Score Adjustment Research Articles

Psychological adjustments among lower limb amputees in North Indian population: A cross-sectional study.

Limb amputation is an extremely stressful event for an individual, following which the amputee develops inferior body image, anxiety, and changes in self-concept and identity. For holistic rehabilitation, understanding the psychosocial status of the amputee and its' predictors is of utmost importance. The aim of the article is to assess the psychological adjustments in patients with lower limb amputation and determine its clinical and sociodemographic correlates. A observational cross-sectional study was conducted from 2020 to 2022 among lower limb amputees of a tertiary care hospital in Lucknow which serves as the only rehabilitation and artificial limb center for the whole state of Uttar Pradesh. Baseline sociodemographic and clinical data were collected. The Hospital Anxiety and Depression Scale was used to determine underlying depression and anxiety, while the Trinity Amputation and Prosthesis Experience Scale was used for understanding the psychological adjustment. The mean age of the amputee was 39.47 ± 16.99 years. The mean general, social adjustment, and adjustment to limitation score was 16.3 ± 3.34, 15.19 ± 3.59, and 12.76 ± 3.15, respectively. Male amputees, aged >40 years, and pensioners had significantly higher scores for general adjustment (P < 0.05). Those aged >40 years were pensioners and had no underlying depression and anxiety and had better social adjustment (P < 0.05). Those with transfemoral amputation had a significantly lesser adjustment to limitation (P = 0.003). Young age amputees had poor general and social adjustments and more activity restriction but high prosthesis satisfaction as compared to the elderly. Those with transfemoral amputation had a poor adjustment to limitation while those wearing above-knee prosthesis had more activity restriction.

Sustaining the benefits of intravenous ketamine with behavioural activation therapy for depression: A case series

BackgroundDespite advances in treatments for depression, approximately one third of patients do not benefit from available therapies. Intravenous ketamine is a novel intervention that can yield rapid yet transient antidepressant effects. Behavioural activation (BA) therapy for depression has been shown to be effective in preventing relapse of major depressive episodes. In this pilot study, we examined whether antidepressant response achieved through repeated ketamine infusions could be maintained with BA. MethodsIn this case series, patients with treatment-resistant depression who met antidepressant response criteria in a clinical trial of repeated ketamine infusions subsequently completed 12–17 sessions of BA. Depressive symptoms were measured at each session with the Beck Depression Inventory-II (BDI-II). Secondary outcomes included changes in work and social adjustment, suicidal ideation, and anxiety. ResultsTen of the 13 participants who initiated BA completed the full course of psychotherapy. These participants showed significant improvement in self-reported depressive symptoms (p = 0.007) and work and social adjustment scores (p<0.001) with BA. The 6 participants who started BA therapy prior to relapse of depressive symptoms following cessation of ketamine sustained the clinical gains achieved with ketamine. LimitationsThe small sample size and lack of control group limit the conclusions. ConclusionsThe transient period of increased mood after repeated ketamine treatment offers a window of opportunity to intervene with psychotherapy such as BA. A better understanding of how to best integrate psychological treatments with pharmacological treatment, particularly the novel use of rapid-acting medications such as ketamine is an unmet clinical need and promising research area.

Effects of posttraumatic growth on psychosocial adjustment in young and middle-aged patients with acute myocardial infarction: The mediating role of rumination

BackgroundPsychosocial adjustment is a core problem faced by young and middle-aged patients following a diagnosis of acute myocardial infarction (AMI), which seriously affects rehabilitation outcomes. However, the relationship and influencing mechanism between post-traumatic growth and psychosocial adjustment in young and middle-aged AMI patients have not been fully explored. ObjectivesThis study aimed to determine the relationship between posttraumatic growth and psychosocial adjustment in young and middle-aged patients following AMI and to explore the mediating role of rumination. MethodsThis cross-sectional study was conducted in Guangdong Province from January 2022 to August 2022. A total of 321 young to middle-aged patients with AMI participated in this study. Self-reported questionnaires were used to assess posttraumatic growth, rumination, and psychosocial adjustment. Pearson's correlation and path analyses were used to analyze the data. ResultsThe total scores for posttraumatic growth, rumination, and psychosocial adjustment in young and middle-aged patients with AMI were 51.24±19.35, 35.18±8.72, and 43.55±26.04, respectively. All three were considered moderate. Posttraumatic growth was positively associated with rumination and negatively associated with psychosocial adjustment (p < 0.01). The relationship between posttraumatic growth and psychosocial adjustment was mediated by deliberate rumination. ConclusionsDeliberate rumination mediated the relationship between posttraumatic growth and psychosocial adjustment. Healthcare providers should therefore guide patients to engage in deliberate rumination to help them grow following their AMI, thereby improving their psychosocial adaptability and prognosis.

Assessment of the Knowledge of Educational and Adjustment Problems among College students at selected Degree Colleges, Tirupathi, AP, India

Adjustment is an eternal process and satisfies one’s desires involving many aspects of behaviour. Education is the process of facilitating learning or acquisition of knowledge, skills, values, beliefs and habits. Adjustment is a behavioural process of balancing conflicting needs. Objectives: To assess the adjustment problem among the college students and to find an association between the adjustment score and selected background variables among college students. Methodology: In this study 100 samples were selected by non-probability convenience sampling technique. The tool used for data collection consisted of adjustment problem for college students. Validity of the tool was appraised by experts and was found to be valid for the study with required modification. Reliability was done by using Cronbach’s alpha reliability method and was found at 0.94. The tools were found reliable. The pilot study was conducted for assessing the feasibility of the study design at selected colleges of Tirupathi, Andhra Pradesh. The collected data was analyzed by harnessing descriptive and inferential statistics.

Behavioral interventions for persons with mild cognitive impairment: Longitudinal effect on partners with low adjustment

AbstractBackgroundPartners of persons with mild cognitive impairment (pwMCI) show increased rates of depression and other mental health problems compared to the general population. While dyadic behavioral interventions such as cognitive rehabilitation have shown beneficial effects in reducing caregiver burden, research to date lacks consistent outcome measures and rarely focuses on distressed partners. Therefore, this study explored the longitudinal effect of the Healthy Action to Benefit Independence &amp; Thinking® (HABIT) program on partners with relatively low initial adjustment level. We hypothesized that the HABIT program would improve partner adjustment in those who were distressed.MethodData from 322 pwMCI and partners were utilized from the HABIT IRB research registry. Among them, 240 completed HABIT while 82 served as an untreated control group. Consistent with our previous exploratory factor analysis, a composite partner adjustment score was calculated using the Center for Epidemiologic Studies Depression scale (CES‐D), the REACH Anxiety Inventory Form, and the Quality of Life scale for adults with Alzheimer’s Disease (QOL‐AD). We included partners with an adjustment score below the median of each group to focus on partners with low levels of baseline adjustment. Latent growth curve models were conducted at baseline, 3‐month, 6‐month, and 1‐year follow‐ups to investigate the trajectories of partner adjustment level.ResultIn the low adjustment subsample, no between group difference was found at baseline. An overall improvement in partner adjustment scores was observed only in the treatment group (b = 5.00, p&lt;.001). The slope of change was larger (b = 3.75, p = .016) in the treatment group, indicating a faster improvement in adjustment level in HABIT partners with marginally lower baseline and higher follow‐up scores. This difference in the improvement rates was most evident at the 3‐month follow‐up (t(1, 94) = ‐2.63, p = .010) and gradually reduced in subsequent visits.ConclusionIn partners of those with MCI who have low levels of emotional adjustment, behavioral interventions like HABIT can be beneficial in accelerating improvement in their overall adjustment level and facilitate adaptation to their loved ones’ MCI symptoms compared to untreated controls. Techniques taught in dyadic interventions may serve as protective factors for mental health problems in primary caregivers of pwMCI.

Students with learning disabilities/attention-deficit/hyperactivity disorder in higher education dealing with remote learning: lessons learned from COVID-19 era.

The current study aimed to examine how students with learning disabilities (LD) and/or attention-deficit/hyperactivity disorder (ADHD) adjusted to higher education during the transition to remote learning (RL) in Israel during the COVID-19 pandemic. The study involved 621 undergraduate students, 330 of whom participated during the COVID-19 pandemic and 291 before the pandemic. Among these students, 198 had been diagnosed with LD and/or ADHD, while 423 had no reported disabilities (control group). Students with LD/ADHD generally had lower adjustment scores during face-to-face learning and RL than the control group. In-depth analyses of four subgroups revealed that students with LD + ADHD reported lower academic, emotional, and institutional adjustments as well as reported lower satisfaction with life during RL than the control group members. ADHD was found to directly predict low satisfaction with life through the mediation of adjustment scores. In conclusion, it is recommended that support be provided to high-risk LD/ADHD populations during a crisis. Furthermore, the implication of this study can inform intervention during emergency times.

MP-453089-1 DIGOXIN AND RISK OF VENTRICULAR TACHYARRHYTHMIA AND DEATH IN ICD RECIPIENTS

Digoxin continues to be used in patients with heart failure with reduced ejection fraction (HFrEF), especially among those with atrial fibrillation (AF) with difficult to control ventricular response. However, some studies have shown digoxin use to be associated with adverse outcomes including increased mortality. There are limited data on whether digoxin use is associated with increased risk of ventricular tachycardia/ventricular fibrillation (VT/VF) in implantable cardioverter defibrillator (ICD) recipients. We sought to assess whether digoxin use would be associated with increased risk of VT/VF in patients with HFrEF who were implanted with a primary prevention ICD in landmark clinical trials. Our study cohort consisted of patients with an ICD or cardiac resynchronization therapy-defibrillator (CRT-D) who were enrolled in the four landmark MADIT trials. Propensity score for digoxin at baseline was developed using a wide variety of baseline clinical measures with a logistic regression model stepwise variable selection approach. All potential variables which met a significance level <0.10 were included in the propensity score model. Additionally, a multivariate proportional hazards regression model was developed for the endpoint of VT/VF. This multivariate model was used along with propensity score quintile stratification for the endpoints of VT/VF, death and VT/VF/death. At baseline, 1155 of 4499 patients were on digoxin (26%). Propensity score variables are shown in Table 1. From statistical models using both multivariate adjustment and propensity score quintile stratification, patients prescribed digoxin exhibited a statistically significant 28% increased risk of VT/VF [HR 1.28 (1.10-1.50); p=0.002; Figure 1A], 38% increased risk of the composite of VT/VF or death [HR 1.38 (1.21-1.58); p<0.0001; Figure 1B]; and a 64% increased risk of death [HR 1.64; (1.32-2.04); p<0.0001]. Our findings suggest that digoxin use is associated with a significant increased risk of ventricular tachyarrhythmic events and death among ICD recipients. This adds to the growing evidence that digoxin use is associated with adverse outcomes in certain groups of patients and suggest a need for reconsideration on use of digoxin in HFrEF patients with an ICD.

Influencing factors analysis of adaptability of cancer patients to return-to-work

To clarify the adaptability of cancer patients to return to work and explore its influencing factors. A cross-sectional study. From March to October 2021, 283 cancer patients in the follow-up period were recruited from the oncology departments of four secondary and above hospitals and cancer friendship associations in Nantong city using self-developed scale of adaptability to return to work for cancer patients by convenience sampling method. The contents included general sociodemographic data, disease-related data, cancer patients' readability to work Scale, Medical Coping Style Questionnaire, Social Support Rating Scale, Family Closeness and Readability Scale, General self-efficacy Scale and Social impact Scale. Paper questionnaires were used for face-to-face data collection, and SPSS17.0 was used for statistical analysis. Univariable analyses and multiple linear regression analysis were conducted. The overall score of cancer patients' adaptability to return to work was (87.05±20.255), (22.54±4.234) for the dimension of focused rehabilitation, (32.02±9.013) for the dimension of reconstruction effectiveness, and (32.49±9.023) for the dimension of adjustment planning. Multiple linear regression analysis showed that the current return to full-time work (β =0.226, P 0.05), the current return to non-full-time work (β =0.184, P 0.05), yield response (β = -0.132, P 0.05), and general self-efficacy (β =0.226, P 0.05) could affect their return to work adaptation. The results of status quo and influencing factors showed that the adaptability of cancer patients to return to work was generally higher in this study. Cancer patients who had participated in work, had lower yield coping scores and stigma scores, and higher self-efficacy scores and family adjustment and intimacy scores had better adaptability to return to work again. It has been approved by the Human Research Ethics Committee of the Affiliated Hospital of Nantong University (Project No.202065).

Prognostic significance of incorporating exercise tissue doppler mitral annular early diastolic velocity in exercise diastolic dysfunction assessment.

The existing algorithm for defining exercise-induced diastolic dysfunction incorporates resting e' velocity as a surrogate of myocardial relaxation. The additive prognostic value of incorporating post-exercise e' velocity in definition of exercise-induced diastolic dysfunction is poorly studied. To define the additive prognostic value of post-exercise e' septal velocity in the assessment of exercise-induced diastolic dysfunction compared to the traditional approach. This retrospective study included 1409 patients undergoing exercise treadmill echocardiography with available full set of diastolic variables. Doppler measures of diastolic function included resting septal e' velocity, post-exercise septal e' velocity, post-exercise E/e' ratio, and post-exercise tricuspid regurgitant jet velocity. Approaches incorporating resting septal e' velocity and post-exercise septal e' velocity were compared in defining exercise-induced diastolic dysfunction, and for association with adverse cardiovascular outcomes. The mean age of study subjects was 56.3 ± 16.5 years and 791 (56%) patients were women. A total of 524 patients had disagreement between resting and post exercise septal e' velocities, and these values showed only weak agreement (kappa statistics: .28, P = .02). All categories of the traditional exercise-induced DD approach incorporating resting septal e' velocity witnessed reclassification when exercise septal e' velocity was used. When both approaches were compared, increased event rates were only evident when both approaches agreed on exercise-induced diastolic dysfunction (HR: 1.92, P < .001, 95% CI: 1.37-2.69). This association persisted after multivariable adjustment and propensity score matching for covariates. Incorporation of post-exercise e' velocity into the set of variables defining exercise-induced diastolic dysfunction can improve the prognostic utility of diastolic function assessment.

The Effect of Fear of COVID-19 Experienced by Married Individuals Living in Türkiye on Marital Adjustment

Aim: We aimed to investigate the effect of fear of COVID-19 experienced by married individuals living in Türkiye on marital adjustment. Methods: A cross-sectional study design was used. Research data were collected between April 10 and 24, 2021, using the nonprobability snowball sampling technique. An online questionnaire that consisted of a participant information form, the Fear of COVID-19 Scale, and the Marital Adjustment Scale was applied to the participants via social media. Results: A total of 503 married individuals participated in the study. We found that the majority of the participants had negative changes in their feelings, thoughts, social lives, plans, and friend and work relationships during the pandemic process. According to the results of the regression analysis, the fear of COVID-19 explained 32.6% of the marital adjustment score of the participants. Conclusion: In stressful life events such as pandemics, it is necessary to plan appropriate interventions to protect married individuals’ mental health and marital adjustment. Keywords: COVID-19, fear, marital status, adjustments

Effectiveness of a Nursing Intervention Based on Acceptance Commitment Therapy on Stress, Marital adjustment, Sleep quality, and Fatigue among Patients with Breast Cancer

The most common kind of cancer among Egyptian women is breast cancer. Most patients presentat a late stage with subsequent poor outcomes. It ranks as the second-most common malignanttumor in women and the most common cause of cancer-related death. Aim: to evaluateeffectiveness of a nursing intervention based on acceptance commitment therapy on stress, maritaladjustment, sleep quality, and fatigue among patients with breast cancer. Design: Aquasi-experimental design was utilized. Setting: The study was conducted at the Menoufia UniversityHospital's oncology outpatient clinic in Egypt's Menoufia Governorate. Sample: Sixty adult breastcancer patients were selected by purposive sample. Tools: Four tools used; (1) Depression,Anxiety and Stress Scale (DASS); stress self-reported subscale(2) Marital adjustment Scale(3)Pittsburg sleep quality index(4) Piper Fatigue Scale. Result: shown that after two months ofintervention, When compared to prior intervention, there was a highly significant difference (p =0.00) between the study and control groups in terms of the total mean score for fatigue, stress,sleep quality, and marital adjustment. When compared to the control group, there was a highlystatistically significant negative correlation between the study group's marital adjustment and theiroverall scores for fatigue, stress, and sleep quality (high scores indicate poor sleepquality).Conclusion: Acceptance commitment therapy-based nursing intervention improvesstress, marital adjustment, quality of sleep, and fatigue in breast cancer patients.Recommendation: - Acceptance commitment therapy should be the foundation of non-pharmacological cancer treatment for many malignancie

Coping styles and quality of life in oral cancer patients undergoing radical resection and free flap reconstruction

ObjectiveOral cancer is associated with functional impairment and changes in appearance due to disease progression and/or treatment. It therefore places a heavy psychological burden on patients. Coping styles of patients with cancer may affect their quality of life (QOL). However, there is limited research assessing this association. We aimed to clarify the relationship between coping styles and QOL in patients with oral cancer to underpin personalized patient care. MethodsPatients who underwent surgery with reconstruction for oral cancer between February 2017 and June 2021 were included in this study. Coping styles were assessed preoperatively using the Mental Adjustment to Cancer (MAC) scale. Mental and physical QOL was assessed preoperatively and at 3, 6 and 9 months postoperatively, using the Short Form-8 (SF-8) health survey. ResultsTwenty-seven patients completed the MAC and SF-8. The median (interquartile range) scores of MAC subscales summary positive adjustment (SPA) and summary negative adjustment were 48.0 (44.0–55.0) and 34.0 (29.0–38.0) points, respectively. The mental component summary (MCS) scores of the SF-8 at the preoperative assessment and 3, 6 and 9 months postoperatively were 47.2 (43.5–50.6), 45.2 (41.2–51.3), 48.4 (43.7–52.0) and 47.7 (43.2–51.0) points, respectively; the physical component summary scores were 47.2 (42.4–51.0), 41.9 (38.4–47.7), 44.8 (41.4–49.9) and 47.0 (42.9–50.0) points, respectively. A positive correlation was noted between the SPA and MCS preoperatively, and 3 and 9 months postoperatively. ConclusionsCoping style may have predictive value for oral cancer patients with low mental QOL.

Cognitive characteristics in women with mastectomy, mental symptoms and marriage compliance

IntroductionAlthough mastectomy is a treatment for the cleaning of cancer cells in the breast, it can also cause psychological changes in women.ObjectivesThis research was carried out to investigate the cognitive distortions, mental symptoms, and marital adjustment relationships in women with mastectomy.MethodsThe descriptive and comparatice study was conducted in a public hospital with 90 mastectomies and 90 healthy female samples. The data were collected using The Cognitive Distortions Scale (CDS), The Brief Symptom Inventory (BSI), and Marriage Adjustment Scale (MAS) and were evaluated by descriptive statistical analyzes, t test, Mann-Whitney U test and Spearman Correlation Analysis.ResultsWomen with mastectomy scored high in the healthy control group in all sub-dimensions of CDS and BSI and this difference is highly significant (p&lt;0,5). Women with mastectomy scored higher in total agreement sub-dimensions than the healthy control group and the difference between them was statistically significant (p&lt;0,5). There ara positive, very strong and statistically significant relationships between all sub-dimensions of the CDS and the total sub-dimension scores of the BSI (r=,769and, 919). There are positive, strong and statistically significant relationships between the sub-dimensions of the CDS and the sub-dimension of the agreement and the total score of MAS (r=681 and 734). There are strong and statistically significant relationships between the total and sub-dimension scores of the BSI and the sub-dimension and total score of the MAS’s agreement (r=,672 and 778).ConclusionsCognitive distortions and mental symptoms are significantly higher in women with mastectomy, and cognitive distortions are associated with mental symptoms. Cognitive distortions and psychological symptoms scores, marriage adjustment scores and agreement sub-dimension scores increase in women.Disclosure of InterestNone Declared

Effects of Learned Helplessness on College Life Adjustment of Health College Students during the COVID-19 Pandemic

Objectives: This study aimed to identify the learned helplessness felt during COVID-19 as a basis for understanding the correlation with actual college life adjustment. Furthermore, the study aimed to develop strategies to enhance student adjustment to college life.Methods: A total of 284 college students in the nursing and emergency medical service department were given a questionnaire on learned helplessness and college life adjustment. The data were analyzed through the SPSS 23.0 program.Results: The college life adjustment score were significantly higher in the nursing department, the senior, high grades, and high major satisfaction. The learned helplessness and college life adjustment of health college students were negatively correlated. The effects of learned helplessness on the participant’s college life adjustment were lacking in confidence, lack of control, passivity, and lack of responsibility. The explanatory power of the model was 60.3%.Conclusions: Based on the results of this study, it is necessary to develop and apply various programs for health college students to reduce learned helplessness and increase college life adjustment.

Investigating the role of defense mechanisms on marital adjustment in infertile couples based on the cause of infertility: A cross-sectional study.

Infertility affects individual's and couples' adjustment. The defense mechanism and marital adjustment are mental processes that play a key role in infertile couples' life. This study aims to investigate the role of defense mechanisms on marital adjustment in infertile couples based on the cause of infertility. This cross-sectional study was conducted on 400 infertile couples at Royan Institute (A referral center for infertility, Tehran, Iran). Infertile couples were divided into 4 groups based on the cause of infertility (female, male, both, and unknown). Demographic questionnaire, revised dyadic adjustment scale, and defense styles questionnaire were used for data collection. Results showed that the mean score of marital adjustment of men based on the cause of infertility (female, male, and both) was significantly higher in comparison with their wives (p = 0.04, p 0.001, p 0.001, respectively). However, no difference was observed between the mean score of women, men, and couples (women and husbands) in defense mechanisms. But marital adjustment has a significant positive correlation with mature defense mechanisms and a negative correlation with immature ones (p 0.05). The mean score of marital adjustment is higher in men than in their wives in all groups. So, counseling infertile couples in the field of marital adjustment and training in the use of mature defense mechanisms is recommended especially in women.

The moderating effect of resilience on the relationship between academic stress and school adjustment in Korean students.

This study investigated the moderating effects of resilience on the relationship between academic stress and school adjustment among Korean adolescents. We examined the moderating effect for the total scores of school adjustment and the two subscales of school adjustment (academic adjustment and general school adjustment). Data were obtained in Pusan, Korea, using the convenience sampling method, and a total of 674 participants' responses were used for the final analysis. Hierarchical regression analysis and multiple regression analysis were performed to examine our research questions. The results of the study showed that academic stress was a significant predictor of school adjustment among Korean adolescents. More specifically, academic stress was related to poor school adjustment. The study also found that resilience has a significant mediating effect on the relationship between academic stress and school adjustment. Our findings suggest that resilience is likely to alleviate the harmful effect of academic stress on school adjustment. Finally, implications for school-based intervention were discussed for providing practical academic assistance.

Short-term effectiveness of dapagliflozin versus DPP-4 inhibitors in elderly patients with type 2 diabetes: a multicentre retrospective study

AimTo compare effectiveness of dapagliflozin versus DPP-4 inhibitors on individualized HbA1c targets and extra-glycaemic endpoints among elderly patients with type 2 diabetes (T2D).MethodsThis was a multicentre retrospective study on patients aged 70–80 years with HbA1c above individualized target and starting dapagliflozin or DPP-4 inhibitors in 2015–2017. The primary outcome was the proportion reaching individualized HbA1c targets. Confounding by indication was addressed by inverse probability of treatment weighting (IPTW), multivariable adjustment (MVA), or propensity score matching (PSM).ResultsPatients initiating dapagliflozin (n = 445) differed from those initiating DPP-4i (n = 977) and balance between groups was achieved with IPTW or PSM. The median follow-up was 7.5 months and baseline HbA1c was 8.3%. A smaller proportion of patients initiating dapagliflozin attained individualized HbA1c target as compared to those initiating DPP-4 inhibitors (RR 0.73, p < 0.0001). IPTW, MVA, and PSM yielded similar results. Between-group difference in the primary outcome was observed among patients with lower eGFR or longer disease duration. Dapagliflozin allowed greater reductions in body weight and blood pressure than DPP-4 inhibitors.ConclusionsElderly patients with T2D initiating dapagliflozin had a lower probability of achieving individualized HbA1c targets than those initiating DPP-4 inhibitors but displayed better improvements in extra-glycaemic endpoints.

Communication skills training with the transactional analysis approach developed menopausal women's marital adjustment - a quasi-experimental study.

Communication skills help people have a better life. Due to the changes caused by menopause and their effects on interpersonal communication, it is essential to reinforce communication skills during this period. This study aimed to investigate the effect of communication skills training (CST) using the transactional analysis (TA) approach on menopausal women's marital adjustment. This quasi-experimental study with a parallel design was performed by the availability sampling method with participation of 46 married menopausal women. Participants were randomly assigned to two groups. The intervention group participated in eight CST sessions with a TA approach. The control group did not receive any psychosocial or educational services. Participants completed the demographic information, Queen Dam communication skills, and Spinner's marital adjustment questionnaire before, at the end of, and one month after the training period. Data were analyzed by descriptive and analytical tests with SPSS22 software. There was no significant difference in demographics between the groups (p < 0.05). The mean marital adjustment scores were 53.48 ±12.24, 117.70 ±11.15, and 116.52 ±10.73 before, at the end of, and one month after the intervention, respectively. The marital adjustment scores before the intervention did not differ between the two groups but significantly increased after training and in the follow-up period (p < 0.001). Communication skills training with a TA approach in postmenopausal women improves marital adjustment. Therefore, it is suggested that midwives use this method in comprehensive health centers as an effective method for improving the lives of postmenopausal women.

ADJUSTMENT LEVEL AMONG ELDERLY PEOPLE RESIDING AT HOMES AND OLD AGE HOMES

The present study aims at comparing old age adjustment problems in men and women residing at homes and old age homes. The sample of the present investigation was comprised 186 old age subjects, out of which 100 were staying at homes while 86 were staying at old age homes. In order to collect information regarding old age adjustment problems, a standardized tool developed by Smt. Ragini Dubey (1997) was used. Results revealed that total adjustment score of females residing at home was significantly (P &lt; 0.01) higher as compared to females residing at old age homes similarly males residing at home showed significantly (P &lt; 0.01) higher adjustment score compared to males residing at old age homes. The mean score of adjustment among old age people indicated a moderate to poor level of adjustment. The study concludes that the type of residence and gender can significantly affect the adjustment during old age.

Evaluation of Quality of Life, Social Support and Coping Strategies and Illness Adjustment in Patients with Breast Cancer: A Cross-sectional Study

Background: Breast cancer patients experience physical and emotional distress due to their diagnosis and treatment of their disease. Objectives: This study aimed to assess the quality of life (QOL), social support and coping strategies, illness adjustment among breast cancer patients, and the type of breast surgery. Methods: We conducted a cross-sectional study at hospitals in Zahedan, Iran, in 2020. We recruited 120 patients with breast cancer by census method. Data collection tools were the breast cancer-specific module (QLQ-BR 23), The adjustment to illness measurement inventory for Iranian women with breast cancer (AIMI-IBC), and the multidimensional scale of perceived social support (MSPSS) questionnaires. We performed the statistical analysis in SPSS software version 19.0. Results: The mean age of patients in this survey was 47.35 ± 10.67 years. 53.3% of patients underwent a mastectomy, 34.2% had a lumpectomy, and 12.5% of patients had not been surgery. Patients on the functioning scale reported high scores for body image (78.61 ± 26.69) and future perspective (55.27 ± 26.71). Patients on the symptom scale had a high score upset by hair loss (49.16 ± 38.88). Also, the mean score of total social support was 45.71 ± 9.92. in addition, they used the reasonable efforts coping strategy (4.07 ± 0.35), and the mean score of illness adjustment was 150.91 ± 16.29. Conclusions: The results of this study indicated that breast cancer patients received a high social support level, especially from family members, and had a high degree of adjustment to their illness. Also, patients were more upset about their hair loss and body image. Therefore, early disease detection can improve breast cancer women's quality of life and disease adaptation.