Kermanshah University Of Medical Sciences Research Articles

Designing and psychometric evaluation of safe nursing care instrument in intensive care units

BackgroundProviding safe care in a sensitive and high-risk unit such as the ICU is one of the most crucial tasks for nurses. One way to establish the criteria for safe care is by creating a instrument to assess it. Therefore, this study was conducted with the aim of designing and psychometrically evaluating an instrument for safe nursing care in the ICU.MethodsThe current study employed a sequential-exploratory mixed-method approach with two qualitative and quantitative phases. Based on the results of qualitative phase and the literature review, the primary instrument was designed. In the quantitative phase, the designed instrument underwent psychometric evaluation. Face, content and construct validity were assessed. Face validity was assessed by 20 nurses, and content validity was assessed by 26 experts. In the construct validity stage, the sample size for the exploratory factor analysis (EFA) included 300 nurses, and for the confirmatory factor analysis (CFA) included 200 nurses who work full-time in the ICUs of hospitals affiliated with Kermanshah University of Medical Sciences in western Iran. EFA sampling was conducted in three hospitals, encompassing six ICUs, while CFA sampling was carried out in two hospitals, covering four ICUs. Sampling was done using the convenience method. The reliability of the instrument was also assessed. Finally, the interpretability, feasibility, weighting, and scoring of the instrument were evaluated.ResultsThe qualitative phase identified three themes, including professional behavior (with categories: Implementation of policies, organizing communication, professional ethics), holistic care (with categories: systematic care, comprehensive care of all systems), and safety-oriented organization (with categories: human resource management and safe environment). The primary instrument was designed with 107 items rated on a five-point Likert scale. In the quantitative phase, the psychometrics of the instrument were conducted. First, the face and content validity were assessed, and the average scale content validity index (S-CVI) was 0.94. Then, a preliminary test was conducted to assess the initial reliability (α = 0.92) and the correlation of each item with the total score. After completing these steps, the number of items in the instrument was reduced to 52. The results of the EFA explained 58% of the total variance, with 4 factors identified: professional behavior by following guidelines, comprehensive care, accurate documentation, and pressure ulcer care. At the CFA stage, the results of the calculation of indices and goodness of fit showed that the model had a good fit. The reliability of the relative stability by examining the intraclass correlation coefficient (ICC) for the whole instrument in 20 samples was 0.92 with a confidence interval of 0.97 − 0.81. To measure absolute stability and determine the responsiveness of the instrument, the standard error of measurement (SEM) was 4.39 and the minimum detectable change (MDC) was 12.13.ConclusionThe instrument for safe nursing care in the ICU has favorable psychometric properties.

The State of Moral Intelligence of Medical Students of Kermanshah University of Medical Sciences in 2022

Background: Recently, new dimensions have been recognized in the field of intelligence. One of the most important of these is moral intelligence, which has not been extensively addressed in Iran. Objectives: Moral intelligence represents the mental capacity of individuals to relate universal human principles to their values, goals, and actions. It guides all other types of human intelligence towards performing valuable work. Methods: The current descriptive cross-sectional study involved a statistical population of medical students, with a sample size of 248 people selected through random and available sampling methods. To collect data, the standard moral intelligence questionnaire by Lennik, Keel, and Jordan was used. The data collected was analyzed using SPSS-21 software, employing both descriptive and inferential statistics, including Spearman's correlation coefficient. Results: The total score of students' moral intelligence was 76.29 ± 9.80, which is evaluated as good. The area of honesty had the highest score (81.2), while the area of empathy had the lowest score (70.3). Among the indexes, keeping promises scored the highest (93.6), and admitting mistakes and omissions scored the lowest (70.5). Scores were higher among women and married individuals, and moral intelligence scores increased with advancing academic semesters. However, there were no significant differences overall, except that the empathy field had a significant relationship with age (P = 0.031), and gender had a significant relationship with the overall score of moral intelligence (P = 0.041). Conclusions: According to the total moral intelligence score of the students, which was 76.29 ± 9.80, it was determined that the moral intelligence status among the medical students of Kermanshah Medical School is in good condition.

Investigating perceived core disaster competencies of nurses in Iran: A case study of northwest hospitals.

This study was carried out to investigate the perception of the main competencies of disaster management in Iranian emergency department nurses in 2023 in hospitals affiliated with Kermanshah University of Medical Sciences. The present study was conducted to explore the perceived core disaster competencies in nurses of hospitals affiliated with Kermanshah University of Medical Sciences in 2023. Due to the rise in natural disasters, their escalating severity and associated regulatory response necessitate a closer look at the preparedness and core competencies of nursing personnel. The main competencies of nurses are necessary to deal with disasters in unexpected events, and they are expected to use their professional expertise to provide the required nursing services to reduce the risks caused by disasters. This descriptive-analytical study was conducted cross-sectionally between May and September 2023. In the study, a sample of 384 nurses working in the departments of four hospitals affiliated with Kermanshah University of Medical Sciences was selected through a random stratification. The data collection instrument was a 45-item scale of nurses' perceived core competencies (NPDCC) in handling disasters. The data were analyzed using the Mann-Whitney U-test, Kruskal-Wallis test, and independent samples t-test. The significance level was set at 5%. The mean total score of perceived core disaster competencies was 139.11±37.65. The technical skills subscale got the highest score (51.81±11.28) and critical thinking skills received the lowest (9.74±3.92). Also, "technical skills" had the highest average and "critical thinking skills" had the lowest average in all three age groups. The results found a significant difference between the scores of nurses in perceived core disaster competencies in age groups, work environments, education degrees, marital statuses, and experiences of attending disaster workshops (p ≤ 0.05). The results showed that nurses had different levels of core disaster competencies in the department. There are gaps in the core disaster nursing competencies that need to be filled. Nursing managers should consistently evaluate the core nursing competencies to achieve efficacious disaster preparedness. To this aim, it is recommended that authorities implement training courses and programs to enhance the preparedness of nurses in responding to disasters.

Translation and Psychometric Properties of the Persian Version of Neonatal Intensive Care Unit Parental Belief Scale in Iranian Parents.

This study is done to determine the translation and psychometric properties of the Persian version of Neonatal Intensive Care Unit Parental Belief Scale (NICU-PBS) in Iranian parents. The present study was conducted by the descriptive cross-sectional method. This research was conducted from January to August 2021. The population included all parents whose infants were hospitalized in NICUs of two university-affiliated hospitals (Kermanshah University of Medical Sciences and Shiraz University of Medical Sciences). Out of them, 291 subjects were selected by the purposeful sampling method. The utilized questionnaires included a demographic information form, NICU-PBS, Beck Depression Inventory, and Maternal role adaptation scale. The descriptive statistical indexes, Cronbach's alpha, intra-class correlation coefficient, and Pearson's correlation coefficient were used for data analysis. Also, to evaluate the construct validity of the NICU-PBS, we used Confirmatory Factor Analysis (CFA). The participants included 97 fathers (33.33%) and 194 mothers (66.67%). According to the CFA results, the three-factor model NICU-PBS (confidence in the parental role, parent-child interaction, parental knowledge of the NICU) was approved in Iranian parents (χ2/df = 1.79; p < 0.001; GFI = 0.91; AGFI = 0.89; CFI = 0.91; RMSEA = 0.05). NICU-PBS with BDI-II (r = -0.42) has divergent validity, and material role adaptation (r = 0.46) has moderate and acceptable convergence validity (p < 0.01). The results of Cronbach's alpha for the total NICU-PBS were 0.85. The results demonstrated the proper and acceptable validity and reliability of NICU-PBS among Iranian parents.

Identifying the Effective Components on Nurses' Knowledge Sharing Behavior with Mixed Method Research

Background. Knowledge-sharing is a process in which people mutually exchange tacit and objective knowledge and create new knowledge. This study aimed to identify the main themes and organize the components of nurses' knowledge sharing. Methods. A mixed research method was adopted to conduct the present study. To this end, a qualitative method with a thematic analysis approach was first implemented to investigate the statistical population. The required data were collected by reviewing the published national and international articles using the keyword "knowledge sharing" in search engines. In total, 387 scientific research articles were retrieved from searching the literature. Then, the inclusion criteria were used to filter the information and reduce the number of articles to 48 containing the related codes specific to the themes. The quantitative part was an analytical survey. The statistical population included the nurses of Kermanshah University of Medical Sciences. The structural equation modeling methodology was adopted to determine a sample size of 284 individuals. Results. In the qualitative part, there were 27 main themes, 11 sub-core themes, and nine knowledge-sharing organizing themes, including attitude, mental norms, rewards, costs, perceived behavioral control, mutual benefits, knowledge-sharing tools, and perception of gaining reputation. The components of knowledge-sharing intention were identified in the quantitative part based on the nurses' points of view, and gaining reputation, mutual benefits, and mental norms were found the most important components in order of priority. Conclusion. Based on the findings of this study, the components of attitude, perceived behavioral control, reward, mutual benefits, reputation and subjective norms are effective in the knowledge sharing behavior pattern of nurses and can cause the actual behavior of the individual.

Prevalence and risk factors associated with coronary artery disease in Iranian patients with peripheral artery disease

IntroductionIt is well known that peripheral artery disease (PAD) and coronary artery disease (CAD) coexist and therefore, patients diagnosed with PAD have an increased chance of developing concomitant CAD. CAD-related complications could be a leading cause of postoperative mortality in individuals with PAD undergoing vascular surgery. We present a case series of 48 patients who underwent coronary angiography before vascular surgery and an updated review of previous reports to determine the prevalence of concomitant CAD in a convenience sample of Iranian patients. MethodsThis cross-sectional study was performed on 48 patients with confirmed PAD admitted to Imam Ali Hospital, affiliated with the Kermanshah University of Medical Sciences (KUMS), Kermanshah Province, Iran. A vascular surgeon diagnosed PAD based on the patient's symptoms, Doppler ultrasound, and CT angiography (CTA). All patients underwent coronary angiography to determine if they also had CAD. We defined significant CAD as a ≥70% luminal diameter narrowing of a major epicardial artery or a ≥50% narrowing of the left main coronary artery. ResultsOf 48 patients, 35 (72.9%) were male, 13 (27.1%) were female, and the mean age was 64.18±12.11 years (range, 30 to 100 years). The incidence of CAD in patients with PVD was 85.42% (41/48). The patients with CAD were more likely to be hypertensive than those without CAD (80.5 vs. 14.3, p-value<0.001). Of 41 patients with CAD, 9 (22.0%) had one-vessel disease, 10 (24.3%) had two-vessel disease, and 22 (53.7%) had three-vessel disease. ConclusionHypertension was a significant risk factor for CAD. Patients with hypertension and multiple major coronary risk factors scheduled for PVD surgery should be carefully evaluated for concomitant CAD.

Exploring nurses' experiences of recommended patient care: a descriptive phenomenological study.

Caring for recommended patients creates work and emotional challenges for nurses. Nurses are obligated to provide care regardless of the patient's situation. Therefore, knowing the experiences of nurses in dealing with recommended patients in order to provide quality and effective care can be the basis for increasing patient satisfaction. The present study was conducted aimed to explain nurses' experiences of caring for recommended patients. This was a qualitative study with descriptive phenomenological approach. Participants were 12 nurses working in different wards of hospitals affiliated to Kermanshah University of Medical Sciences, selected by purposive sampling method with maximum diversity. The data collected using semi-structured interviews in face-to-face and audio-recorded methods. MAXQDA 2020 software was used for data management. The analysis of the data was done using the Colaizzi's 7-step method. In order to verify the trustworthiness of the data, Lincoln and Guba criteria were used. After continuous data analysis, 110 initial codes were extracted. These codes emerged in 18 sub-themes and 6 main themes including: catastrophe, be in decline, be in progress, discrimination, work overload, and poor prognosis. The results showed information about the presence of recommended patients in the hospital, which can have consequences for patients and nurses. Therefore, it is advised that nurses provide standard care and avoid any kind of discrimination against all patients regardless of whether the patient is recommended or not.

Organizational Commitment in Kermanshah University of Medical Sciences Faculty Members

Background: Organizational Commitment (OC) is an attitude or orientation toward the organization that connects the individual's identity to the organization. Objectives: This study aimed to determine the OC level of Kermanshah University of Medical Sciences (KUMS) faculty members. Methods: This cross-sectional study was conducted among 177 faculty members of KUMS in western Iran. The samples were randomly selected among faculty members. The data were collected by self-reporting using a standard Balfour and Whechler questionnaire and analyzed in SPSS software version 16 using t-tests and Pearson correlations. Results: The mean score of OC was 28.12 (SD: 4.82), ranging from 9 - 45. There was no significant difference between gender and OC (P = 0.239). OC had a positive and significant correlation with age (r = 0.192 &amp; P = 0.011). The relationship between job history and OC was positive but insignificant (r = 0.147 &amp; P = 0.057). Conclusions: According to the OC score, emphasizing the subjects and areas of OC can effectively increase faculty members' dedication to the university.

Design, implementation and evaluation of e-learning program for common diseases to smartphone-based medical students: at a developing university

ObjectiveMobile-based educational software offers a wealth of resources that can foster the growth of learners and facilitate the creation of an interactive learning environment. This environment encourages both students and instructors to engage in exploration and the examination of various medical issues. The objective of this study is to design, implement, and evaluate an electronic educational program focused on common medical conditions, specifically tailored for medical students and accessible through mobile phones.MethodThe study was conducted following an action research approach, which comprised four key stages: needs assessment, application design, training, and evaluation. This research took place at the Kermanshah University of Medical Sciences’ Medical School. In the needs assessment phase, a formal survey was distributed to the teaching faculty members, requesting them to identify diseases and medical issues of high importance for medical interns’ education that were suitable for virtual teaching. Each faculty member was asked to prioritize a minimum of three and a maximum of seven cases. Subsequently, 10 faculty members from various departments completed the survey, leading to the identification of 47 common diseases after eliminating duplicates. These 47 cases were then presented to 30 medical interns, who were asked to select the 20 most significant cases. The 20 diseases with the highest statistical frequency were selected for further development due to resource constraints. The mobile application was developed for the Android platform using the Java programming language and the Android Studio development environment. To assess the application’s effectiveness from the students’ perspective, a questionnaire was designed, encompassing 25 questions across five domains: satisfaction, performance, learning, usability, and educational effectiveness. The questionnaire employed a Likert scale, with response options ranging from ‘completely disagree’ to ‘completely agree,’ scored from 1 to 5. One hundred medical interns and trainees were invited to participate in the evaluation, with 92 of them completing the questionnaires.ResultsThe findings revealed a significant disparity in the average scores between students who underwent traditional teaching methods and those who engaged in mobile-based app-assisted education. This discrepancy was statistically significant across all three examined components.ConclusionMobile-based learning represents a burgeoning educational approach with profound implications for healthcare education and the enhancement of patient care quality. The widespread integration of mobile phones into the educational framework offers a flexible teaching paradigm, fostering the potential for continuous lifelong learning.

Evaluation of Critical Thinking Skills in Medical Students of Kermanshah University of Medical Sciences

Background: According to the 21st Century Partnership Learning Framework, several competencies or skills should be possessed regarding critical thinking and problem-solving, communication and collaboration skills, creative and updating skills, information and communication technology literacy skills, contextual learning skills, and information and media literacy skills. Increasing critical thinking skills is necessary in modern and advanced educational systems. Objectives: This study aimed to evaluate the critical thinking skills of medical students. Methods: This descriptive and analytical cross-sectional study was conducted on 271 medical students in the primary science section of Kermanshah University of Medical Sciences, Iran, in 2023 who were selected by a convenient sampling method. The data were collected by demographic characteristics and the California Critical Thinking Skills Test (CCTST). Descriptive and inferential statistical methods were used to analyze the data using SPSS software version 21. Results: The total critical thinking skills score in the studied students was 8.89 ± 3.60, equivalent to 25% of the total score. The highest and lowest areas were related to comparative reasoning and inference, with an average of 4.35 ± 1.94 and 2.59 ± 1.56, respectively. There was no significant difference between the average critical thinking skills score regarding age, gender, academic semesters, and living or not in a dormitory. Conclusions: Based on the results, medical students’ critical thinking skills are weak and lower than the exam average. The educational system of Kermanshah University of Medical Sciences should be reviewed in designing a curriculum to foster critical thinking.

Risk Factors for Candidiasis among Patients Referred to Medical Mycology Laboratory of the Special Clinical of Kermanshah University of Medical Sciences

Introduction: Candidiasis is undoubtedly one of the most important and common diseases of opportunistic fungi in human. Factors such as: age, physiological changes, long-term use of antibiotics, diabetes, immune deficiency, cardiovascular disease can make a person prone to candidiasis. In this study, risk factors contributing to candidiasis in the patients referred to the mycology laboratory of the special clinic of Kermanshah University of Medical Sciences in 2013 to 2018 were investigated. Methods: In a descriptive study, to show the effective factors in the development of candidiasis as an opportunistic fungal disease, all patients during 2013 to 2018 that referred to the mycology laboratory of the special clinic of Kermanshah University of Medical Sciences were examined. In this study, demographic characteristics such as age, gender, occupation, and residence were collected. The results of direct microscopic observation and mycological culture of patient samples were determined. The results were expressed as descriptive statistics. Results: In this study, 26.98% of 541 people had cutaneous candidiasis, 72.08% had nail candidiasis, and 0.92% had systemic candidiasis. The most common species is Candida albicans. The highest frequency of skin candidiasis is related to the age group of 40-49 years (20.54%). It was more common in patients with a history of cardiovascular disease and diabetes and 47% of patients mentioned excessive contact with water. The highest frequency of nail candidiasis is related to the age group of 30- 39 years and women. It is more common among housewives. It is more prevalent in patients with a history of cardiovascular disease and diabetes, respectively. 75% of patients with systemic mucosal candidiasis had immunodeficiency. Conclusion: The most important factor in preventing candidiasis is public health. For age group of 20-29 years, when suffering from chronic diseases such as diabetes, cardiovascular and immunodeficiency disease.

The effect of hemodialysis with cool dialysate on nausea in hemodialysis patients: A randomized clinical trial.

Experiencing nausea leads to decreased self-esteem and social isolation in hemodialysis patients and affects all aspects of their quality of life. Nausea and vomiting make hemodialysis unpleasant for patients leading to premature termination of hemodialysis. Therefore, based on this necessity, the present study was conducted to determine the effect of hemodialysis with cool dialysate on nausea in hemodialysis patients. In this clinical trial, 60 eligible patients receiving hemodialysis were randomly assigned to the control (30 participants) and intervention (30 participants) groups. In the control group, the patients received standard hemodialysis (37°C) for three sessions. Simultaneously, patients in the intervention group received hemodialysis with a cold solution (of 36°C) for three sessions. The patients' nausea and shivering rates were measured using the visual analog scale and the shivering standard assessment scale, respectively. Both groups were evaluated before and after 1 week of intervention. The study did not include blinding. The trial has been registered in the Iranian Registry of Clinical Trials (IRCT) with the number IRCT20200530047597N1. The present study was financially supported by Kermanshah University of Medical Sciences, Kermanshah, Iran (no. 990220). Data were analyzed using SPSS-25 software. The independent t test showed no statistically significant difference between the two control and experimental groups regarding the nausea rate in the three evaluation times (p < 0.05). Nevertheless, nausea severity decreased significantly after the intervention in the two groups. However, the rate of nausea in the intervention group with cold solution decreased more compared to the control group. Moreover, no patient in the intervention group experienced shivering during hemodialysis with a cool dialysate. According to the results of this study, it can be stated that the use of cold hemodialysis to control nausea in patients undergoing hemodialysis requires further studies and can be recommended as a nonpharmacological treatment to manage the treatment costs in case of efficiency.

Internalized AIDS-Related Stigma Experiences in West of Iran

Background and Objective: Internalized stigma (IS) is defined as negative stereotypes people hold about themselves and have accepted them. The purpose of this study was to determine IS among HIV/AIDS patients in Kermanshah, Iran. Materials and Methods: This cross-sectional research was conducted on 200 HIV/AIDS patients in the Behavioral Diseases Counseling Center of Kermanshah University of Medical Sciences, Kermanshah, Iran, in 2021. The required data were collected using a questionnaire and holding an interview. The gathered data were analyzed in SPSS-16 software using one-way analysis of variance, independent samples t-test, and bivariate correlation tests. Results: The average overall score of IS was obtained at 5.65 (score range: 0 to 6). The mean internalized stigma score was slightly higher among male patients, single individuals, those with primary education, unemployed patients, and those with poor economic status; however, it was not statistically significant. Conclusions: It can be concluded that IS highly prevalent among HIV/AIDS patients in Kermanshah. Comprehensive interventions among patients are needed to reduce stigma.

Midwifery students' experiences: Violations of dignity during childbirth.

The principle of human dignity is woven into the ethical principles of the midwifery profession, noted as both an obligation and a human right. The aim of this study is to explore the experiences of midwifery students regarding threats to women's dignity during childbirth. This is a qualitative study with explorative design. Participants and Research Context: The research was carried out in 2022 at Kermanshah University of Medical Sciences, involving 32 midwifery students in individual interviews that lasted between 30 and 90 minutes. These participants aged 21 to 28 years, with an average age of 23.5 years, provided their perspectives on the matter. Four key themes described the threats to women's dignity during childbirth: 1) professional incompetence, 2) abuse of power imbalance, 3) caring only for physical and not mental health, and 4) structural issues within the healthcare system. Professional incompetence was characterized by outdated practices and lack of adherence to evidence-based medicine. Abuse of power imbalance was demonstrated in instances where the authoritative position of healthcare providers was misused, thereby disrupting the respectful care that women are entitled to receive. The disproportionate emphasis on physical health over mental health was evidenced by the disregard for mothers' psychological well-being during childbirth. Lastly, systemic structural issues emerged as significant impediments, revealing the need for system-wide changes. Ethical considerations: This study was approved by the Ethics Committee of the Research Deputy at Kermanshah University. Participation was voluntary and the confidentiality were maintained. The findings underscore the role that unprofessional behavior, ethical lapses in medical practices, and systemic challenges play in undermining maternal dignity during childbirth. These threats necessitate urgent attention and must be adequately addressed in policy development and program implementation to safeguard the dignity of mothers during childbirth.

The effect of Iran's health sector evolution plan on hospitals performance indicators: an interrupted time series analysis.

The Health Sector Evolution Plan (HSEP) was set up in Iran's health system to respond to some of the main problems in hospitals and other health sectors. We aimed to compare the effect of the HSEP on teaching hospital performance before and after the implementation of the HSEP through the interrupted time series (ITS) analysis. With a cross-sectional design, data collection was performed in 17 teaching hospitals affiliated with the Kermanshah University of Medical Sciences (KUMS). We used the existing data on three indicators of hospitalization rate (per 10,000 population), Emergency Department Visits (EDVs) (per 10,000 population), and in-hospital mortality (per 10,000 population). The monthly data from 2009 to 2019 was analyzed by the ITS method 60 months before and 61 months after the HSEP. We found a non-statistically significant decrease in the monthly trend of hospitalization rate relative to the period before the HSEP implementation (-0.084 per 10,000 population [95%CI: -0.269, 0.101](. There was a statistically significant increase in the monthly trend of EDVs rate compared to before the HSEP implementation (1.07 per 10,000 population [95%CI: 0.14, 2.01]). Also, a significant decrease in the monthly trend of in-hospital mortality compared to before the HSEP implementation [-0.003 per 10,000 population (95%CI: -0.006, -0.001)] was observed. Our study demonstrated a significant increasing and decreasing trend for EDVs and in-hospital mortality following the HSEP implementation, respectively. Regarding the increase in hospitalization rate and EDVs after the implementation of HESP, it seems that there is a need to increase investment in healthcare and improve healthcare infrastructure, human resources-related indicators, and the quality of healthcare.

Evaluation of digital literacy of professors and students of Kermanshah University of Medical Sciences regarding independent and distance learning (Preprint)

Evaluation of digital literacy of professors and students of Kermanshah University of Medical Sciences regarding independent and distance learning (Preprint)

Investigating the outcomes of cardiopulmonary resuscitation and factors affecting it: A cross-sectional study at Dr. Moaven Hospital, Sahneh City from 2014 to 2021.

Cardiopulmonary resuscitation (CPR) is referred to an attempt to maintain the respiratory system and blood circulation active to oxygenate the body's important organs until the heart and blood circulation system return to normal. CPR results are influenced by a variety of circumstances and factors. The purpose of this study was to look into the outcomes of CPR and the factors that influence them at the Dr. Moaven Hospital in Sahneh. This cross-sectional descriptive study was carried out retrospectively from the start of 2014 to the start of 2021. Kermanshah University of Medical Sciences provides hospitals with a two-page form for data collection. After entering the data into SPSS24, descriptive and inferential statistical tests were applied to analyze the results. Out of 497 patients who referred to Dr. Moaven Hospital in Sahne City, 280 were men and 217 were women, with a resuscitation success rate of 22.5% in men and 23.5% in women. CPR was conducted on 63.2% of patients in the emergency department, with 22.2% of them having successful CPR. The existence of the underlying disease had a statistically significant link with the outcomes of CPR (p = 0.007). The most prevalent cause for visit was cardiorespiratory arrest (30.6%), and there was no statistically significant difference between the diagnostic and reason for visit and the outcome of resuscitation, according to the χ 2 test. According to the findings of this study, increasing age and duration of CPR, the existence of underlying diseases, and the absence of shockable rhythms all reduce the likelihood of success in CPR.

Examining the relationship between depression and medication adherence among elderlies suffering from cardiovascular disease referring to the clinics affiliated with Kermanshah Universityof Medical Sciences: A cross-sectional study.

In recent years, around 30% of all mortalities worldwide has been related to cardiovascular disease (CVD).The most important predictor solution of cardiovascular events is enhancing medication adherence. Meanwhile, the main reason behind development of physical disorders among the elderlyis depression. In this regard, the present research was performed to determine the relationship between depression and medication adherence among the elderlysuffering from CVD. A cross-sectional study was done via an analytical approach on 188 elderlies fulfilling the inclusion criteria. The participants were chosen through convenience nonrandomized sampling from March to July 2022. The data were collected through demographic and healthcare information form plus Madanloo chronic disease medication adherence and geriatric depression scale. The analysis of the data was done by SPSS 26 plus Stata 14.2. The mean depression score was 5.6(4.3) and the mean score of medication adherence in the elderlies was 168.03(23.85). The prevalence of depression was higher in women than in men (p = 0.015), and the elderlies differing from heart failure reported the minimum extent of medication adherence. The findings obtained from analysis of variance showed that age, level of education, and monthly level of income were among the effective demographic factors in the extent of depression and medication adherence (p < 0.05). Meanwhile, 26% of changes in medication adherence can be attributed to depression. Further, the results of the multiple linear regression model reported that depression, age, and polypharmacy are among the predictors of medication adherence. A weak to moderate relationship existed between depression and medication adherence among these elderlies. Given the growing elderly population, the importanceof depression, and lack of medication adherence in incidence of CVD events, it is recommended to train the healthcare team tomonitorthe elderlyregarding depression symptoms.

The Relationship between Mental Health and Loneliness in the Elderly during the COVID-19 Pandemic

Background and Aim: The coronavirus pandemic has had a negative impact on the health and well-being of communities and individuals around the world. One of the concerns about the COVID-19 epidemic is the impact of social isolation due to social distancing on the mental health of older adults. This study aimed to investigate the relationship between mental health and loneliness among seniors during the COVID-19 pandemic. Materials and Methods: In this cross-sectional study, 211 retirees of Kermanshah University of Medical Sciences were selected by available sampling method in 2021. Data were collected through the Demographic, Mental Health Questionnaire (GHQ-28) and the Adult Social and Emotional Feeling Questionnaire (SELSA-S). Data were analyzed using paired t-test, one-way analysis of variance, covariance, and chi-squared tests. The significance level was considered 0.05. Results: The mean age of participants was 71.26 years and the results showed a significant relationship between feeling lonely and mental health (r = 0.535, p = 0.001). There were statistically significant relationships between mental health and social functioning (r = −0.204, p ≥ 0.001) and depression (r = 0.501, p = 0.001) and also between mental health and three subscales of loneliness: romantic loneliness (r = 0.001, p = 0.001), social loneliness (r = 0.493, p = 0.001), and family loneliness (r = 0.289, p = 0.001). Conclusion: Feeling lonely during the coronavirus disease pandemic has a negative effect on the mental health of older adults; therefore, it is necessary for mental health professionals to improve the mental health of the elderly with proper planning and interventions.

The Association between Apolipoprotein E Genotypes and Serum Malondialdehyde Level with End-Stage Renal Disease.

The Apolipoprotein E (ApoE) polymorphism plays an important role in the pathophysiology of end-stage renal disease (ESRD). Additionally, ApoE may contribute to the progression of oxidative stress. Thus, this study aimed to determine the ApoE gene polymorphism and evaluate the malondialdehyde (MDA) level in ESRD patients and healthy individuals. The present cross-sectional study was conducted at 2010 at Kermanshah University of Medical Sciences (Kermanshah, Iran). The study population comprised ESRD patients (n=136) and healthy individuals (n=137). The MDA level was assessed using high-performance liquid chromatography (HPLC), and the frequencies of ApoE gene alleles were analyzed using restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). The data were analyzed using Statistical Package for Social Sciences (SPSS), version 13. The significant differences of ApoE genotypes in case and control groups were assessed using Pearson's Chi square tests, and two-tailed Student's tests. A logistic regression model was used to calculate the odd ratio. P<0.05 was considered statistically significant. According to the results, ESRD patients had a higher frequency of the E2/E3 genotype than the healthy group (P<0.001). The results indicated that E3/E4 genotype frequency in the patients' group was higher than that of the control group (P=0.026). Furthermore, the E3/E2 (OR=5.7, 95% CI=2.68-12.14) (P<0.001) and E3/E4 (OR=1.57, 95% CI=1.05-2.34) (P=0.029) genotypes were found to increase the risk of ESRD. Moreover, the MDA level in ESRD patients was higher than the healthy individuals (P<0.001). The patients with E3/E2 (P<0.001) and E3/E4 (P<0.001) genotypes had a higher level of MDA than the control group. According to the findings, patients with ESRD had higher genotypes of E3/E2 and E3/E4, which suggests a higher risk of developing ESRD.