Health Psychology

Predicting the Orthorexia Nervos based on Health Anxiety, Obsessive and Pathological Worry

ali mostafaie

Volume 14, Issue 54 , September 2025, Pages 7-26

https://doi.org/10.30473/hpj.2025.72268.6112

Abstract

Objective: Orthorexia nervosa (ON) is a proposed mental illness characterised by a fxation on eating “healthy” foods, resulting in psychological, physical, and/or social impairment. Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy eating, inflxible dietary ... Read More Objective: Orthorexia nervosa (ON) is a proposed mental illness characterised by a fxation on eating “healthy” foods, resulting in psychological, physical, and/or social impairment. Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy eating, inflxible dietary rules, and recurrent and persistent preoccupations related to food that signifiantly interferes with the functioning of the person in society. Persons presenting orthorexic behaviors are overly focused not only on the quality of food but also on the methods and materials used in its preparation. They read product labels carefully and commonly do healthy grocery shopping. To alleviate the numerous concerns related to food preparation and purchasing and to maximize the health benefis of eating, individuals with ON engage in specifi behavioral patterns and, non-adherence to self-imposed nutritional rules might trigger feelings of anxiety, obsessive and further dietary restrictions. Although Orthorexia nervosa has been increasingly recognized in diverse populations including young persons and working adults, and multiple systematic reviews on the topic exist (Atchison and Zickgraf, 2022; Gkiouleka et al, 2022). Since the researchers always pay attention to healthy diet and the factors related to the physical and psychological health, therefore,This research aimed to predict the Orthorexia Nervos based on health anxiety, obsessive and Pathological Worry. Method: This study is applied in terms of its objectives and descriptive-correlational type. The statistical population of this study included all the students of Payam Noor University were from Miandoab Center in 2024. Accordingly, 282 participants (180 women, 102 men) selected using the available sampling method. Data collection tools include the Orthorexia Nervos scale (Donini et al., 2005), Health anxiety scale (Salkovskis et al., 2002), Obsessive-Compulsive Inventory-Revised scale (Foa et al., 2002), and Penn State Worry scale (Meyer et al., 1990). The research data collected using descriptive statistics, Pearson's correlation coefficient, and step-by-step regression using SPSS-24 software. Results: Of the participants, 180 individuals (64%) were Woman, 102 individuals (36%) were Man. Additionally, total participants were between 20 and 28 years old. Finally, concerning According to Table 4, The results Regression showed that health anxiety, obsessive and Pathological Worry could predict 46.9% of the variance in Orthorexia Nervos. health anxiety predicted 30/1% of the variance of Orthorexia Nervos (P<0.01, β=-0.301), Negative consequences of the disease predicted 29/5% of the variance of Orthorexia Nervos (P<0.01, β=-0.295), The possibility of contracting the disease predicted 27/8% of the variance of Orthorexia Nervos (P<0.01, β=-0.278), Obsessive predicted 51/6% of the variance of Orthorexia Nervos (P<0.01, β=-0/516), and Pathological Worry predicted 33/4% of the variance of Orthorexia Nervos (P<0.01, β=-0.334). Conclusion: Based on this study, it can to conclude that health anxiety, obsessive and Pathological Worry are among the factors that play an effective role in increase the Orthorexia Nervos, which requires high attention and sensitivity, On the other hand, knowing the main factors affecting the Orthorexia Nervos, It can be used to reduce Orthorexia Nervos and increase people's health and adaptiveness, started planning and intervention measures. Therefore,The findings of this study can strengthen theoretical models related to health and especially health psychology.

The Relationship between Early Maladaptive Schemas and Psychosomatic Symptoms in Infertile Women: the Mediating Role of Cognitive Emotion Regulation Strategies

Mozhgan Shakhseniaei; Imanollah Bigdeli; Abbas Firoozabadi

Volume 14, Issue 54 , September 2025, Pages 27-44

https://doi.org/10.30473/hpj.2025.72689.6136

Abstract

Objective: Infertility is a medical condition that can cause psychological, physical, psychological, spiritual and medical harm to the patient. Psychosomatic symptoms are prevalent among infertile women and can significantly impair their quality of life and daily activities. Psychosomatic symptoms are ... Read More Objective: Infertility is a medical condition that can cause psychological, physical, psychological, spiritual and medical harm to the patient. Psychosomatic symptoms are prevalent among infertile women and can significantly impair their quality of life and daily activities. Psychosomatic symptoms are created as physiological symptoms associated with emotional situations .Infertile women experience psychosomatic symptoms such as headache, lack of concentration, nausea and mental distress. Considering the critical need for improving and addressing these symptoms, it is essential to examine the psychological factors that affect psychosomatic symptoms. The purpose of this study is to explore the association between early maladaptive schemas and psychosomatic symptoms, with a focus on the mediating role of cognitive emotion regulation strategies in infertile women to help identify the variables affecting psychosomatic symptoms and also to reduce these symptoms and psychological injuries of these people. Method: This research uses a descriptive, correlational approach and has a structural equation modeling. The statistical population consisted of infertile women who visited an infertility clinic in Mashhad. To this end, 360 individuals volunteered to participate. Data were collected using the Young Early Maladaptive Schema Questioner Short Form (1994), Takata and Sakata Psychosomatic Symptoms Questioner (2004), and the Cognitive Emotion Regulation Questionnaire Short Form (2007). The analysis of the data was carried out using the Pearson correlation test, structural equation modeling, and path analysis by SPSS 22 and AMOS 24 software. Results: According to the results, early maladaptive schemas and maladaptive cognitive emotion regulation strategies have a positive relationship with psychosomatic symptoms and adaptive cognitive emotion regulation strategies have a significant negative relationship with psychosomatic symptoms (P<0.001). The relationship between early maladaptive schemas and adaptive cognitive emotion regulation strategies in infertile women (P < 0.001 and β = -0.41) was statistically significant. The relationship between early maladaptive schemas and maladaptive cognitive emotion regulation strategies in infertile women (P < 0.001 and β = 0.43) was statistically significant. The relationship between adaptive cognitive emotion regulation strategies and psychosomatic symptoms in infertile women (P < 0.001 and β = -0.18) was statistically significant. The relationship between maladaptive cognitive emotion regulation strategies and psychosomatic symptoms in infertile women (P < 0.001 and β = 0.21) was statistically significant. The indirect relationship of early maladaptive schemas through adaptive cognitive emotion regulation strategies with psychosomatic symptoms (P = 0.001 and β = 0.130) and the indirect relationship of early maladaptive schemas through maladaptive cognitive emotion regulation strategies with psychosomatic symptoms (P = 0.001 and β = 0.140) were statistically significant. Furthermore, the structural equation modeling results showed that cognitive emotion regulation strategies play a mediating role in the relationship between early maladaptive schemas and psychosomatic symptoms, and all fit indices indicated a good model fit. Conclusion: This research can be used as a basis for conducting interventional research, including cognitive emotion regulation strategies and schema therapy. The results demonstrate the importance of teaching cognitive emotion regulation skills to infertile women. Given the emergence of psychosomatic symptoms in these individuals, adaptive cognitive emotion regulation strategies may help alleviate the frequency and intensity of psychosomatic symptoms in this group.

Developing Relationship Model Quality of Life, Mindfulness, and Self-Compassion with Mediating Role Self-Care Behaviors among Dialysis Patients

Fatemeh Abdoli Arani; MohammadReza Tamannaeifar

Volume 14, Issue 54 , September 2025, Pages 45-62

https://doi.org/10.30473/hpj.2025.72797.6142

Abstract

Objective: The growing trend of diseases such as type 2 diabetes, high blood pressure, as well as the increase in the obese and elderly population in different countries caused the growth rate of chronic kidney diseases globally to be higher than the annual growth rate of the world population. It is ... Read More Objective: The growing trend of diseases such as type 2 diabetes, high blood pressure, as well as the increase in the obese and elderly population in different countries caused the growth rate of chronic kidney diseases globally to be higher than the annual growth rate of the world population. It is estimated that more than 850 million people worldwide are affected by this disease. If kidney diseases are not diagnosed on time and treated appropriately, it leads to end-stage kidney disease. The purpose of the present study was to investigate developing relationship model quality of life, mindfulness and self-compassion with mediating role self-care behaviors among dialysis patients. This was descriptive-correlation research. Method: The statistical population of the study was dialysis patient’s Kashan city in March to July of year 2024. The sample size was selected based on Klein's model (2023) and with subjectivw sampling of 300 dialysis patient’s. Data collection tools include the quality of life-BRIEF of World Health Organization (2004), Freiburg mindfulness inventory of Walach and et al (2006), short form of the self‐compassion scale of Raes and et al (2011) and exercise of self‐care agency scale of Kearney and Fleischer (1979). Data were analyzed using Pearson correlation and structural equations modeling. Data analysis software was SPSS and AMOS version 28. Results: Te results showed direct effect of mindfulness (β=0.51 and sig=0.001) and self-compassion (β=0.54 and sig=0.001) were significant on quality of life. Also, the results showed that self-care behaviors had a mediating role in relationship between mindfulness (β=0.61 and sig=0.001) and self-compassion (β=0.52 and sig=0.001) with quality of life. Also, the final research model had a good fit (RMSEA=0.03, p<0.05). Conclusion: In explaining the mediating role of self-care behaviors in the relationship between mindfulness and quality of life, it can be said that a dialysis person with mindfulness can help himself to experience more peace and relaxation, this peace and relaxation has helped him to Adhere to self-care and fulfill medical and pharmaceutical orders, and this adherence to self-care in dialysis patients makes them experience a better quality of life. Also, In explaining the mediating role of self-care behaviors in the relationship between self-compassion and quality of life, it can be said that self-compassion can lead to an increase in the level of self-care behaviors and a person can take better and more effective care of him and therefore follow up on his treatment process. slow and adheres to medical and medication orders, as a result, it shows a higher recovery rate, which makes the quality of life of patients better than other dialysis patients. According to the findings of this research and the importance of the role of the mindfulness and self-compassion in quality of life of dialysis patients, it is suggested to experts in this field to use the training of mindfulness and self-compassion to improve quality of life in dialysis patients.

Effectiveness of Schema Therapy and Cognitive Behavioral Therapy on Anxiety, Depression, and Stress in Patients with Ménière's Disease

Mahdi Rahmani; mohsen jalali; elnaz pourahmadi; Abdolsamad nikan

Volume 14, Issue 54 , September 2025, Pages 63-80

https://doi.org/10.30473/hpj.2025.72787.6141

Abstract

Objective: Patients with Ménière's disease often report experiencing various psychological challenges, including heightened levels of anxiety, depression, and stress. Despite these concerns, research addressing the treatment of psychological aspects in Ménière's disease remains ... Read More Objective: Patients with Ménière's disease often report experiencing various psychological challenges, including heightened levels of anxiety, depression, and stress. Despite these concerns, research addressing the treatment of psychological aspects in Ménière's disease remains limited. Individuals living with this condition face substantial difficulties, compounded by the absence of a definitive cure. A review of the literature, both within and outside Iran, highlights a scarcity of evidence supporting the efficacy of psychological interventions for this population. Furthermore, existing studies provide mixed findings regarding the effectiveness of schema therapy and cognitive-behavioral therapy (CBT) in alleviating anxiety, depression, and stress among these patients. This study aimed to address this gap by comparing the efficacy of schema therapy and CBT in reducing psychological symptoms in patients with Ménière's disease. Method: This quasi-experimental study employed a pre-test, post-test, and follow-up design to evaluate the interventions. The statistical population comprised patients diagnosed with Ménière's disease who exhibited comorbid depression and anxiety. From this population, 45 patients were selected using purposive sampling and assigned to three groups: schema therapy, CBT, and a control group. Participants were randomly distributed among these groups, with 15 patients in each. Inclusion and exclusion criteria ensured the selection of participants suitable for the study. The schema therapy group underwent intervention facilitated by the researcher in ten weekly group sessions, each lasting two hours over a 2.5-month period. The CBT group also participated in ten weekly two-hour sessions, administered by a therapist specializing in CBT. The control group received no therapeutic intervention but participated in the pre-test, post-test, and follow-up assessments. Psychological outcomes were measured at baseline, immediately following the intervention, and one month post-intervention using the Depression, Anxiety, and Stress Scale (DASS). Data were analyzed using repeated mesure variacnes. Results: The results revealed significant reductions in depression, anxiety, and stress among patients in both schema therapy and CBT groups compared to the control group at post-test and follow-up (P < 0.05). Notably, schema therapy demonstrated significantly greater efficacy than CBT in reducing depression (P < 0.05), while no significant differences were observed between the two therapies for anxiety and stress reduction (P > 0.05). These findings indicate that schema therapy was particularly effective in mitigating depressive symptoms during the follow-up phase, whereas both therapies were equally beneficial in addressing anxiety and stress relative to the control condition. Conclusion: This study underscores the effectiveness of schema therapy and CBT in alleviating psychological symptoms in patients with Ménière's disease. The findings suggest that these interventions may serve as valuable therapeutic approaches for improving the mental health of this population. Schema therapy, in particular, appears to offer superior benefits in reducing depressive symptoms. However, several limitations should acknowledged. The study's relatively small sample size and the geographic dispersion of participants posed logistical challenges. Additionally, the researcher’s dual role as therapist for the schema therapy group may have introduced bias, potentially impac the double-blind rigor of the study. Future research with larger, more diverse samples and independent therapists recommended to validate findings and refine treatment strategies

The Relationship between Pain Coping Strategies and Body Image Dimensions with the Moderating Role of Body Mass Index in Patients with Chronic Pain

Zohreh Rafezi; fatemeh Nourbehesht

Volume 14, Issue 54 , September 2025, Pages 81-96

https://doi.org/10.30473/hpj.2025.73086.6154

Abstract

Objective: Chronic diseases pose a significant challenge to global healthcare, affecting not only physical health but also the psychological well-being of patients. This study aimed to investigate the relationship between coping strategies (active, passive, and pain acceptance, with the sub-scales of ... Read More Objective: Chronic diseases pose a significant challenge to global healthcare, affecting not only physical health but also the psychological well-being of patients. This study aimed to investigate the relationship between coping strategies (active, passive, and pain acceptance, with the sub-scales of activity engagement and pain willingness) and dimensions of body image (body satisfaction, appearance evaluation, body appreciation, and perceptions of body functionality), with body mass index (BMI) as a moderating variable. Method: A correlational research design was employed, with a sample of 125 chronic disease patients (including cancer, diabetes, and rheumatoid arthritis) recruited from hospitals and clinics in Isfahan, Iran (Khoreshid Hospital, Seyed al-Shohada Hospital, Al-Zahra Hospital, and Ariana Specialized Clinic). After coordinating with the mentioned medical centers, sample individuals were selected based on inclusion criteria (at least 6 months since disease diagnosis, age between 20-45 years, at least a high school education level to understand the questionnaire questions, and experiencing pain on most days of the week) and exclusion criteria (presence of psychotic disorders, psychiatric disorders affecting BMI such as eating disorders and substance abuse except for opioid medications commonly used in the treatment of chronic pain in patients' medical records). Data were collected using the Vanderbilt Pain Management Questionnaire, the revised Chronic Pain Acceptance Questionnaire, the subscale of satisfaction with different parts of the body from the Multidimensional Body-Self Relationships Questionnaire, the shortened body shape questionnaire, the functionality appreciation scale, and the body appreciation scale. statistical equation test based on partial least squares variance and Pearson correlation test were used for data analysis. Results: Results indicated that BMI played a moderating role in the relationship between coping strategies and body image. Therefore, the positive or negative impact of coping strategies on body image varied among individuals with different body mass indexes. As body mass index decreased, the relationship between active coping strategies and body image satisfaction generally increased (β=-0/249, P<0.01), while the relationship between passive coping strategies and body image satisfaction decreased (β=-0/147, P<0.05). Dimensions of body image (body satisfaction, appearance evaluation, body appreciation, and perception of body functionality) were positively correlated with active coping and pain acceptance (activity engagement) (P<0.01 **) and a negative and significant relationship with passive coping and pain acceptance (pain willingness) (P<0.01 ** and P<0.05*). Overall, individuals who employed more active coping strategies and engagement in activities (a subscale of pain acceptance) scored higher on most body image dimensions. Conversely, those who used more passive coping strategies and a pain willingness (a subscale of pain acceptance, which was reverse-coded in the overall score) scored lower on body image dimensions. Conclusion: The findings suggest that as BMI increases, individuals become more vulnerable to ineffective coping strategies (passive coping and pain willingness) and less likely to employ effective coping strategies (active coping and activity engagement). The results of the study also confirm the effectiveness of active coping strategies and pain acceptance and the ineffectiveness of passive coping strategies in relation to body image. ultimately, it seems that patients with chronic pain can have a better experience of body image with the help of more beneficial coping strategies.

Developing a Causal Model of Sense of Coherence based on Psychological Capital Mediated by Perfectionism and Coherent Self-Knowledge in Cancer Patients

mehdi sheikhi; Abolghasem Yaghoobi; Tooraj Sepahvand; reyhane sheykhan

Volume 14, Issue 54 , September 2025, Pages 97-114

https://doi.org/10.30473/hpj.2025.73173.6159

Abstract

Objective: With the global increase in risk factors and the increasing prevalence of the most stressful human disease, cancer, the need to pay attention to the psychological problems and quality of life of these patients is felt more than ever. this study was to create a causal model of the sense of ... Read More Objective: With the global increase in risk factors and the increasing prevalence of the most stressful human disease, cancer, the need to pay attention to the psychological problems and quality of life of these patients is felt more than ever. this study was to create a causal model of the sense of coherence based on psychological capital mediated by perfectionism and coherent self-knowledge in cancer patients. And is the proposed theoretical model consistent with the empirical model? Method: This study was descriptive in terms of its fundamental purpose and data collection. Its statistical population was all cancer patients referred to medical centers in Markazi province, from which 200 people were selected purposefully. In order to validate the proposed model and determine the relationship between variables, structural equation modeling and data analysis were also performed using PLS software. One of the most important reasons for using this method is the purposive sampling method in this study. This method does not rely on sample size and the assumption of normality of the population. The measurement tools were Antonovsky's Sense of Coherence Questionnaire (1993), Felt's Identity and Perfectionism Questionnaire (1999), Victim Consciousness Coherence Questionnaire (2008), and Psychological Capital Questionnaire (Luthans 2008). The data analysis method was structural equation modeling with Smart-PLS4 and SPSSv26 software. The bootstrap method was also used to measure the indirect effect. Results: In this study, the direct and causal effect of psychological capital on coherent self-knowledge was positive (β=0.155) and negative perfectionism (β=-0.225) at the P<0.01 level. The direct effect of perfectionism on sense of coherence was negative (β=-0.360) and the effect of coherent self-knowledge on sense of coherence was also positive (β=0.428) at the P<0.01 level. The indirect effect of psychological capital through coherent self-knowledge (0.066) and perfectionism on sense of coherence was also significant (0.08). Conclusion: The model obtained from this study draws the attention of health researchers to the fact that psychological capital is not directly able to predict sense of coherence, but it can be improved by reducing perfectionism or increasing coherent self-knowledge. Since there is not much research on this topic, there are probably many factors that need to be considered in this model. And not all of them can be studied in this model. It should be emphasized that the causality of these relationships, although it seems obvious from a theoretical perspective, requires more longitudinal and experimental designs.

The Effect of Play Therapy Package Based on Temporal Self-regulation Theory on Body Mass Index of Obese Children

Volume 13, Issue 52 , March 2025, , Pages 139-154

https://doi.org/10.30473/hpj.2025.68972.5883

Abstract

Objective: Weight loss and its maintenance were one of the most important goals of therapists in the field of treating chronic obesity in children due to the inadequacies of current treatments. Thus, the researchers of this study decided to test the effect of their play therapy package based on Hall ... Read More Objective: Weight loss and its maintenance were one of the most important goals of therapists in the field of treating chronic obesity in children due to the inadequacies of current treatments. Thus, the researchers of this study decided to test the effect of their play therapy package based on Hall and Fong's temporal self-regulation theory in this regard. Method: By implementing a semi-experimental research design with pre-test, post-test and follow-up at 2-month intervals on a convenience sample from the population of the Iranian Health Centers-Isfahan City, including 45 parent-obese child pairs randomly assigned to two experimental and control groups, at the same time as conducting family-based behavioral intervention on both groups, members of the experimental group also received play therapy package training. Results: By analyzing the data of children's body mass index (measured by dividing the weight measured in kilograms on a scale by the square of the height measured in meters with a stadiometer) in three sections in the form of pre-test, post-test and follow-up by one-way covariance method, significant difference between the experimental group (combined play therapy method with family-based behavioral intervention method) and the control group (only family-based behavioral intervention method) in both post-test stages (F(42,1)=2188.34, P<0.001, ŋ2=0.98) and follow-up (F(42,1)=1036.61, P<0.001, ŋ2=0.96) was observed which according to the observed strong size effect indicates the effectiveness of the combined method was much better than using the family-based behavioral intervention method alone on weight loss and maintenance. Conclusion: The interpretation of the results indicates the effectiveness of adding the training package designed based on Hall and Fong's temporal self-regulation theory to strengthen the three executive functions of working memory,response inhibition, and cognitive flexibility to the usual family-based behavioral intervention as the best method available in the field of reducing and maintaining weight of children. In such a way that this combined method according to restrictions set in the field of using medical treatments (including drug therapy and surgery) for children under 12 years of age, could be considered as a step in the field of designing complementary methods, which by addressing other causes of chronic obesity including the neurological causes and the psychological structures attributed to it, including the executive functions, has been able to be effective with minimal side effects on the process of treating chronic obesity. The primary step that taking other steps in the direction of improvement and expansion of the designed play therapy package was subject to its retesting and application in other societies, and in comparison, with other methods by interested researchers.

The Effectiveness of Hope Therapy on Cognitive-Behavioral Avoidance and Self-Care Activities in Patients with Type 2 Diabetes

Volume 13, Issue 50 , September 2024, , Pages 7-22

https://doi.org/10.30473/hpj.2024.66826.5733

Abstract

Objective: one of the most common chronic diseases afflicting a wide range of human population is diabetes. In addition to the body, it also affects psychological characteristics, as well as personal and social functioning of the person. Since type II diabetes has many physical and psychological ... Read More Objective: one of the most common chronic diseases afflicting a wide range of human population is diabetes. In addition to the body, it also affects psychological characteristics, as well as personal and social functioning of the person. Since type II diabetes has many physical and psychological complications, and meanwhile the prevalence of this disease is growing based on predictions, thus development of short-term therapeutic interventions that would promote self-care activities in these patients while also helping them use less of avoidant behaviors as they cause possible harms is essential. Accordingly, increasing hope through hope therapy in these patients can underlie positive transformations in the impaired areas of life. As such, the aim of the present research is to investigate the effectiveness of hope therapy on cognitive behavioral avoidance and self-care behavior among patients with type II diabetes. Method: this quasi-experimental research was performed based on pretest posttest design with control group. The statistical population consisted of all married women and men suffering from type II diabetes in Ahwaz city, who were a member of diabetes Association of this city in 2021. Then, 40 subjects from the applicant individuals and willing to participate in the research with lower scores compared to the mean value of diabetes self-care questionnaires (Tubert et al., 2000) and cognitive behavioral avoidance (Attenberg and Dabson, 2004) were chosen purposefully. After matching the subjects based on demographic characteristics such as age, gender, and history of disease, they were randomly assigned into two groups of 20: treatment group with hope therapy method (n=20) and control group (n=20). Results: the findings indicated that there was a difference between the hope therapy treatment group and control group regarding cognitive behavioral avoidance (F=75.680, p<0.001). Furthermore, for the variable of self-care activities, there was a significant difference between the hope therapy group and control group regarding self-care activities (F=40.240 and p<0.001). Thus, hope therapy had a significant impact on cognitive behavioral avoidance and self-care activities among type II diabetes patients (p<0.05). Conclusion: based on the findings of the present research, a significant difference was found between the treatment group and control in the variables of cognitive behavioral avoidance and self-care activities. In other words, hope therapy has been effective on reducing the extent of cognitive behavioral avoidance of type II diabetes patients in Ahwaz city, and hope therapy has been influential on enhancing self-care activities of these patients in Ahwaz city. Thus, based on these findings, hope therapy can be an effective method for reducing cognitive behavioral avoidance and enhancing self-care activities among patients with type II diabetes. It is suggested that this therapeutic method be used as a complement to pharmacotherapy in governmental and private centers who deal with treating type II diabetes patients.

Breaking bad news to patients protocols: a review study

Volume 12, Issue 47 , January 2024, , Pages 71-88

https://doi.org/10.30473/hpj.2024.67159.5762

Abstract

Objective: Breaking bad news to the patients and their family is an important and difficult stage in disease process requiring both verbal and non-verbal skills. Thus, studies in the field of health psychology have provided protocols to explain step by step how to break bad news. These protocols have ... Read More Objective: Breaking bad news to the patients and their family is an important and difficult stage in disease process requiring both verbal and non-verbal skills. Thus, studies in the field of health psychology have provided protocols to explain step by step how to break bad news. These protocols have focused on how to break bad news in various therapeutic fields and different approaches. The diversity of these models can make health professionals hesitate in choosing the right model. The purpose of this review study was to identify the most widely used protocols for breaking bad news, their similarities and differences, and to provide a structure to compare these protocols.Methods: The search for breaking bad news protocols was conducted in Google Scholar and Science Direct databases. Then, the most widely used protocols that were mostly referred to by other studies were identified. Finally, 13 protocols were selected for detailed investigation. Results: As a result of comparing these protocols, 9 common concepts were find, including: 1- preparation before the session, 2- setting up the proper communicational space, 3- personal evaluation of the patient, 4- evaluation of the patient's environment, 5- approaching the news, 6- exploring the emotions and providing empathic response, 7-talking about treatment plans, 8- investigating support systems, 9- summarizing and concluding the session. Along with these common steps, 47 sub-steps were identified. All these findings were classified altogether in both summarized and extended model. In summarized model the one look table consisting of 9 common concepts and 47 sub-steps was provided. While in an extended table, the contribution of each of 13 investigated protocols in each of the concepts and sub-steps was clarified by detail. Conclusion: The extended table also highlights the unique features of each protocol, allowing health professionals to choose the most appropriate approach based on the specific needs of the patients and their families. In general, this study reviews and compares the most important protocols of breaking bad news to patients to provide a relatively comprehensive picture of what has been considered in different studies for breaking bad news. Therefore, it provided the summarized and extended models of breaking bad news to health professionals as a practical tool containing common concepts and different sub-steps of the most important protocols. This study emphasizes the importance of a structured and empathetic approach to breaking bad news, which can improve patient satisfaction, trust, and coping strategies.

The Effectiveness of Neurofeedback on Pregnancy Anxiety and Prenatal Depression in Pregnant Women during the COVID-19: A Single-Case Research with Multiple Baseline Design

Volume 12, Issue 47 , January 2024, , Pages 1-18

https://doi.org/10.30473/hpj.2024.64013.5544

Abstract

Objectives: During the pandemic COVID-19, numerous studies displayed an increase in anxiety and depression in pregnant women. This present study aimed to investigate the effect of neurofeedback therapy on pregnancy anxiety and prenatal depression in pregnant women. Methods: The study was a single-case ... Read More Objectives: During the pandemic COVID-19, numerous studies displayed an increase in anxiety and depression in pregnant women. This present study aimed to investigate the effect of neurofeedback therapy on pregnancy anxiety and prenatal depression in pregnant women. Methods: The study was a single-case experimental study with multiple baseline design with a follow-up period. Three pregnant women were selected according to purposive sampling method and entered the study gradually in fixed intervals. The research tools included the neurofeedback therapy, Pregnancy Related Anxiety Questionnaire (PRAQ) and Beck Depression Inventory Second Edition (BDI-II). Results: The findings showed that the neurofeedback reduced the severity of pregnancy anxiety and prenatal depression symptoms in both post-treatment and follow-up stages, so that the percentage of improvement for the first, second and third participants in the symptoms of pregnancy anxiety was 72%, 74% and 71% in post-treatment and 75%, 80% and 73% in follow-up stage, respectively. The percentages of improvement for the first, second and third participants in the symptoms of prenatal depression were also 72%, 77% and 77% in post-treatment and 79%, 77% and 83% in follow-up stages, respectively. Moreover, the overall percentages of improvement in post-treatment and follow-up stage in the symptoms of pregnancy anxiety were 72% and 79% and in the symptoms of prenatal depression was 75% and 80%, respectively. In addition, at the end of the intervention sessions and at the 1-month follow-up, all the three patients scored less than 14 on BDI-II, which indicated the clinical significance of the reduction of their depression symptoms on this scale. The visual analyses and the results of inter-positional and intra-positional analyses showed a significant difference between baseline and intervention stage for all subjects (PND>70, PAND>50). The percentages of non-overlapping data (PND) as a measure of effect size for the first, second and third participants in the symptoms of pregnancy anxiety were 83%, 100% and 83% respectively. The percentages of all non-overlapping data (PAND) as the second effect size criterion for the subjects were also 87.5%, 100% and 90%, respectively, which shows the effectiveness of the intervention for all the three subjects in the symptoms of pregnancy anxiety. The percentages of non-overlapping data (PND) for the first, second and third participants in the symptoms of prenatal depression were 83%, 83% and 67% respectively. The percentages of all non-overlapping data (PAND) for the subjects were 87.5%, 89% and 800% respectively, which shows the effectiveness of the intervention for all the three subjects in the symptoms of prenatal depression.

The Effect of Group Self-Healing Training on Distress Tolerance, Emotional Reactivity and Anxiety in Women with Breast Cancer

Volume 12, Issue 47 , January 2024, , Pages 19-32

https://doi.org/10.30473/hpj.2024.66318.5692

Abstract

Objectives: Cancer has experienced alarming growth in the last two decades and is considered as an urgent health problem of modern life. Meanwhile, breast cancer is one of the most common types of cancer, and its annual incidence is increasing at a rate of 1.8 to 2% in the world, and it ranks first among ... Read More Objectives: Cancer has experienced alarming growth in the last two decades and is considered as an urgent health problem of modern life. Meanwhile, breast cancer is one of the most common types of cancer, and its annual incidence is increasing at a rate of 1.8 to 2% in the world, and it ranks first among all women's cancers. However it has a major difference from other chronic diseases. In addition to requiring long-term care and treatment, it cannot be completely cured. This study aimed to investigate the effectiveness of group self-healing training on distress tolerance, emotional reactivity and anxiety in women with breast cancer in Isfahan. Methods: It was semi-experimental in the form of pre-test-post-test with a control group. The statistical population included all women with breast cancer in Isfahan who had referred to support center for cancer patients in the first quarter of 2011, and their number was 93 people in this period of time based on the statistics received from the counseling center. 30 people were selected as the sample through available sampling and were placed in two experimental (15 people) and control (15 people) groups. The used tools were Simons & Gaher's distress tolerance (2005), Matuo & Nock's emotional reactivity (2008) and Reese and Patterson anxiety (1985) questionnaires. Self-healing group training sessions based on the protocol of Latifi and Meravi (2017) adapted from Loyd and Johnson (2010) were conducted during 14 sessions. The data were analyzed using SPSS-24 software in two descriptive and inferential (normalization and MANCOVA) according to the investigated hypotheses. Results: The results showed that group self-healing training on distress tolerance and its dimensions (tolerance, evaluation and regulation), emotional reactivity (sensitivity, intensity and stability) and anxiety (fear of physical symptoms, fear of cognitive control distortion, fear of observing anxiety reactions) is effective in women with cancer in Isfahan (P<0.05). Conclusion: Therefore, it seems that this method can be used for breast cancer patients. The reason for the effectivness of self-healing training on reducing cancer patients’ anxiety and stress in physical and psychological dimensions can be attributed to the effects of direct training in the field of fear and anxiety in this intervention. In this treatment method for treating anxiety, strategies include self-education and communication management (keeping calm, avoiding haste, avoiding useless discussions, speaking in a soft tone, not reacting quickly and not judging quickly), trusting others (patience, calmness, happiness and entrusting the solution of the problem to a higher power), adjustment of idealism (reducing the desire to be perfect and accepting mistakes as an inseparable part of every human being), order and time management (having discipline, planning and prioritization and doing necessary daily tasks), correct connection with the mind (living in the present moment), and using physical and muscle relaxation techniques (muscle relaxation, breathing, hydrotherapy, swimming, walking, religious behaviors, watching the sky, listening to the sound of water, meditation and yoga, the use of relaxing audio files at least once a day) were used and the patients were helped to reduce their anxiety to a great. Considering the confirmation of the effectiveness of self-healing training on reducing emotional reactivity and anxiety in people with cancer, it is suggested that doctors and nurses pay attention to their psychological condition in addition to physical treatments for these patients and if they observe psychological problems caused by the disease, refer them to psychologists and counsellors. It is also suggested to set up counseling and psychological centers for cancer patients in hospitals.