Hospital Practices and Research

Abstract Background: Evaluating preparedness in the health sector, particularly within hospitals, is crucial for mitigating the impact of uncontrollable disasters like chemical incidents.
Objectives: This study aims to evaluate the readiness of a military hospital in Tehran to respond effectively to such emergencies.
Methods: In this study, data were collected using a standardized and validated questionnaire, specifically the Hospital Preparedness Tool for Chemical Crises, developed to assess the readiness of the selected military hospital in Tehran.
Results: According to the study's results, the overall level of preparedness at the hospital was assessed as "very good," with a total score of 119. Among the six areas examined in the selected hospital, the highest score was for the planning and guidelines area, with points (73.94%), and in the "very good" category. In contrast, the lowest score was for the risk assessment and early warning area with 7 points (70%), and in the "good" category.
Conclusion: Based on the study findings, the performance of the selected hospital in various dimensions of preparedness and response is assessed at a very favorable level. Also, the hospital has significant capabilities in improving preparedness for various events, including chemical incidents.

Abstract Background: Given the high prevalence and chronic nature of psychosomatic disorders, there is a significant need for effective and sustainable psychotherapeutic interventions.
Objectives: This research aimed to investigate the efficacy of Schema Therapy Based on Mindset (STBM) in enhancing distress tolerance among patients presenting with psychosomatic symptoms in Rasht, Ira.
Methods: This randomized controlled clinical trial followed a pre-test, post-test, and 3-month follow-up design included 30 female patients selected via convenience sampling and randomly allocated to the experimental (n = 15) or control (n = 15) group. The experimental group received eight 2-hour sessions of the STBM protocol. Data were collected using the Distress Tolerance Scale (DTS) and analyzed via Repeated Measures Analysis of Variance (RMANOVA) in SPSS-27.
Results: The findings confirmed a statistically significant effect of STBM on improving overall distress tolerance (P < 0.01), with therapeutic gains successfully maintained at 3-month follow-up. The intervention specifically yielded significant improvements in the tolerance, absorption, and appraisal subscales. However, the effect on the regulation subscale was not statistically significant.
Conclusion: STBM appears to be a promising intervention for modifying maladaptive cognitive-emotional patterns. This protocol is recommended as a valuable therapeutic tool for managing psychological distress and enhancing coping mechanisms in patients with psychosomatic symptoms.

Abstract Background: Menopause represents a significant physiological and psychological transition, often accompanied by negative attitudes and considerable challenges in health adjustment.
Objectives: This study aimed to investigate the effectiveness of mindfulness training in improving attitudes toward menopause and health adjustment among menopausal women.
Methods: This quasi-experimental study employed a pre-test, post-test design with a control group. The statistical population included menopausal women referred to a health center in Ahvaz, Iran, in 2024. A sample of 30 eligible women aged 51-65 years was selected using convenience sampling and randomly allocated into two equal groups (experimental, n = 15; control, n = 15). The experimental group received eight 70-minute sessions of mindfulness training, while the control group was placed on a waitlist. Data were collected using the Attitudes Toward Menopause Questionnaire and the Health Adjustment subscale of the Bell Adjustment Inventory. Data were analyzed using Chi-square and Multivariate Analysis of Covariance (MANCOVA) via SPSS 25.
Results: Initial analysis indicated no significant differences in age and educational level between the two groups (P > 0.05). The MANCOVA results showed that the mindfulness intervention significantly improved both attitudes toward menopause (η²p = 0.60) and health adjustment (η²p = 0.57) in the experimental group compared to the control group (P < 0.001), with large effect sizes.
Conclusion: The findings suggest that mindfulness training is an effective, non-pharmacological intervention for enhancing psychological resilience and improving women's adaptation during the menopausal transition. Specialists and therapists are encouraged to incorporate mindfulness protocols into women's health promotion and counseling programs.

Abstract Background: Klebsiella pneumoniae (K. pneumoniae) is a major cause of hospital-acquired infections, where treatment options are restricted due to drug-resistant strains, including those producing extended-spectrum beta-lactamases (ESBLs) and carbapenemases.
Objectives: This study focuses on the molecular identification of beta-lactamase and carbapenemase genes in K. pneumoniae strains from Valiasr Hospital, Zanjan, to enhance infection control and antimicrobial strategies.
Methods: In this cross-sectional study, 50 K. pneumoniae clinical isolates were obtained from blood, urine, and wound samples of ICU patients in 2024. Phenotypic identification and antimicrobial susceptibility testing were performed using the Kirby-Bauer disk diffusion method. Genomic DNA extraction was performed using the phenol-chloroform method, followed by polymerase chain reaction (PCR) to identify resistance genes (blaCTX-M, blaTEM, blaSHV, blaIMP, blaVIM). The PCR products were analyzed via agarose gel electrophoresis, with data processed using SPSS version 26.
Results: The mean age of the patients was 58.90 years, and the isolates exhibited high resistance rates to ampicillin (90%), piperacillin (78%), and cefotaxime (72%). Genotypic testing indicated ESBL gene frequencies: blaTEM (46%), blaSHV (44%), and blaCTX-M (40%), along with carbapenemase genes blaVIM and blaIMP in 26% and 22% of isolates, respectively. A significant link was found between the blaTEM gene and urinary isolates (P = 0.037). Furthermore, the presence of the blaTEM, blaSHV, and blaCTX-M genes was associated with MDR, XDR, and PDR phenotypes (P < 0.05), with 100% of MDR isolates containing all three genes.
Conclusion: The study found a high prevalence of ESBL genes linked to multidrug resistance patterns among K. pneumoniae isolates in ICUs. The presence of carbapenemase genes (blaIMP and blaVIM) indicates a shift toward carbapenem resistance, underscoring the urgent need for better antibiotic surveillance and infection control in these settings.

Abstract Background: Kidney stones significantly raise healthcare expenses due to the requirement for specialized treatments and frequent hospital visits. Kidney stones lower workforce productivity because affected individuals frequently miss work or are less efficient due to pain and the necessity of treatment. In society, kidney stones lead to reduced productivity and quality of life, affecting both individuals and the broader economy.
Objectives: The primary objective of this study is to analyze the influence of urine-based biochemical and physical parameters on kidney stone formation and to develop a high-accuracy machine learning model for early kidney stone prediction.
Methods: In this paper, data analytics methods are used to investigate kidney stones based on urea analysis and uncover valuable insights from the relationship between various factors. Additionally, a predictive model is developed by integrating deep learning with Particle swarm optimization (PSO) algorithms, where PSO is utilized to tune the model hyperparameters.
Results: This model boasts an impressive 98.1% accuracy in predicting kidney stones. Such a proactive approach can significantly enhance patient outcomes by preventing the onset of painful and debilitating kidney stones.
Conclusion: In this research, it was shown that early prediction allows for timely medical intervention, reducing symptom severity and preventing complications like urinary tract infections or kidney damage. Consequently, the need for emergency treatments and hospitalizations is minimized, lowering healthcare costs.

Abstract Background: Hospital nurses face psychological challenges and occupational burnout due to the demanding nature of their profession. Variables such as resilience, openness to experience, identity styles, and expansion of spiritual experiences have been shown to reduce these problems, but have mainly been studied in non-Muslim societies using non-Islamic approaches. This study addresses this gap by examining the effectiveness of Islamic spiritual therapy on these variables in hospital nurses.
Objectives: To investigate the effectiveness of Islamic spiritual therapy on resilience, openness to experience, identity styles, and expansion of spiritual experience in hospital nurses.
Methods: This was a semi-experimental study with a pre-test-post-test design and a control group. The sample consisted of 30 nurses working in public hospitals in Tehran, Iran, selected using convenience sampling and randomly assigned to experimental and control groups. The experimental group received 10 sessions of 90-minute Islamic spiritual therapy, while the control group received no intervention. Data were collected using the Connor and Davidson Resilience Scale (CD-RISC), the Revised NEO Personality Inventory (NEOPI-R) for openness to experience, the Berzonsky Identity Styles Questionnaire (ISI-6G), and the Underwood and Teresi Daily Spiritual Experiences Scale (DSES). Data were analyzed using analysis of covariance (ANCOVA).
Results: The results showed that Islamic spiritual therapy had a significant effect on resilience, openness to experience, identity styles (informational, normative, avoidant/confused, and commitment), and the expansion of spiritual experience in hospital nurses (P < 0.05).
Conclusion: Islamic spiritual therapy enhances resilience, openness to experience, identity styles, and spiritual experiences in hospital nurses. It can reduce burnout and promote holistic (physical-psychological-spiritual) care in hospital settings. Future research should include larger sample sizes and follow-up assessments.

Abstract Background: Mild cognitive impairment (MCI) represents a transitional stage between normal age-related cognitive decline and dementia. In this population, psychological factors such as hope and self-efficacy are frequently impaired, contributing to reduced quality of life and potential progression to dementia.
Objectives: This study aimed to compare the effects of cognitive rehabilitation (CR) and mindfulness-based stress reduction (MBSR) on self-efficacy and hope in individuals with MCI.
Methods: A quasi-experimental pretest-posttest design with a control group and a three-month follow-up was employed. The study population comprised patients with MCI attending memory and cognitive rehabilitation clinics in Tehran in 2024. Forty-five participants were selected through convenience sampling and randomly allocated to three groups: CR (n = 15), MBSR (n = 15), and control (n = 15). Each intervention group received 10 sessions, while the control group received no intervention. Outcomes were assessed using the General Self-Efficacy Scale and the Adult Hope Scale. Data were analyzed with repeated-measures analysis of variance (ANOVA).
Results: CR significantly improved self-efficacy at posttest (P < 0.01), with effects well maintained (and slightly numerically increased) at the three-month follow-up. MBSR showed no significant immediate effect on self-efficacy but was superior to control at follow-up. Both CR and MBSR significantly increased hope (P < 0.05), with CR showing greater improvements at posttest (P < 0.05). Direct comparisons indicated CR superiority over MBSR mainly at posttest for both outcomes.
Conclusion: Both interventions provide psychological benefits for individuals with MCI, but CR appears to be more effective in strengthening self-efficacy beliefs and future-oriented motivation. Clinically, this suggests CR as a valuable adjunct to support autonomy in MCI patients.