Spielberger's Anxiety Inventory Research Articles

The design, implementation, and evaluation of a blended (in-person and virtual) Clinical Competency Examination for final-year nursing students

IntroductionStudies have reported different results of evaluation methods of clinical competency tests. Therefore, this study aimed to design, implement, and evaluate a blended (in-person and virtual) Competency Examination for final-year Nursing Students.MethodsThis interventional study was conducted in two semesters of 2020–2021 using an educational action research method in the nursing and midwifery faculty. Thirteen faculty members and 84 final-year nursing students were included in the study using a census method. Eight programs and related activities were designed and conducted during the examination process. Students completed the Spielberger Anxiety Inventory before the examination, and both faculty members and students completed the Acceptance and Satisfaction questionnaire.FindingsThe results of the analysis of focused group discussions and reflections indicated that the virtual CCE was not capable of adequately assessing clinical skills. Therefore, it was decided that the CCE for final-year nursing students would be conducted using a blended method. The activities required for performing the examination were designed and implemented based on action plans. Anxiety and satisfaction were also evaluated as outcomes of the study. There was no statistically significant difference in overt, covert, and overall anxiety scores between the in-person and virtual sections of the examination (p > 0.05). The mean (SD) acceptance and satisfaction scores for students in virtual, in-person, and blended sections were 25.49 (4.73), 27.60 (4.70), and 25.57 (4.97), respectively, out of 30 points, in which there was a significant increase in the in-person section compared to the other sections. (p = 0.008). The mean acceptance and satisfaction scores for faculty members were 30.31 (4.47) in the virtual, 29.86 (3.94) in the in-person, and 30.00 (4.16) out of 33 in the blended, and there was no significant difference between the three sections (p = 0.864).ConclusionEvaluating nursing students’ clinical competency using a blended method was implemented and solved the problem of students’ graduation. Therefore, it is suggested that the blended method be used instead of traditional in-person or entirely virtual exams in epidemics or based on conditions, facilities, and human resources. Also, the use of patient simulation, virtual reality, and the development of necessary virtual and in-person training infrastructure for students is recommended for future research. Furthermore, considering that the acceptance of traditional in-person exams among students is higher, it is necessary to develop virtual teaching strategies.

The Effectiveness of Active Music Therapy on Anxiety and Sleep Quality in Adolescents Aged 11-14 with Stargardt Disease

Objective: This study aimed to examine the effectiveness of active music therapy on anxiety and sleep quality in adolescents aged 11-14 with Stargardt disease. Methods and Materials: The current research is a quasi-experimental study with pre-test, post-test, and a control group. In this study, 20 patients with Stargardt disease were selected through convenience sampling and divided into two groups: experimental and control (10 individuals each). They responded to the Spielberger Anxiety Inventory and the Petersburg Sleep Quality Index. Subsequently, training sessions were conducted, followed by post-tests and a one-month follow-up. The research data were analyzed using SPSS software version 22 and the covariance analysis method. Findings: The findings indicated that active music therapy was effective in reducing anxiety and improving sleep quality in adolescents with Stargardt disease (P < 0.01). Conclusion: Music therapy is an affordable, effective, and side-effect-free method that can be introduced for reducing anxiety and improving sleep quality. Health-related centers can utilize it to create better living conditions for such individuals

Chronic dizziness: modern treatment methods taking into account comorbidity

In most cases, chronic dizziness is persistent postural perceptual dizziness (PPPD), which is often combined with other diseases of the vestibular system and anxiety disorders. In real-life clinical practice, PPPD and comorbid disorders are rarely diagnosed and effective treatments are rarely prescribed, so the development of modern methods for managing patients with PPPD with comorbid diseases is important.Objective: to analyze the typical management practices and evaluate the effectiveness of complex therapy in patients with PPPD and comorbid disorders.Material and methods. We examined 60 patients (mean age – 42.5±13.8 years) with diagnosis of PPPD (according to the diagnostic criteria of the Barany Society) and comorbid diseases. All patients were examined twice: at the beginning and after completion of treatment, which lasted an average of 1 month. Treatment included antidepressants (serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors), anti-anxiety medications, vestibular exercises, an educational program, and cognitive behavioral therapy. Arlevert (a combination of cinnarizine 20 mg + dimenhydrinate 40 mg) was used as a drug therapy for the treatment of vestibular dizziness in 28 patients. A clinical otoneurological evaluation and videonystagmography were performed to assess vestibular disorders; the severity of dizziness was assessed using an otoneurological questionnaire and the Dizziness Handicap Inventory (DHI); the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Spielberger Anxiety Inventory (STAI) were used to assess anxiety and depressive disorders.Results. None of the 60 patients had previously been diagnosed with PPPD. They were observed with a misdiagnosis of cerebrovascular disease and/or cervical spine pathology and received ineffective treatment. Anxiety and depressive disorders were detected in 32 (53.33%) patients, migraine – in 20 (33.33%) and previous peripheral vestibular disorders – in 8 (13.33%) patients. After one month of treatment in patients with PPPD and comorbid conditions, the severity of dizziness according to DHI decreased from 45.59±15.47 to 29.9±12.56 points (p<0.001), the severity of anxiety according to BAI from 27.50±6.38 to 15.66±4.07 points (p<0.001), the severity of depression according to BDI from 11.91±6.24 to 7.06±4.12 points (p<0.001), the severity of anxiety according to HADS from 13.47±4.16 to 8.60±2.86 points (p<0.001), the severity of depression according to HADS from 6.34±3.72 to 4.31±2.82 points (p<0.001), situational anxiety according to STAI from 50.69±7.13 to 41.26±6.24 points (p<0.001), personal anxiety according to STAI from 54.66±8.21 to 43.78±6.75 points (p<0.001).Conclusion. It was found that PPPD is rarely diagnosed, and anxiety disorders, migraine and peripheral vestibular disorders are very common in PPPD patients. The integrated approach in the treatment of patients with PPPG, taking into account concomitant disorders, has demonstrated high efficacy.

The effect of family support on anxiety and depression in pregnant women with high-risk pregnancies hospitalized in the third trimester of pregnancy: Results of randomized controlled trial

Background. During pregnancy, it is crucial to minimize maternal anxiety to maintain the mental and physical health of both the mother and fetus, especially in high-risk pregnancies. This study aimed to investigate the effect of family support on decreasing depressive and anxiety symptoms in women hospitalized with high-risk pregnancies in their third trimester. Methods. This randomized controlled clinical trial was performed on 70 high-risk pregnant women in their third trimester. Samples were randomly divided into intervention and control groups. The intervention group walked for five weeks, five days a week, with their spouse or a family member for half an hour a day in the hospital. The control group received routine care. Participants completed the Spielberger Anxiety and Beck Depression Inventory once before and once a week during the intervention. Data were analyzed using SPSS.21 software using ANCOVA, independent t-test, and Mann-Whitney U. Results. Results showed that the subjects were homogeneous in terms of mean overall score of anxiety before the intervention, and there is no significant difference between the intervention group 43.2 (±2.93) and the control group 42.63 (±3.3) (P=0.53). Statistical tests showed that, three weeks after the intervention, the mean anxiety score in the study group decreased significantly, and there was a significant difference in the mean anxiety score of women in the intervention 41.3(±3.07) and control 42.12(±3.6) groups (P=0.032). On the other hand, the level of state anxiety in the study group decreased (P=0.03). The results showed that the depression score after the intervention in the study group decreased significantly (P=0.001). Conclusion. Anxiety level and depression score decreased after the intervention. Practical Implications. The current study's results showed that talking to a spouse or relatives during pregnancy can increase women's peace of mind, and social support during hospitalization can reduce the anxiety and depression of the pregnant mother. Therefore, using such methods will be beneficial for the pregnant mother.

Evaluation of Saffron (Crocus Sativus L) Effects on Anxiety in Hospitalized Patients with Acute Coronary Syndrome.

Anxiety is a common psychiatric condition in cardio-vascular diseases. Saffron appears to have a wide range of therapeutic effects on psychiatric conditions and cardio-vascular disorders. The aim of this study was to determine the effect of saffron on anxiety in hospitalized patients with acute coronary syndrome (ACS). In this clinical investigation, we selected 80 patients with ACS from Tohid Medical Center, Sanandaj. Patients were divided randomly into two groups, intervention group (n = 41), and control group (n = 39), based on how they received saffron and placebo every 12 hours for 4 days, respectively. The Spielberger Anxiety Inventory was completed before and after the intervention in both groups. There was no significant difference between the intervention and control groups regarding the mean scores of the trait and state anxiety before and after the intervention (P > 0.05). The present study did not corroborate the therapeutic effects of saffron on reducing anxiety in patients with ACS.

A Study of Pregnancy-Related Anxiety with Spiritual Health Among Cesarean and Vaginal Delivery

Background: One of the most important causes of anxiety during pregnancy is postpartum anxiety and the effects that this anxiety can have on the health of mother and infant and the role that studies have considered for spiritual health in promoting mental health. Objective: the aim of this study is to investigate the correlation between anxiety and spiritual health of mothers with cesarean section and vaginal delivery. Methods: This study was performed on 171 women referred to Amir al-momenin (PB) in Gerash Hospital (Fars, Iran) from August 2017 to October 2018. Convenience sampling was used. Data were collected through Demographic Information Questionnaire, Spielberger Anxiety Inventory, and Pulotzin and Ellison Spiritual Health Questionnaire. Data were analyzed by descriptive statistical methods including mean, standard deviation and frequency percentage and analytical methods, such as independent t-test and Pearson correlation. Results: There was no significant difference between the mean of total score of anxiety (P = 0.560) and spiritual health (P = 0.313) in mothers with cesarean section and vaginal delivery). There was no significant correlation between maternal spiritual health, maternal anxiety, cesarean delivery (r = -0.111, p = 0.269) and vaginal delivery (r = 0.152, p = 0.209). Conclusion: In this study, anxiety and spiritual health were not different among cesarean section and vaginal delivery women and unlike other studies, no correlation was found between spiritual health and anxiety. However, further studies in this field and attention to other strategies to control labor anxiety among women seem necessary.

Mechanism underlying painful radiculopathy in patients with lumbar disc herniation.

Painful lumbar radiculopathy is a neuropathic pain condition, commonly attributed to nerve root inflammation/compression by disc herniation. The present exploratory study searched for associations between pain intensity and inflammatory markers, herniated disc size, infection, psychological factors and pain modulation in patients with confirmed painful lumbar radiculopathy scheduled for spine surgery. Prior to surgery, 53 patients underwent the following evaluation: pain intensity measured on a 0-10 numeric rating scale (NRS) and the Short-Form McGill Pain Questionnaire; sensory testing (modified DFNS protocol); pain processing including temporal summation and conditioned pain modulation (CPM); neurological examination; psychological assessment including Spielberger's Anxiety Inventory, Pain Sensitivity Questionnaire and the Pain Catastrophizing Scale. Pro-inflammatory cytokine levels (IL-1b, IL-6, IL-8, IL-17, TNFα, IFNg) and microbial infection (ELISA and rt-PCR) in blood and disc samples obtained during surgery. MRI scans assessments for disc herniation size/volume (MSU classification/ three-dimensional volumetric analysis). Complete data were available from 40 (75%) patients (15 female) aged 44.8±16.3years. Pain intensity (NRS) positively correlated with pain catastrophizing and CPM (r=0.437, p=0.006; r=0.421, p=0.007; respectively), but not with disc/blood cytokine levels, bacterial infection or MRI measures. CPM (p=0.001) and gender (p=0.029) were associated with average pain intensity (adjusted R2 =0.443). This exploratory study suggests that pain catastrophizing, CPM and gender, seem to contribute to pain intensity in patients with painful lumbar radiculopathy. The role of mechanical compression and inflammation in determining the intensity of painful radiculopathy remains obscure. Pain catastrophizing, CPM and gender rather than objective measures of inflammation and imaging seem to contribute to pain in patients with painful radiculopathy.

Patients with depression in the early stages of Parkinson's disease: A cross-sectional observational study

Background. Depression is one of the most maladaptive manifestations of Parkinson's disease (PD). The relationship between depression and motor, cognitive, and other affective disorders in the early stages of PD remains debatable.
 Aim. To assess the frequency and severity of depression, to clarify the features of motor, affective disorders, and cognitive functions in patients with depression in the early stages of PD.
 Materials and methods. We observed 61 patients diagnosed with PD at stages III according to the HoehnYahr scale. The average age was 62.29.6 years, the average duration of PD was 2.51.6 years. Data were analyzed using the Unified PD Scale, the Beck Depression Inventory, the Apathy Scale, the Spielberger Anxiety Inventory, the PD Cognitive Assessment Scale (SCOPA-COG), the digital character substitution test (the symbolsnumbers test), the Montreal the Cognitive Function Assessment Scale (MoCA), the number-to-letter combination test, the Stroop test.
 Results. Symptoms of depression were detected in 48 (79%) patients with PD; 20 (33%) patients had subdepression, 24 (39%) had moderate and severe depression, and 4 (7%) had severe depression. In patients at stage I PD according to HoehnYahr, the frequency of moderate depression was 28%, at stage II (moderate and severe) 45%, and severe 10%. Patients with depression were characterized by a greater severity of motor symptoms, disturbances in daily activities, anxiety, apathy, as well as a decrease in executive cognitive functions. An inverse correlation was noted between the duration of depressive symptoms and deterioration in performance on tests to assess attention and control cognitive functions.
 Conclusion. Depression is a characteristic feature of the early stages of PD. Its frequency and severity increase from stage I to stage II of PD. Depression can be considered as an indicator of a more severe course of the disease, the progression of impairments in controlling cognitive functions. The possibility of assessing the prognosis of the course of the disease additionally substantiates the need to diagnose depression in patients with PD in the early stages of the disease.

Comparison of the effect of prayer and ginger on the severity of pain and anxiety in inpatients with burn: Palliative care.

One of the symptoms of burning is chronic and severe pain that affects the quality of life of patients. The aim of this article was to compare of the effect of prayer and ginger on the severity of pain and anxiety in inpatients with burn. This study is a clinical trial study on 120 patients referred to the Burn Ward of Kashani Hospital affiliated to Shahrekord University of Medical Sciences in the southwest of Iran. Patients were randomly divided into three groups: control, prayer and ginger. The visual analogue scale (VAS) was used to determine the severity of pain and the standard measure Spielberger Anxiety Inventory was used to assess anxiety. In this study, group 1 received placebo (starch) capsules (250 mg) daily, group 2 - ginger capsules (250 mg) plus 20 ml water after each meal on a daily basis and group 3 was asked to recite the prayer for 10 minutes three times in the morning, evening and night every day. Data analysis was done by descriptive and inferential statistics (ANOVA and Tukey's test) in the SPSS. After the intervention, the pain levels in the prayer and ginger groups at days 3 and 6 of hospitalization, were lower than the control group. On day 6 mean anxiety level was significantly lower in the prayer group than in the ginger group (P < 0.05). According to the results of this study, it is recommended that using ginger or prayer be applied to reduce the pain and anxiety of burn patients, because they not only cause no side effects but also are low cost, leading to reduction in drug consumption and the resulting side effects.

Non-physiological and Physiological Delivery Method: Comparison of Maternal Attachment Behaviors and Anxiety.

Introduction: Attachment is a stable connection or emotional knot between two individuals as one of the parties tries to maintain this connection. Delivery time as a turning point between two stages of attachment is very important.Methods: In a descriptive–analytical study based on specific inclusion criteria, 262 pregnant women were selected in the age range of 15-45 years old and the gestational age of 37 to 42 weeks who were candidates for physiological or non-physiological delivery. After obtaining written consent forms, the demographic information questionnaire was given to the participants. One hour after delivery, the attachment questionnaire was completed by the researcher in the postpartum ward. Also, the Spielberg anxiety inventory was completed up to 1 hour after delivery. Independent sample t test was used to compare the results between the two groups. Data were analyzed by SPSS software version 21.Results: The participants in the physiological delivery group showed more positive attachment behaviors in comparison with the other group. In all three dimensions of attachment (emotional, contiguous, and caring behavior), physiological delivery showed higher scores than the other group. Also in non-physiological delivery group, the participants had experienced higher levels of anxiety and the differences between the groups were not significant.Conclusion: Results of the current study indicated that mothers engaged in physiological delivery had higher scores in mother to child attachment behaviors. It means they are more successful than the non-physiological delivery group in getting attached to their babies.

Effect of guided imagery on anxiety, muscle pain, and vital signs in patients with COVID-19: A randomized controlled trial

BackgroundCOVID-19 can lead to anxiety due to its high mortality rate. Patients with COVID-19 may suffer from muscle pain. This study aimed to determine the effect of guided imagery on anxiety, muscle pain, and vital signs in patients with COVID-19. Methods110 patients with COVID-19 were recruited and randomly assigned to two control and intervention groups. Data were collected using the Spielberger Anxiety Inventory, the McGill Pain Questionnaire, and the Visual Analogue Scale. The intervention group received ten training sessions of guided imagery. ResultsThe results indicated a significant difference in the mean scores of state (t = -3.829, p < .001), trait anxiety (t = -2.946, p = .004), pain quality (t = -4.223, p < .001), pain intensity (t = -3.068, p = .003), and heart rate, systolic blood pressure, and oxygen saturation (p < .001) between the two groups after the intervention. ConclusionsGuided imagery as a cost-effective method of complementary medicine is recommended to manage anxiety and pain in patients with COVID-19.

The reliability and validity of the Hungarian version of the Brief Illness Perception Questionnaire

Interdisciplinary studies confirm that patients' illness perception can have a substantial effect on the healing process. The aim of this study was to assess the reliability and validity of the Hungarian version of the Brief Illness Perception Questionnaire in chronic disease, cancer, and transplant patients. 490 patients were assessed using the Spielberger Anxiety Inventory, the Beck Depression Inventory, Posttraumatic Growth Inventory and quality of life questionnaires. The scale showed good internal consistency, and the test-retest reliability was excellent. The Brief Illness Perception Questionnaire scores moderately correlated with anxiety, depression, posttraumatic growth and quality of life. Examining predictive validity, the questionnaire correlated with eGFR level (p = 0.027). The discriminant validity of the questionnaire was supported by its ability to distinguish between different patient groups. The reliability and validity of the Hungarian version of the Brief Illness Perception Questionnaire in the sample were excellent. The questionnaire turned out to be a useful psychometric tool in the measurement of illness perception. Orv Hetil. 2021; 162(6): 212-218.

Resilience Skills Training Versus Metacognitive Therapy: A Comparison of Effectiveness on Anxiety in Nurses Working in Intensive Care Units and Emergency Department

Background: Anxiety is an outcome of stressful work environments like clinical environments, which harms the mental health and delays provision of services to patients, consequently. Objectives: This study examined the effects of resilience skills training and metacognitive therapy on nurses’ anxiety who work in intensive care units and an emergency department. Methods: This randomized controlled field trial was carried out on 54 nurses working in ICU, PICU, and NICU units and the emergency department of Valiasr Hospital, Birjand, Iran. The participants were allocated via permuted block randomization into three groups of resilience, metacognitive therapy, and control. Research instruments include a demographics form and the Spielberger anxiety inventory. Parametric statistics (e.g., ANOVA, repeated measures ANOVA, Chi square and Fisher’s exact test) were employed for data analysis in SPSS (V.19) (P &lt; 0.05). Results: In the resilience group, the mean scores of trait and state anxiety significantly decreased immediately and one month after the intervention compared to the period before the intervention (P &lt; 0.001). However, there was no significant difference in the metacognitive therapy group in terms of the mean score of trait and state anxiety in the three stages of study (P &gt; 0.05). There were significant differences between the three groups in terms of trait and state anxiety mean score changes before and immediately after the intervention, and before and one month after the intervention (P &lt; 0.05). Conclusions: Resilience skills training were more efficient than metacognitive therapy in attenuating anxiety in emergency and intensive care nurses. Nursing managers are recommended to hold resilience skills training sessions to alleviate nurses’ anxiety.

The role of comorbid anxiety in exercise and depression trials: Secondary analysis of the SMILE-II randomized clinical trial.

To explore the anxiolytic effects of a 4-month randomized, placebo-controlled trial of exercise and antidepressant medication in patients with major depressive disorder (MDD), and to examine the potential modifying effects of anxiety in treating depressive symptoms. In this secondary analysis of the SMILE-II trial, 148 sedentary adults with MDD were randomized to: (a) supervised exercise, (b) home-based exercise, (c) sertraline, or (d) placebo control. Symptoms of state anxiety measured by the Spielberger Anxiety Inventory were examined before and after 4 months of treatment. Depressive symptoms were assessed by the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory-II (BDI-II). Analyses were carried out using general linear models. Compared to placebo controls, the exercise and sertraline groups had lower state anxiety scores (standardized difference = 0.3 [95% CI = -0.6, -0.04]; p = 0.02) after treatment. Higher pretreatment state anxiety was associated with poorer depression outcomes in the active treatments compared to placebo controls for both the HAMD (p = .004) and BDI-II (p = .02). Aerobic exercise as well as sertraline reduced symptoms of state anxiety in patients with MDD. Higher levels of pretreatment anxiety attenuated the effects of the interventions on depressive symptoms, however, especially among exercisers. Patients with MDD with higher comorbid state anxiety appear to be less likely to benefit from exercise interventions in reducing depression and thus may require supplemental treatment with special attention to anxiety.

Prediction Modeling of Eating Behavior based on Attachment Styles Mediated by Anxiety among Adolescent Girls

Background and objective: Unhealthy eating behavior is one of the four major risk factors for diseases. This study was conducted to model the prediction of eating behavior based on anxiety mediated attachment styles. Materials and Methods: This correlational research was carried out based on a path analysis approach. The statistical population (n=461) included all high school female students in Tehran, Iran, in the school year of 2018-19, who were selected using the cluster sampling method. The required data were collected using the Attachment Styles Questionnaire, Spielberger Anxiety Inventory, and Eating Behavior Questionnaire. The gathered data were analyzed by path analysis based on regression equations in LISREL software (version 8.80). Results: Based on the findings, secure, ambivalent, and avoidant attachment could influence studentschr('39') eating behavior both directly and indirectly. It was also revealed that state anxiety (β=0.24) and trait (β=0.34) could directly increase unhealthy eating behavior in the samples (β=0.41). Model fit indices showed that the presented paths could explain the data well. Conclusions: It can be concluded that a secure attachment style reduced unhealthy eating behavior by reducing anxiety. Moreover, avoidant and ambivalent attachment styles increased anxiety and resulted in unhealthy eating behavior.

The Impact of Educational Intervention on the Anxiety of Family Caregivers of the Elderly with Dementia: A Randomized Controlled Trial.

ABSTRACTBackground: Due to the increasing population of elderly and the consequent increase in the number of chronic diseases such as dementia, the psychological complications such as anxiety in the family caregivers increase. The aim of this study was to determine the effect of educational intervention on the anxiety of family caregivers of the elderly people with dementia.Methods: This randomized controlled trial was performed in the elderly Neurology Clinics in Shiraz from May to August 2017. This study was conducted on 70 families with elderly people with dementia who were randomly divided into an intervention (receiving in groups for seven sessions of educational intervention) and a control group (Conventional care). Data collection tool was Spielberger’s Anxiety Inventory (40-items, score=20-80). Data were analyzed by SPSS version 21 using ANOVA test with repeated measures and independent t-test.Results: One and three months after the interventions, the mean scores of anxiety in the intervention group were 70.51±3.78 and 70.31±3.43 and in the control groups they were 76.45±3.45 and 76.22±5.08 respectively. The results showed significant differences between the two groups regarding anxiety after the intervention (P<0.001).Conclusion: Educational programs held to promote and maintain the physical and mental health of caregivers could reduce the anxiety of family caregivers of the elderly with dementia.Trial Registration Number: IRCT2017080915426N4.

The effect of lavender herbal tea on the anxiety and depression of the elderly: A randomized clinical trial

BackgroundThe prevalence of depression and anxiety is increasing among the elderly around the world. It is believed that lavender can stabilize the people's mood, so this study was designed to evaluate the effect of lavender on anxiety and depression of the elderly. MethodsThis study was a single blind clinical trial with a control group. The participants in the study consisted of 60 elderly subjects (30 in each group) who referred to the Health Center of Larestan city in the south of Iran in 2019. The intervention consisted of using 2 g of lavender teabag, which was prescribed to be used 2 times as decoction in the morning and night. The duration of the intervention was 2 weeks. The eligible participants were randomly assigned to the intervention and control groups using balanced block randomization with a block size of ten. The control group did not receive any placebo. Data collection tools in this study included demographic information questionnaire, Beck Depression and Spiel Berger Anxiety Inventory. Chi-square test and independent t-test were used to analyze the data. The significance level was considered 5 %. ResultsThe two groups were similar in terms of age, gender, educational level and marital status and there was no significant difference. The mean score of depression in the intervention group before and after drinking lavender herbal tea was 17.80 ± 1.49 and 16.33 ± 1.49, respectively. The mean score of depression between intervention and control groups after drinking herbal tea were 16.33 ± 1.49 and 18.33 ± 1.84, respectively. This indicated the effect of herbal tea on reducing depression (P < 0.001). Also, mean difference of intervention and control groups after drinking herbal tea in terms of depression and anxiety (state and trait) were (−2.00, 95 % CI (−2.86, −1.13)), (−6.40, 95 % CI (−9.43, −3.36)) and (−4.13, 95 % CI (−7.66, −0.60)), respectively. ConclusionThe results of the present study showed that consumption of lavender herbal tea can reduce depression and anxiety scores and since it is inexpensive and accessible, it is suggested to be used as a complementary treatment in reducing anxiety and depression.

Social Determinants of Health, Maternal Involvement, and Child Development: Direct and Mediated Pathways.

In the process of child development, a variety of factors are at play. In this regard, social determinants of health play a determining role in the development and growth of the child. This study aimed to design and test the model for social determinants of health for the development of 36-6o-month-old children in Tehran with the mediation of maternal involvement. This cross-sectional study was conducted among 1067 mothers and their 36-60-month-old children in childcare centers in Tehran, using multistage sampling. Data gathering tools consisted of a demographic questionnaire for mothers and children, a questionnaire on unhealthy behaviors, Ages and Stages Questionnaire, Economic and Social Status Questionnaire, Perceived Social Support Questionnaire, Perceived Stress Questionnaire, Spielberger Anxiety Inventory, Beck Depression Inventory, ENRICH: Marital Satisfaction Scale, and Participation Scale for Parents and Mothers. Model fit measures were suitable and goodness of fit (RMSEA = 0.031, GFI = 1) was satisfactory. In addition, the results of path analysis indicated that the participation of mothers in the development of children had a direct positive (ß = 0.089) and increasing effect. Findings indicated that depression, anxiety, stress, and marital satisfaction have both direct and indirect effects on the participation of mothers and child development. Moreover, the model fit measures indicated the utility and high proportionality of the model, as well as the logic of the adjusted relationships of variables based on the conceptual model.

Follow-up Study of Drug Use, Depression, and Anxiety Reduction and Quality of Life in Addicts on Methadone Maintenance Therapy

Background: This study aimed to evaluate reduced drug consumption, risky behaviors, depression, and anxiety and improved quality of life in addicts on methadone maintenance therapy (MMT) at baseline and six months after therapy. Methods: In this descriptive cross-sectional study, 275 addicts were selected by a random sampling method in 2017. The data collection tools consisted of four questionnaires including a demographic information questionnaire, the Beck depression inventory questionnaire, WHOQOL-26, and Spielberger Anxiety Inventory. Data analysis was done by SPSS20 software at a confidence level of 95%. Results: Based on the obtained results, after six months, MMT efficiency was 50.5% and no cases of intravenous injection were reported. The consumption of other drugs was significantly reduced (P < 0.05). The highest prevalence of depression was observed in cannabis and opium users. Depression decreased from 85.81% to 63.27%. The mean scores of quality of life and anxiety after MMT increased to 89.6 and 20.41, respectively. The most improvement was in the physical health domain (mean score of 64.11). Conclusions: The results showed improvements in all the four domains of physical health, psychological health, social relationship, and environment and reductions in depression and anxiety.

Comparison of the Effects of Hand Reflexology versus Acupressure on Anxiety and Vital Signs in Female Patients with Coronary Artery Diseases.

Hospitalization in the cardiac care unit can increase anxiety in patients. This study aimed to compare hand reflexology versus acupressure on anxiety and vital signs in female patients with coronary artery diseases. This double-blinded randomized placebo-controlled trial with a pre- and post-intervention design was conducted on 135 female patients with coronary artery diseases. Female patients hospitalized in a cardiac care unit were randomly divided into three groups of hand reflexology, acupressure and placebo (n = 45 patients in each group) using blocking and a table of random numbers. Data was collected using the Spielberger anxiety inventory. Also, their vital signs were measured before, immediately after and half an hour after the intervention. Data analysis was performed using descriptive and analytical statistics. Before the intervention, there was no statistically significant difference in anxiety levels between the groups (p > 0.05). Also, the effects of hand reflexology and acupressure immediately and half an hour later on the reduction of anxiety and vital signs were equal (p < 0.05). Implementation of hand reflexology and acupressure can have positive effects on anxiety and vital signs in patients with coronary artery diseases. They can reduce patients’ anxiety with an equal effectiveness.