between job compatibility and control of job stress with nurses' performance in 2020. Methods: The present study was performed by descriptive-correlation method with applied nature in 2020. The statistical population includes nurses working in Shiraz government hospitals. The sample size was calculated according to the Cochran's formula of 196 nurses and the sampling method was performed in Stratified Sampling. In this study, researchers’ self-made questionnaire with three main sections and 13 questions and 5-option Likert scale was used, from completely agreeing to completely disagreeing. Cronbach's alphas reliability was calculated 77.4 in the questionnaire and its validity was obtained using the opinion of experts. Statistical analysis was performed using SPSS22 software and Spearman ,correlation coefficient regression model were used at 0.95 confidence level. Results: The mean and standard deviation of job compatibility variable were 3.368 and 1.15. Job Stress Control variable were 3.084, 1.17 And the performance of nurses variable were 3.408 and 1.02 .There was a significant relationship between job compatibility and performance (r=0.731, p<0.001) and also between stress control and performance (r=0.651 , p<0.001). Conclusion: Job compatibility leads to effective performance of people's duties and a positive attitude towards the new job role which has a positive effect on performance and also reduces high stress and productivity and it causes physical and psychological damage, so by controlling Job stress, personal and organizational performance also improves. 100 106 2020/06/62019/02/162019/12/262020/01/192020/02/2 1398/11/13 2020/06/202020/06/292020/06/292020/06/292020/06/29 1399/4/9 علیرضا موسوی alireza mosavi Department of Management , Firoozabad Branch, Islamic Azad University, Firoozabad, Iran. Iran ali_mosavi75@yahoo.com جمال الدین الوانی jamaledin alvani Department of Medical, Kazerun Branch, Islamic Azad University, Kazerun, Iran Iran Dr.alvani@yahoo.com Job compatibility Stress management Nurses' performance سازگاری شغلی کنترل استرس کاری عملکرد پرستاران 1. Faragher EB, Cass M, Cooper CL. The relationship between job satisfaction and health: a meta-analysis. InFrom Stress to Wellbeing Volume. 2013: 254-271.##Salovey P, Mayer JD. Emotional intelligence. Imagination, cognition and personality. 1990; 9(3): 185-211.##Akbari J, Akbari R, Shakerian M, et al. Job demand-control and job stress at work: A cross-sectional study among prison staff. Journal of Education and Health Promotion. 2017: 45-64.##Häusser JA, Schulz-Hardt S, Mojzisch A. The active learning hypothesis of the job-demand-control model: An experimental examination. Ergonomics. 2014; 57(1): 23-33.##Khalifeh sultani SA, Barari S. Antecedents and Consequences of Auditor's Role Stress. quarterly financial accounting journal. 2016; 7(28) :32-55. [Persian]##Barzideh M, Choobineh A, Tabatabaei S. Job stress dimensions and their relationship to general health status in nurses. Occupational Medicine Quarterly Journal. 2013; 4(3): 17-27. [Persian]##Azad ME, Gholami Fesharaki M. Reliability and validity assessment for the HSE job stress questionnaire. Journal Of Behavioral Sciences. 2011; 4(4): 291-297.[Persian]##Yoshida Y, Sandall J. Occupational burnout and work factors in community and hospital midwives: A survey analysis. Midwifery. 2013; 29(8): 921-626.##Kim H, Kao D. A meta-analysis of turnover intention predictors among US child welfare workers. Children and Youth Services Review. 2014; 47: 214-223.##Hong K,Tornell A. Recovery from a CurrencyCrisis: Some Stylized Facts. Journal of Development Economics. 2005; 76 (1): 71- 96.##Chung EK, Jung Y, Sohn YW. A moderated mediation model of job stress, job satisfaction, and turnover intention for airport security screeners. journal homepage Safety Science. 2017; 98: 89-97.##Kelliher C, Richardson J, Boiarintseva G. All of work? All of life? Reconceptualising work‐life balance for the 21st century. Human Resource Management Journal. 2019; 29(2): 97-112.##Chukwunedu OS, Ogochukwu OG. Board effectiveness and Audit Quality in Nigeria: A perspective study. International Journal of Management Sciences. 2014; 2(9): 406-17.##Soltani, Iraj. The Role of Employees in the Effectiveness of Performance Evaluation System. Management Journal. 2006: 107-108. [Persian]##1. Faragher EB, Cass M, Cooper CL. The relationship between job satisfaction and health: a meta-analysis. InFrom Stress to Wellbeing Volume. 2013: 254-271.##Salovey P, Mayer JD. Emotional intelligence. Imagination, cognition and personality. 1990; 9(3): 185-211.##Akbari J, Akbari R, Shakerian M, et al. Job demand-control and job stress at work: A cross-sectional study among prison staff. Journal of Education and Health Promotion. 2017: 45-64.##Häusser JA, Schulz-Hardt S, Mojzisch A. The active learning hypothesis of the job-demand-control model: An experimental examination. Ergonomics. 2014; 57(1): 23-33.##Khalifeh sultani SA, Barari S. Antecedents and Consequences of Auditor's Role Stress. quarterly financial accounting journal. 2016; 7(28) :32-55. [Persian]##Barzideh M, Choobineh A, Tabatabaei S. Job stress dimensions and their relationship to general health status in nurses. Occupational Medicine Quarterly Journal. 2013; 4(3): 17-27. [Persian]##Azad ME, Gholami Fesharaki M. Reliability and validity assessment for the HSE job stress questionnaire. Journal Of Behavioral Sciences. 2011; 4(4): 291-297.[Persian]##Yoshida Y, Sandall J. Occupational burnout and work factors in community and hospital midwives: A survey analysis. Midwifery. 2013; 29(8): 921-626.##Kim H, Kao D. A meta-analysis of turnover intention predictors among US child welfare workers. Children and Youth Services Review. 2014; 47: 214-223.##Hong K,Tornell A. Recovery from a CurrencyCrisis: Some Stylized Facts. Journal of Development Economics. 2005; 76 (1): 71- 96.##Chung EK, Jung Y, Sohn YW. A moderated mediation model of job stress, job satisfaction, and turnover intention for airport security screeners. journal homepage Safety Science. 2017; 98: 89-97.##Kelliher C, Richardson J, Boiarintseva G. All of work? All of life? Reconceptualising work‐life balance for the 21st century. Human Resource Management Journal. 2019; 29(2): 97-112.##Chukwunedu OS, Ogochukwu OG. Board effectiveness and Audit Quality in Nigeria: A perspective study. International Journal of Management Sciences. 2014; 2(9): 406-17.##Soltani, Iraj. The Role of Employees in the Effectiveness of Performance Evaluation System. Management Journal. 2006: 107-108. [Persian]## ##

The Mediating Role of Resilience and Diabetes Distress in Relationship between Depression and Treatment adherence in type 2 Diabetic among Iranian patients نقش واسطه ای تاب آوری در رابطه بین افسردگی و تبعیت از درمان دیابت نوع 2 در بیماران ایرانی 2 1 مقدمه: همزیستی مشکلات بهداشت روان در بیماران دیابتی می تواند منجر به مدیریت ضعیف بیماری، عدم پیروی از درمان و کیفیت پایین زندگی شود. بنابراین ، این مطالعه با هدف بررسی نقش واسطه ای تاب آوری و پریشانی دیابت در رابطه بین افسردگی و تبعیت از درمان در دیابت نوع 2 در بیماران ایرانی انجام شد. مواد و روش ها: این یک نوع مطالعه تحلیلی است که در دوره زمانی 2020-2019 انجام شده است. جامعه آماری این مطالعه شامل بیماران دیابتی در شهر تهران بود. افراد (200 نفر) پس از ارزیابی بالینی هدفمند و صلاحیت تحقیق انتخاب شدند. در این مطالعه از پرسشنامه افسردگی بک (BDI) ، نسخه فارسی مقیاس پایبندی به داروهای موریسکی ، مقیاس پریشانی دیابت (DDS)، مقیاس تاب آوری کانر و دیویسون (CDRS) استفاده شده است. از آزمون همبستگی پیرسون با استفاده از نرم افزار SPSS نسخه 24 و تحلیل عاملی تأییدی در نرم افزار AMOS نسخه 22 برای تجزیه و تحلیل استفاده شد (0/05> p). یافته ها: در مطالعه حاضر، بیشتر شرکت کنندگان (36/5٪) در گروه سنی 56-65 سال و 58/5٪ زن بودند. براساس نتایج ، متغیرهای افسردگی و دیابت پریشانی با تبعیت از درمان همبستگی منفی و معنی داری دارند( 05 / 0P<، 0/408- = r) تاب آوری با تبعیت از درمان رابطه مثبت و معناداری دارد (05 / 0P<، 0/414= r). طبق نتایج ضرایب غیر استاندارد افسردگی با واسطه نقش تاب آوری و پریشانی دیابت، تأثیر غیر مستقیمی بر تبعیت از درمان دارند. نتیجه گیری: یافته ها نشان داد که بین افسردگی، دیابت نوع دو، تاب آوری و تبعیت از درمان رابطه وجود دارد. همچنین، تاب آوری و پریشانی دیابت بین افسردگی و تبعیت از درمان نقش واسطه ای دارند. بنابراین تاب آوری در بیماران ممکن است منجر به بهبود افسردگی و پریشانی دیابت در بیماران دیابتی شود و یک روش مفید برای افزایش تمایل بیمار در تبعیت از درمان باشد. 2 Introduction: The coexistence of mental health problems in diabetic patients can lead to poor disease management. This study aimed at investigating the mediating role of resilience and diabetes distress in the relationship between depression and treatment adherence in type 2 diabetes among Iranian patients. Methods: It is a type of analytical study conducted from 2019 to 2020. The statistical population of this study consisted of all-diabetic patients in Tehran. The subjects (200) were selected after purposeful clinical evaluation and qualification of research. In this study, Beck Depression Inventory (BDI), the Persian Version of the Morisky Medication Adherence Scale-8, Diabetes Distress Scale (DDS), Conner & Davison Resilience Scale (CDRS) were used to collect the data. Pearson correlation test by SPSS version 24 and Confirmatory Factor Analysis in AMOS software version 22 were used for analysis (P<0.05). Results: In the present study, most participants (about 36.5%) were in the age group of 56-65 and 58.5% of them were female. According to the results, the variables of depression and diabetes distress has a negative and significant correlation with adherence to treatment (r= -.408, p<0.05). The resiliency has a positive and significant correlation with adherence to treatment (r= 0.414, p<0.05). Conclusion: The findings showed a link between depression, diabetes distress, resilience, and treatment adherence. Resilience and anxiety from diabetes play a mediating role between depression and adherence to care. Paying attention to patient resilience may lead to improved depression and diabetes distress in patients with diabetes, to increase the patient’s involvement in treatment adherence. 107 118 2020/06/62019/02/162019/12/262020/01/192020/02/22020/01/22 1398/11/2 2020/06/202020/06/292020/06/292020/06/292020/06/292020/06/29 1399/4/9 معصومه رحیمی masoumeh Rahimi 1. Department of Cilinical Psychology, Faculty of Educational Sciences & Psychology, Kharazmi University, Tehran, Iran Iran masomerahimi59@yahoo.com مهسا جلالی Mahsa Jalali 2. Department of Psychology, Faculty of Educational Sciences & Psychology, Islamic Azad University, Buin zahra Branch, Karaj, Iran Iran ربابه نوری Rababeh Nouri 1. Department of Cilinical Psychology, Faculty of Educational Sciences & Psychology, Kharazmi University, Tehran, Iran Iran مژگان رحیمی Mojgan Rahimi 3. Internal medicine specialist, Isfahan University of Medical Sciences, Isfahan, Iran Iran Depression Treatment adherence Type 2 diabetes Resiliency Diabetes distre افسردگی تبعیت از درمان دیابت نوع 2 تاب آوری پریشانی دیابت Sun N, Lou P, Shang Y, et al Prevalence and determinants of depressive and anxiety symptoms in adults with type 2 diabetes in China: a cross-sectional study. BMJ Open. 2016; 6(8): e 012540.##Bai X, Liu Z, Li Z, et al. The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis. BMJ Open. 2018; 8(11): e 020062.##Khan ZD, Lutale J, Moledina SM. Prevalence of Depression and Associated Factors among Diabetic Patients in an Outpatient Diabetes Clinic. Psychiatry Journal. 2019.##Kumar N, Unnikrishnan B, Thapar R, et al. Distress and Its effect on adherence to antidiabetic medications among type 2 diabetes patients in Coastal South India. Journal of Natural Science, Biology, and Medicine. 2017; 8(2): 216.##Wang X, Kindzierski W, Kaul P. Comparison of transient associations of air pollution and AMI hospitalisation in two cities of Alberta, Canada, using a case-crossover design. BMJ open. 2015; 5(11): e 009169.##Gonzalez JS, Peyrot M, McCarl LA, et al. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008; 31(12): 2398-2403.##Gonzalez JS, Tanenbaum ML, Commissariat PV. Psychosocial factors in medication adherence and diabetes self-management: Implications for research and practice. American Psychologist. 2016; 71(7): 539-551.##Luca A, Luca M, Di Mauro M, et al. Alexithymia, more than depression, influences glycaemic control of type 2 diabetic patients. Journal of endocrinological investigation. 2015; 38(6): 653-660.##Gonzalez JS, Shreck E, Psaros C, et al. Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control. Health Psychology. 2015; 34(5): 505-513.##Félix IB, Guerreiro MP, Cavaco A, et al. Development of a Complex Intervention to Improve Adherence to Antidiabetic Medication in Older People Using an Anthropomorphic Virtual Assistant Software. Frontiers in Pharmacology. 2019; 10: 680.##Krass I, Schieback P, Dhippayom T. Adherence to diabetes medication: a systematic review. Diabetic Medicine. 2015; 32(6): 725-737.##Juste AM, Miguel AG, Plou BP, et al. 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Identification of Psychological Factors Associated with Adherence to Self-Care Behaviors amongst Patients with Type 1 Diabetes. Journal of Diabetes Research. 2019.##Pereira MG, Pedras S, Ferreira G. Self-reported adherence to foot care in type 2 diabetes patients: do illness representations and distress matter ?. Primary health care research & development. 2019; 20: e40.##Sun N, Lou P, Shang Y, et al Prevalence and determinants of depressive and anxiety symptoms in adults with type 2 diabetes in China: a cross-sectional study. BMJ Open. 2016; 6(8): e 012540.##Bai X, Liu Z, Li Z, et al. The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis. BMJ Open. 2018; 8(11): e 020062.##Khan ZD, Lutale J, Moledina SM. Prevalence of Depression and Associated Factors among Diabetic Patients in an Outpatient Diabetes Clinic. Psychiatry Journal. 2019.##Kumar N, Unnikrishnan B, Thapar R, et al. Distress and Its effect on adherence to antidiabetic medications among type 2 diabetes patients in Coastal South India. Journal of Natural Science, Biology, and Medicine. 2017; 8(2): 216.##Wang X, Kindzierski W, Kaul P. Comparison of transient associations of air pollution and AMI hospitalisation in two cities of Alberta, Canada, using a case-crossover design. BMJ open. 2015; 5(11): e 009169.##Gonzalez JS, Peyrot M, McCarl LA, et al. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008; 31(12): 2398-2403.##Gonzalez JS, Tanenbaum ML, Commissariat PV. Psychosocial factors in medication adherence and diabetes self-management: Implications for research and practice. American Psychologist. 2016; 71(7): 539-551.##Luca A, Luca M, Di Mauro M, et al. Alexithymia, more than depression, influences glycaemic control of type 2 diabetic patients. Journal of endocrinological investigation. 2015; 38(6): 653-660.##Gonzalez JS, Shreck E, Psaros C, et al. Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control. Health Psychology. 2015; 34(5): 505-513.##Félix IB, Guerreiro MP, Cavaco A, et al. Development of a Complex Intervention to Improve Adherence to Antidiabetic Medication in Older People Using an Anthropomorphic Virtual Assistant Software. Frontiers in Pharmacology. 2019; 10: 680.##Krass I, Schieback P, Dhippayom T. Adherence to diabetes medication: a systematic review. Diabetic Medicine. 2015; 32(6): 725-737.##Juste AM, Miguel AG, Plou BP, et al. Adherence to treatment of hypertension, hypercholesterolaemia and diabetes in an elderly population of a Spanish cohort. Medicina Clínica (English Edition). 2019; 153(1): 1-5.##Menditto E, Cahir C, Aza-Pascual-Salcedo M, et al. Adherence to chronic medication in older populations: application of a common protocol among three European cohorts. Patient preference and adherence. 2018; 12: 1975-1987.##Massey CN, Feig EH, Duque-Serrano L, et al. 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The Effectiveness of the Native Training Model Designed Based on Lazarus Theory and Behavioral Planning Theory in the Consolidation of Family Functioning: A case study تدوین و اثر بخشی الگوی بومی مبتنی بر نظریه لازاروس و تئوری برنامه ریزی رفتاری بر تحکیم بنیان خانواده 2 1 چکیده: مقدمه: امروزه،تحکیم خانواده یکی از مهمترین راهکارهایی است که می تواند به غنی سازی و در نهایت استحکام زندگی زناشویی بیانجامد. بنابراین استفاده از رویکردهایی که باعث تحکیم خانواده شود از اهمیت بسزایی برخوردار است. لذا پژوهش حاضر با هدف شناسایی تدوین و اثربخشی مدل بومی مبتنی بر نظریه لازاروس و تئوری برنامه ریزی رفتاری بر تحکیم خانواده می باشد. روش بررسی:پژوهش حاضر شبه آزمایشی از نوع پیش آزمون- پس آزمون با گروه کنترل بود جامعه پژوهش شامل تمام زوجین مراجعه کننده به مراکز مشاوره و روان درمانی سطح شهر یزد بود که با استفاده از روش نمونه گیری هدفمند تعداد 34 نفر از زوجینی که شرایط ورود به پژوهش را داشتند انتخاب و به صورت تصادفی به دو گروه آزمایش و گواه گمارده شدند.پرسشنامه تحکیم خانواده پور موحد و همکاران بر روی زوجین اجرا گردید. گروه آزمایش، 11 جلسه مداخلات استخراج شده بر اساس مدل لازاروس و تئوری برنامه ریزی رفتاری که البته بومی شده بودند دریافت کرد. در نهایت داده ها با استفاده از نرم افزار SPSS16 و آزمون های تحلیل کواریانس مورد تحلیل قرار گرفتند. یافته ها: نتایج نشان داد تفاوت معنی‌داری بین میانگین برآورد شده نمرات تحکیم بنیان خانواده آزمودنی‌های گروه آزمایش و کنترل وجود دارد. همچنین یافته ها نشان داد نمرات پس‌آزمون متغیرهای عملکرد، حل مشکل، ارتباط، آمیختگی عاطفی، همراهی عاطفی، ایفای نقش، کنترل رفتار، رسانه و خرافات در گروه آزمایش در مقایسه با گروه گواه بهبود پیدا کرده است این تفاوت معنی دار است وتغییرات ناشی از مداخله آموزشی است. ولی متغیر باورهای مذهبی، تغییر چندانی پیدا نکرده است. نتیجه گیری: آموزش ومداخله مبتنی برمدل تدوین شده براساس نظریه لازاروس وتئوری برنامه ریزی رفتاری می تواند باعث تحکیم بنیان خانواده در بین زوجین شود. 2 Abstract Introduction: Recently, consolidation of family functioning is considered as one of the most important solutions for elevating and strengthening marital life. Therefore, benefiting from family strengthening approaches is so truly significant. This research aims at investigating the effectiveness of the native model based on Lazarus theory and behavioral planning theory on the consolidation of family functioning. Method: This research is a quasi-experimental study with a pretest-posttest design and control group. The population includes all the couples referring to counseling and psychotherapy centers of Yazd Province, in Iran, 2019. Purposive sampling was used to select 34 couples who have the inclusion criteria, and they were randomly assigned to experimental and control groups. The couples answered the family consolidation questionnaire designed by Movahed et al. The experimental group received 11 sessions of interventions extracted from the localized Lazarus model and behavioral planning theory. Finally, data analysis was done by SPSS version 16 and an analysis of covariance (ANCOVA). The significance level of research was considered to be α=0.05 Findings: The results showed that there is a significant difference between the estimated mean score of the family consolidation in the experimental and control groups. Also, the findings suggest that compared with the control group, the posttest scores of the performance, problem-solving, relationship, emotional involvement, emotional support, role play, behavioral control, media, and superstition have been improved in the experimental group. This significant difference results from the training intervention. However, the variable of religious beliefs has not changed significantly. Conclusion: The training intervention done by the model has developed based on Lazarus theory and behavioral planning theory which can consolidate the family functioning. 119 128 2020/06/62019/02/162019/12/262020/01/192020/02/22020/01/222020/03/7 1398/12/17 2020/06/202020/06/292020/06/292020/06/292020/06/292020/06/292020/06/29 1399/4/9 جلال ایرانی زاده Jallal Iranizadeh Faculty of Humanities, Yazd Islamic Azad University, Yazd, Iran Iran حسن زارعی محمودآبادی Hassan Zarei Mahmoodabadi Department of Psychology and Counseling, Faculty of Psychology and Educational Sciences, Yazd University, Yazd, Iran Iran سعید وزیری Saeed Vaziri Department of Educational Sciences, Islamic Azad University of Yazd, Iran Iran سید علیرضا افشانی Seyed Alireza Afshani Department of Cooperation and Social Welfare, Faculty of Social Sciences, Yazd University, Yazd, Iran Iran Lazarus multifaceted treatment Behavioral planning theory Consolidation of family functioning واژه کلیدی: درمان چند وجهی لازاروس تئوری برنامه ریزی رفتاری تحکیم بنیان خانواده Corey G. Theory and practice of counseling and psychotherapy. Trans. by Seyyed Mohammadi Y. Tehran: Arasbaran Publication. 2013: 375. [Persian]##Pourmovahed Z, Mahmoodabad SS, ZareeiMahmoodabadi H, et al. Family Stability and Conflict of Spiritual Beliefs and Superstitions among Yazdi People in Iran: A Qualitative Study. Middle East Journal of Family Medicine.2017; 15(9): 97-103.##Zareei Mahmoodabadi H, Zarei F. The Effect of Divorce Counseling based on Gottman's Approach on the Self-Efficacy in Divorce Management of Couples Applying for Divorce. Social Behavior Research & Health (SBRH). 2018; 2(2): 219-227.##Karami A, Arian SKh, Soltani Khorshid H, et al. Exploring the Effectiveness of Group Training Based on Lazarus Multifaceted approach on Women's Marital Satisfaction. 2012; 3(9): 21-39.[Persian]##Lazarus AA. Multimodal strategies with adult. in Carlson J, sperry L editors. brief therapy with individual and couples. 2000: 106-124.##Lazarus AA. Washington DC: American psychological Association. Multimodal therapy: A seven-point integration. In Sticker G, Gold J (Eds).A casebook of psychotherapy integration. American Psychological Association . 2006: 17-28.##Zur O, Lazarus AA. Six arguments against dual relationships and their rebuttals. Dual relationships and psychotherapy. 2002; 1.##Gharibi H, Adib Y, Fathiazar E, et al. The Effect of Strategic Teaching of Thinking on Questioning in Male Fifth-Graders in Sanandaj. Thinking and Children. 2013; 4(7): 79-92.[Persian]##Esmaeili Darmian, M., Javadi, S. The Mediating Role of Stress-Coping Strategies on the Relationship between Thinking Styles and Mental Health of Nursing and Midwifery Students. Journal of Midwifery and Reproductive Health. 2019; 7(4): 1954-1961##Windle M, Windle RC. Coping Strategies, Drinking Motives, and Stressful Life Events Among Middle Adolescents: Associations With Emotional and Behavioral Problems and With Academic Functioning. Journal of Abnormal Psychology. 1996; 105(4): 551-56.##Lopez JD. Healthy and maladaptive coping strategies among master of social work student. Electronic Theses, Projects and Dissertations. 2014: 23.##Pourmovahed Z, Zareei Mahmoodabadi H,YassiniArdekani SM, et al. Validation of the Family Stability Questionnaire in married couples: A confirmatory factor analysis. Electronic Physician. 2018; 10(8): 7185-7195.##Ardian N, Afshani SA, Morowatisharifabad MA, et al. Evaluating Reliability of Theory of Planned Behaviour Questionnaire for Withdrawal of Divorce Petition. Open Access Maced journal of medical sciences. 2018; 6(8): 1512##Michie S, Johnston M, Abraham C, et al. Making psychological theory useful for implementing evidence based practice: a consensus approach. BMJ Quality & Safety. 2005; 14(1): 26-33.##Pourmovahed Z, Mahmoodabad SS, Zareei Mahmoodabadi H, et al. Deficiency of self-efficacy inproblem-solving as a contributory factor inamily instability: A qualitative study. Iranian Journal of Psychiatry. 2018; 13(1): 32.##Ashoogh M, Aghamolaei T, Ghanbarnejad A, et al. Utilizing the theory of planned behavior to Prediction the safety driving behaviors in truck drivers in Bandar Abbas 1392. Iran Journal of Health Education Health Promotion. 2013; 1(3):5-14.[Persian]##Bashirian S, Haidarnia A, Allahverdipour H, et al. Application of Theory of Planned Behavior in Predicting Factors of Substance Abuse in Adolescents. Journal of Fasa University Medical Science. 2012; 2 (3):156-162.[Persian]##Khammar A, Yarahmadi M, Madadizadeh F. "What Is Analysis of Covariance (ANCOVA) and How to Correct-ly Report Its Results in Medical Research?." Iranian Journal of Public Health . 2020; 49(5): 1016-1017.##Tehrani A, Headari H, Jafari A. The Effectiveness of Group Training Based on Multiple Lazarus Approach on Marital Adjustment of Women. Journal of Behavioral Sciences. 2013; 5(16): 83-98. [Persian]##Mami S, Safari A, Mansourian M, et al. Reducing marital conflict by educating problem-solving skill in couple referring to counseling Center of Imam Khomaini Committee, Ilam. Rahavard Salamat Journal. 2016; 2(1): 29-38. [Persian]##Heyman RE, Sayers SL, Bellack AS. Global marital satisfaction versus marital adjustment: An empirical comparison of three measures. Journal of Family Psychology. 1994; 8(4): 432-446.##Rahmni M, Tabrizi M, Kamkar K. The Effect of Group Counseling Based on Lazarus Multimodal‌ ‌‎ Approach on ‎Mothers' Communication with their Adolescent Daughters‎. Journal of Woman and Family Studies. 2010; 3(9): 123-135.[Persian]##Mahmoodabadi HZ, Sardadvar N, Nasirian M. Effectiveness of psycho educational intervention in improving symptoms of patients with obsessive compulsive disorder and general family functioning of companions. Iranian Red Crescent Medical Journal. 2018; 20(12): 58377.##Bloch L, Haase CM, Levenson RW. Emotion regulation predicts marital satisfaction: More than a wives' tale. Emotion. 2014; 14(1): 130-144.##Mahmoodabad SS, Khajedehi Z, Zareei Mahmoodabadi H, et al. Investigating the Factors Related to Substance Use in the Iranian High School Students Using the Positive Youth Development Model. Iranian Journal of Psychiatry and Behavioral Sciences. 2017 ; 11(2): e9332##Zareei Mahmoodabadi H, Zarei F. The Effect of Divorce Counseling based on Gottman's Approach on the Self-Efficacy in Divorce Management of Couples Applying for Divorce. Social Behavior Research & Health (SBRH). 2018; 2(2): 219-227.##ZareeiMahmoodAbadi H. The effectiveness of the training of the positive psychology on the growth of devotion and trust to the life in the normal women of bafq city. Toloo-e-Behdasht. 2017; 16 (2) : 98-109. [Persian]##Mahmoodabadi H, Bahrami F, Ahmadi A, et al.The Effectiveness of Retraining Attribution Styles (Cognitive Therapy) on Dimensions of Family Functioning in Divorce Applicant Couples. International Journal of Psychological Studies. 2012; 4(2): 257-263.##Corey G. Theory and practice of counseling and psychotherapy. Trans. by Seyyed Mohammadi Y. Tehran: Arasbaran Publication. 2013: 375. [Persian]##Pourmovahed Z, Mahmoodabad SS, ZareeiMahmoodabadi H, et al. Family Stability and Conflict of Spiritual Beliefs and Superstitions among Yazdi People in Iran: A Qualitative Study. Middle East Journal of Family Medicine.2017; 15(9): 97-103.##Zareei Mahmoodabadi H, Zarei F. The Effect of Divorce Counseling based on Gottman's Approach on the Self-Efficacy in Divorce Management of Couples Applying for Divorce. Social Behavior Research & Health (SBRH). 2018; 2(2): 219-227.##Karami A, Arian SKh, Soltani Khorshid H, et al. Exploring the Effectiveness of Group Training Based on Lazarus Multifaceted approach on Women's Marital Satisfaction. 2012; 3(9): 21-39.[Persian]##Lazarus AA. Multimodal strategies with adult. in Carlson J, sperry L editors. brief therapy with individual and couples. 2000: 106-124.##Lazarus AA. Washington DC: American psychological Association. Multimodal therapy: A seven-point integration. In Sticker G, Gold J (Eds).A casebook of psychotherapy integration. American Psychological Association . 2006: 17-28.##Zur O, Lazarus AA. Six arguments against dual relationships and their rebuttals. Dual relationships and psychotherapy. 2002; 1.##Gharibi H, Adib Y, Fathiazar E, et al. The Effect of Strategic Teaching of Thinking on Questioning in Male Fifth-Graders in Sanandaj. Thinking and Children. 2013; 4(7): 79-92.[Persian]##Esmaeili Darmian, M., Javadi, S. The Mediating Role of Stress-Coping Strategies on the Relationship between Thinking Styles and Mental Health of Nursing and Midwifery Students. Journal of Midwifery and Reproductive Health. 2019; 7(4): 1954-1961##Windle M, Windle RC. Coping Strategies, Drinking Motives, and Stressful Life Events Among Middle Adolescents: Associations With Emotional and Behavioral Problems and With Academic Functioning. Journal of Abnormal Psychology. 1996; 105(4): 551-56.##Lopez JD. Healthy and maladaptive coping strategies among master of social work student. Electronic Theses, Projects and Dissertations. 2014: 23.##Pourmovahed Z, Zareei Mahmoodabadi H,YassiniArdekani SM, et al. Validation of the Family Stability Questionnaire in married couples: A confirmatory factor analysis. Electronic Physician. 2018; 10(8): 7185-7195.##Ardian N, Afshani SA, Morowatisharifabad MA, et al. Evaluating Reliability of Theory of Planned Behaviour Questionnaire for Withdrawal of Divorce Petition. Open Access Maced journal of medical sciences. 2018; 6(8): 1512##Michie S, Johnston M, Abraham C, et al. Making psychological theory useful for implementing evidence based practice: a consensus approach. BMJ Quality & Safety. 2005; 14(1): 26-33.##Pourmovahed Z, Mahmoodabad SS, Zareei Mahmoodabadi H, et al. Deficiency of self-efficacy inproblem-solving as a contributory factor inamily instability: A qualitative study. Iranian Journal of Psychiatry. 2018; 13(1): 32.##Ashoogh M, Aghamolaei T, Ghanbarnejad A, et al. Utilizing the theory of planned behavior to Prediction the safety driving behaviors in truck drivers in Bandar Abbas 1392. Iran Journal of Health Education Health Promotion. 2013; 1(3):5-14.[Persian]##Bashirian S, Haidarnia A, Allahverdipour H, et al. Application of Theory of Planned Behavior in Predicting Factors of Substance Abuse in Adolescents. Journal of Fasa University Medical Science. 2012; 2 (3):156-162.[Persian]##Khammar A, Yarahmadi M, Madadizadeh F. "What Is Analysis of Covariance (ANCOVA) and How to Correct-ly Report Its Results in Medical Research?." Iranian Journal of Public Health . 2020; 49(5): 1016-1017.##Tehrani A, Headari H, Jafari A. The Effectiveness of Group Training Based on Multiple Lazarus Approach on Marital Adjustment of Women. Journal of Behavioral Sciences. 2013; 5(16): 83-98. [Persian]##Mami S, Safari A, Mansourian M, et al. Reducing marital conflict by educating problem-solving skill in couple referring to counseling Center of Imam Khomaini Committee, Ilam. Rahavard Salamat Journal. 2016; 2(1): 29-38. [Persian]##Heyman RE, Sayers SL, Bellack AS. Global marital satisfaction versus marital adjustment: An empirical comparison of three measures. Journal of Family Psychology. 1994; 8(4): 432-446.##Rahmni M, Tabrizi M, Kamkar K. The Effect of Group Counseling Based on Lazarus Multimodal‌ ‌‎ Approach on ‎Mothers' Communication with their Adolescent Daughters‎. Journal of Woman and Family Studies. 2010; 3(9): 123-135.[Persian]##Mahmoodabadi HZ, Sardadvar N, Nasirian M. Effectiveness of psycho educational intervention in improving symptoms of patients with obsessive compulsive disorder and general family functioning of companions. Iranian Red Crescent Medical Journal. 2018; 20(12): 58377.##Bloch L, Haase CM, Levenson RW. Emotion regulation predicts marital satisfaction: More than a wives' tale. Emotion. 2014; 14(1): 130-144.##Mahmoodabad SS, Khajedehi Z, Zareei Mahmoodabadi H, et al. Investigating the Factors Related to Substance Use in the Iranian High School Students Using the Positive Youth Development Model. Iranian Journal of Psychiatry and Behavioral Sciences. 2017 ; 11(2): e9332##Zareei Mahmoodabadi H, Zarei F. The Effect of Divorce Counseling based on Gottman's Approach on the Self-Efficacy in Divorce Management of Couples Applying for Divorce. Social Behavior Research & Health (SBRH). 2018; 2(2): 219-227.##ZareeiMahmoodAbadi H. The effectiveness of the training of the positive psychology on the growth of devotion and trust to the life in the normal women of bafq city. Toloo-e-Behdasht. 2017; 16 (2) : 98-109. [Persian]##Mahmoodabadi H, Bahrami F, Ahmadi A, et al.The Effectiveness of Retraining Attribution Styles (Cognitive Therapy) on Dimensions of Family Functioning in Divorce Applicant Couples. International Journal of Psychological Studies. 2012; 4(2): 257-263.## ##

Coaxing as a strategy to deal with ethical issues in community home care: An ethnographic study Coaxing as a strategy to deal with ethical issues in community home care: An ethnographic study 2 1 Abstract Introduction: The provision of home health care services increases as a desirable option in the western society. Previous studies indicate that health care professionals encounter ethically difficult situations when providing home care services. There is a lack of studies describing ethically difficult situations through observation. This study aimed to explore ethical issues experienced by healthcare staff when providing community home care services. Methods: Qualitative design, using ethnographical approach. Data gathered as fieldwork in terms of memos, non-participant observation and informal interview with registered nurses (n=8), and nurse-assistants (n=4) during three weeks (in total 148 hours, 7am -5pm) Results: The result generated two main categories: 1) To balance stakeholders’ requirements, and, 2) Strategy to deal with ethical issues. Coxing was used as a strategy to deal with ethically difficult situations in patient care. The results showed that the complexity of the ethical issues is often related to personal values and organisational impact. The staff experienced need for a structured approach to assist them in identifying, analysing, and resolving ethical issues that arise in clinical practice. Health care organisations, personnel and patients are disagreed about values and choices that could lead to the best course of actions. Conclusion: This study reveals that the ethically difficult situations in the context of community home care services are complex and are influencing the provision of care. The personnel enforced to find a balance between different expectations and from different stakeholders. To deal with these situations coaxing was used as a strategy for managing ethical issues. 2 Abstract Introduction: The provision of home health care services increases as a desirable option in the western society. Previous studies indicate that health care professionals encounter ethically difficult situations when providing home care services. There is a lack of studies describing ethically difficult situations through observation. This study aimed to explore ethical issues experienced by healthcare staff when providing community home care services. Methods: Qualitative design, using ethnographical approach. Data gathered as fieldwork in terms of memos, non-participant observation and informal interview with registered nurses (n=8), and nurse-assistants (n=4) during three weeks (in total 148 hours, 7am -5pm) Results: The result generated two main categories: 1) To balance stakeholders’ requirements, and, 2) Strategy to deal with ethical issues. Coxing was used as a strategy to deal with ethically difficult situations in patient care. The results showed that the complexity of the ethical issues is often related to personal values and organisational impact. The staff experienced need for a structured approach to assist them in identifying, analysing, and resolving ethical issues that arise in clinical practice. Health care organisations, personnel and patients are disagreed about values and choices that could lead to the best course of actions. Conclusion: This study reveals that the ethically difficult situations in the context of community home care services are complex and are influencing the provision of care. The personnel enforced to find a balance between different expectations and from different stakeholders. To deal with these situations coaxing was used as a strategy for managing ethical issues. 129 138 2020/06/62019/02/162019/12/262020/01/192020/02/22020/01/222020/03/72020/01/21 1398/11/1 2020/06/202020/06/292020/06/292020/06/292020/06/292020/06/292020/06/292020/06/29 1399/4/9 Dara Rasoal Dara Rasoal School of Health, Care and Social Welfare, Malardalen University,Vasteras, Sweden Sweden dara.rasoal@mdh.se homecare nursing healthcare professional ethics homecare nursing healthcare professional ethics 1. Chandler J, Williams M, Maconachie M, et al. Living Alone: Its Place in Household Formation and Change. Sociological Research Online . 2004 ; 9(3): 42-54.##Mentsen Ness T, Hellzen O, Enmarker I. The Experience of Nurses Providing Home Nursing Care to Oldest Old Persons Living Alone in Rural Areas-An Interview Study. Open Journal of Nursing. 2015; 5(4): 336-344.##Low LF, Yap M, Brodaty H. A systematic review of different models of home and community care services for older persons. BMC Health services research. 2011; 11(1): 93-107.##Henderson EJ, Caplan GA. Home Sweet Home? Community Care for Older People in Australia. Journal of the American Medical Directors Association. 2008; 9(2): 88-94.##HOD H 1999. Patient and Service User Law. HOD 1999-07-02-63. Lov om pasient- og brukerrettighet. Oslo, Norway; 1999. Report No.: 1999070263.Available at: URL: https://lovdata.no/dokument/NL/lov/1999-07-02-63##Health Care Law. Stockholm, Sweden: Socialstyrelsen; 2006. Report No: 1982: 763.##Tousignant M, Dubuc N, Hébert R, et al. Home-care programmes for older adults with disabilities in Canada: How can we assess the adequacy of services provided compared with the needs of users?. Health & Social Care in the Community. 2007; 15(1): 1-7.##Parks JA. No Place Like Home?: Feminist Ethics and Home Health Care. Indiana University Press. 2003.##Karlsson M, Karlsson C, Barbosa da Silva A, et al. Community nurses' experiences of ethical problems in end-of-life care in the patient's own home. Scandinavian Journal of Caring Sciences. 2013; 27(4): 831-838.##Anstey KW, Wagner F. Community healthcare ethics. The Cambridge Textbook of Bioethics. 2002; 299.##Aroskar M. Community health nurses. Their most significant ethical decision-making problems. The Nursing clinics of North America. 1989; 24(4): 967-75.##SFS 2001:453 Socialtjänstlagen. [The Social Service Act] [Internet]. Stockholm, Sweden##2001 [cited 2016 Nov 11]. Available from: http://www.riksdagen.se/sv/Dokument-Lagar/Laga r/Svenskforfattningssamling/Socialtjanstlag-2001453_sfs-2001-##Teeri S, Leino-Kilpi H, Välimäki M. Long-Term Nursing Care of Elderly People: Identifying ethically problematic experiences among patients, relatives and nurses in Finland. Nursing ethics. 2006; 13(2): 116-129.##Slettebø Å, Bunch EH. Solving Ethically Difficult Care Situations in Nursing Homes. Nursing Ethics. 2004; 11(6): 543-552.##Altun I. Burnout and nurses' personal and professional values. Nursing Ethics. 2002; 9(3): 269-278.##Beagan B, Ells C. Values That Matter, Barriers That Interfere: The Struggle of Canadian Nurses to Enact Their Values. Canadian Journal of Nursing Research Archive. 2007; 39(4): 36-57.##Bentzen G, Harsvik A, Brinchmann BS. Values That Vanish into Thin Air: Nurses' Experience of Ethical Values in Their Daily Work. Nursing Research and practice. 2013: e939153.##Rasoal D, Kihlgren A, James I, et al. What healthcare teams find ethically difficult: Captured in 70 moral case deliberations. Nursing Ethics. 2015; 23(8): 825-837.##Jameton A. Nursing Practice: The Ethical Issues. Englewood Cliffs: Prentice-Hall; 1984 [cited 2016 Nov 11]. 331 p. Available from: https://repository.library.georgetown.edu/handle/10822/800986.##Erlen JA. Moral distress: a pervasive problem. Orthopaedic Nursing. 2001; 20(2): 76-80.##Maluwa VM, Andre J, Ndebele P, et al. Moral distress in nursing practice in Malawi. Nursing Ethics. 2012; 19(2): 196-207.##Austin W, Kelecevic J, Goble E, et al. An overview of moral distress and the paediatric intensive care team. Nursing Ethics. 2009; 16(1): 57-68.##Ulrich C, O'Donnell P, Taylor C, et al. Ethical climate, ethics stress, and the job satisfaction of nurses and social workers in the United States. Social Science & Medicine. 2007; 65(8): 1708-1719.##Hermsen M, van der Donk M. Nurses' moral problems in dialysis. Nursing Ethics. 2009; 16(2): 184-191.##Wilmot S, Legg L, Barratt J. Ethical Issues in the Feeding of Patients Suffering from Dementia: a focus group study of hospital staff responses to conflicting principles. Nursing Ethics. 2002; 9(6): 599-611.##Uden G, Norberg A, Lindseth A, et al. Ethical reasoning in nurses' and physicians' stories about care episodes. Journal of Advanced Nursing. 1992; 17(9): 1028-1034.##Bartholdson C, Lützén K, Blomgren K, et al. Experiences of ethical issues when caring for children with cancer. Cancer Nursing. 2015; 38(2): 125-132.##Fischer Grönlund C. Experiences of being in ethically difficult care situations and an intervention with clinical ethics support (Doctoral dissertation, Umeå universitet). 2016.##Åström G, Jansson L, Norberg A, et al. Experienced nurses' narratives of their being in ethically difficult care situations. The problem to act in accordance with one's ethical reasoning and feelings. Cancer Nursing. 1993; 16(3): 179-187.##Schaffer MA. Ethical Problems in End-of-Life Decisions for Elderly Norwegians. Nursing Ethics. 2007; 14(2): 242-257.##Norberg A, Norberg B, Gippert H, et al. Ethical conflicts in long-term care of the aged: nutritional problems and the patient-care worker relationship. British Medical Journal. 1980; 280(6211): 377-378.##Nordam A, Torjuul K, Sørlie V. Ethical challenges in the care of older people and risk of being burned out among male nurses. Journal of clinical nursing. 2005; 14(10): 1248-1256.##Enes SPD, Vries K de. A Survey of Ethical Issues Experienced by Nurses Caring for Terminally Ill Elderly People. Nursing Ethics. 2004; 11(2): 150-164.##DuVal G, Clarridge B, Gensler G, et al. A national survey of US internists' experiences with ethical dilemmas and ethics consultation. Journal of General Internal Medicine. 2004; 19(3): 251-258.##Cruz EV, Higginbottom G. The use of focused ethnography in nursing research. Nurse Researcher. 2013; 20(4): 36-43.##Emerson RM, Fretz RI, Shaw LL. Writing Ethnographic Fieldnotes. University of Chicago Press; 2011.##Bazeley P, Jackson K. Qualitative Data Analysis with NVivo. SAGE publications limited. 2013.##Hammersley M, Atkinson P. Ethnography: Principles in Practice. 3rd edition. New York, US: Routledge. 2007.##Murchison J. Ethnography Essentials: Designing, Conducting, and Presenting Your Research. John Wiley & Sons. 2010: 258.##Galanti GA. How to do ethnographic research. Western Journal of Medicine. 1999; 171(1): 19-20.##Jeffery R. Normal rubbish: Deviant patients in casualty departments. Sociology of Health & illness. 1979; 1(1): 90-107.##Dingwall R, Murray T. Categorization in accident departments: 'good' patients, 'bad' patients and 'children'. Sociology of Health & illness. 1983; 5(2): 127-148.##McCormack B, McCance T. Person-Centred Practice in Nursing and Health Care: Theory and Practice. John Wiley & Sons. 2016: 289.##Rees J, King L, Schmitz K. Nurses' Perceptions of Ethical Issues in the Care of Older People. Nursing Ethics. 2009; 16(4): 436-452.##Fajer MA. Authority, Credibility, and Pre-Understanding: A Defense of Outsider Narratives in Legal Scholarship, Essay. Georgetown Law Journal. 1993- 1994; 82: 1845-1868.##1. Chandler J, Williams M, Maconachie M, et al. Living Alone: Its Place in Household Formation and Change. Sociological Research Online . 2004 ; 9(3): 42-54.##Mentsen Ness T, Hellzen O, Enmarker I. The Experience of Nurses Providing Home Nursing Care to Oldest Old Persons Living Alone in Rural Areas-An Interview Study. Open Journal of Nursing. 2015; 5(4): 336-344.##Low LF, Yap M, Brodaty H. A systematic review of different models of home and community care services for older persons. BMC Health services research. 2011; 11(1): 93-107.##Henderson EJ, Caplan GA. Home Sweet Home? Community Care for Older People in Australia. Journal of the American Medical Directors Association. 2008; 9(2): 88-94.##HOD H 1999. Patient and Service User Law. HOD 1999-07-02-63. Lov om pasient- og brukerrettighet. Oslo, Norway; 1999. Report No.: 1999070263.Available at: URL: https://lovdata.no/dokument/NL/lov/1999-07-02-63##Health Care Law. Stockholm, Sweden: Socialstyrelsen; 2006. Report No: 1982: 763.##Tousignant M, Dubuc N, Hébert R, et al. Home-care programmes for older adults with disabilities in Canada: How can we assess the adequacy of services provided compared with the needs of users?. Health & Social Care in the Community. 2007; 15(1): 1-7.##Parks JA. No Place Like Home?: Feminist Ethics and Home Health Care. Indiana University Press. 2003.##Karlsson M, Karlsson C, Barbosa da Silva A, et al. Community nurses' experiences of ethical problems in end-of-life care in the patient's own home. Scandinavian Journal of Caring Sciences. 2013; 27(4): 831-838.##Anstey KW, Wagner F. Community healthcare ethics. The Cambridge Textbook of Bioethics. 2002; 299.##Aroskar M. Community health nurses. Their most significant ethical decision-making problems. The Nursing clinics of North America. 1989; 24(4): 967-75.##SFS 2001:453 Socialtjänstlagen. [The Social Service Act] [Internet]. Stockholm, Sweden##2001 [cited 2016 Nov 11]. Available from: http://www.riksdagen.se/sv/Dokument-Lagar/Laga r/Svenskforfattningssamling/Socialtjanstlag-2001453_sfs-2001-##Teeri S, Leino-Kilpi H, Välimäki M. Long-Term Nursing Care of Elderly People: Identifying ethically problematic experiences among patients, relatives and nurses in Finland. Nursing ethics. 2006; 13(2): 116-129.##Slettebø Å, Bunch EH. Solving Ethically Difficult Care Situations in Nursing Homes. Nursing Ethics. 2004; 11(6): 543-552.##Altun I. Burnout and nurses' personal and professional values. Nursing Ethics. 2002; 9(3): 269-278.##Beagan B, Ells C. Values That Matter, Barriers That Interfere: The Struggle of Canadian Nurses to Enact Their Values. Canadian Journal of Nursing Research Archive. 2007; 39(4): 36-57.##Bentzen G, Harsvik A, Brinchmann BS. Values That Vanish into Thin Air: Nurses' Experience of Ethical Values in Their Daily Work. Nursing Research and practice. 2013: e939153.##Rasoal D, Kihlgren A, James I, et al. What healthcare teams find ethically difficult: Captured in 70 moral case deliberations. Nursing Ethics. 2015; 23(8): 825-837.##Jameton A. Nursing Practice: The Ethical Issues. Englewood Cliffs: Prentice-Hall; 1984 [cited 2016 Nov 11]. 331 p. Available from: https://repository.library.georgetown.edu/handle/10822/800986.##Erlen JA. Moral distress: a pervasive problem. Orthopaedic Nursing. 2001; 20(2): 76-80.##Maluwa VM, Andre J, Ndebele P, et al. Moral distress in nursing practice in Malawi. Nursing Ethics. 2012; 19(2): 196-207.##Austin W, Kelecevic J, Goble E, et al. An overview of moral distress and the paediatric intensive care team. Nursing Ethics. 2009; 16(1): 57-68.##Ulrich C, O'Donnell P, Taylor C, et al. Ethical climate, ethics stress, and the job satisfaction of nurses and social workers in the United States. Social Science & Medicine. 2007; 65(8): 1708-1719.##Hermsen M, van der Donk M. Nurses' moral problems in dialysis. Nursing Ethics. 2009; 16(2): 184-191.##Wilmot S, Legg L, Barratt J. Ethical Issues in the Feeding of Patients Suffering from Dementia: a focus group study of hospital staff responses to conflicting principles. Nursing Ethics. 2002; 9(6): 599-611.##Uden G, Norberg A, Lindseth A, et al. Ethical reasoning in nurses' and physicians' stories about care episodes. Journal of Advanced Nursing. 1992; 17(9): 1028-1034.##Bartholdson C, Lützén K, Blomgren K, et al. Experiences of ethical issues when caring for children with cancer. Cancer Nursing. 2015; 38(2): 125-132.##Fischer Grönlund C. Experiences of being in ethically difficult care situations and an intervention with clinical ethics support (Doctoral dissertation, Umeå universitet). 2016.##Åström G, Jansson L, Norberg A, et al. Experienced nurses' narratives of their being in ethically difficult care situations. The problem to act in accordance with one's ethical reasoning and feelings. Cancer Nursing. 1993; 16(3): 179-187.##Schaffer MA. Ethical Problems in End-of-Life Decisions for Elderly Norwegians. Nursing Ethics. 2007; 14(2): 242-257.##Norberg A, Norberg B, Gippert H, et al. Ethical conflicts in long-term care of the aged: nutritional problems and the patient-care worker relationship. British Medical Journal. 1980; 280(6211): 377-378.##Nordam A, Torjuul K, Sørlie V. Ethical challenges in the care of older people and risk of being burned out among male nurses. Journal of clinical nursing. 2005; 14(10): 1248-1256.##Enes SPD, Vries K de. A Survey of Ethical Issues Experienced by Nurses Caring for Terminally Ill Elderly People. Nursing Ethics. 2004; 11(2): 150-164.##DuVal G, Clarridge B, Gensler G, et al. A national survey of US internists' experiences with ethical dilemmas and ethics consultation. Journal of General Internal Medicine. 2004; 19(3): 251-258.##Cruz EV, Higginbottom G. The use of focused ethnography in nursing research. Nurse Researcher. 2013; 20(4): 36-43.##Emerson RM, Fretz RI, Shaw LL. Writing Ethnographic Fieldnotes. University of Chicago Press; 2011.##Bazeley P, Jackson K. Qualitative Data Analysis with NVivo. SAGE publications limited. 2013.##Hammersley M, Atkinson P. Ethnography: Principles in Practice. 3rd edition. New York, US: Routledge. 2007.##Murchison J. Ethnography Essentials: Designing, Conducting, and Presenting Your Research. John Wiley & Sons. 2010: 258.##Galanti GA. How to do ethnographic research. Western Journal of Medicine. 1999; 171(1): 19-20.##Jeffery R. Normal rubbish: Deviant patients in casualty departments. Sociology of Health & illness. 1979; 1(1): 90-107.##Dingwall R, Murray T. Categorization in accident departments: 'good' patients, 'bad' patients and 'children'. Sociology of Health & illness. 1983; 5(2): 127-148.##McCormack B, McCance T. Person-Centred Practice in Nursing and Health Care: Theory and Practice. John Wiley & Sons. 2016: 289.##Rees J, King L, Schmitz K. Nurses' Perceptions of Ethical Issues in the Care of Older People. Nursing Ethics. 2009; 16(4): 436-452.##Fajer MA. Authority, Credibility, and Pre-Understanding: A Defense of Outsider Narratives in Legal Scholarship, Essay. Georgetown Law Journal. 1993- 1994; 82: 1845-1868.## ##