Hospital Practices and Research

Abstract Background: Bulimia nervosa is a complex eating disorder often associated with maladaptive schemas and anxiety sensitivity. Objectives: This study investigated the effectiveness of Compassion-Focused Therapy (CFT) and Emotion-Focused Schema Therapy (EFT) individually on early maladaptive schemas and anxiety sensitivity in women with bulimia nervosa. Methods: This study employed a quasi-experimental, pretest-posttest control group design. The study population consisted of 75 female patients with a confirmed diagnosis of bulimia nervosa, recruited via convenience sampling from those seeking treatment at the Ahvaz Eating Disorders Association. Participants were assigned to one of three groups (n = 25 per group): two experimental groups and a control group. One experimental group received EFT (10 sessions, 90 minutes each), while the other received CFT (8 sessions, 90 minutes each). The control group received no intervention. The Early Maladaptive Schema Questionnaire and the Anxiety Sensitivity Index were used to assess outcomes. Data were analyzed using analysis of covariance (ANCOVA) within SPSS. Results: Results indicated that both treatments significantly reduced early maladaptive schemas and anxiety sensitivity in women with bulimia nervosa. EFT demonstrated greater efficacy, with larger reductions in early maladaptive schemas (η=0.80, P<0.001) and anxiety sensitivity (η=0.74, P<0.001) compared to CFT. The control group showed no significant changes in either outcome. Conclusion: This study revealed that EFT and compassion-focused therapy reduce maladaptive schemas and anxiety sensitivity in women with bulimia nervosa, with the former showing greater efficacy. Future research should explore the mechanisms driving these differential effects and their long-term outcomes. These findings suggest that EFT may be prioritized in clinical settings to effectively target maladaptive schemas and anxiety sensitivity in women with bulimia nervosa.

Abstract Background: Anxiety disorders are highly prevalent among adolescents, particularly girls. These disorders can significantly impair academic performance, social relationships, and overall quality of life, with long-term consequences into adulthood.
Objectives: The research aimed to predict anxiety in adolescent girls using a multilayer perceptron model based on self-awareness and metacognitive beliefs.
Methods: In this correlational study, the statistical population consisted of adolescent girls aged 16-18 enrolled in secondary schools in Ahvaz during the academic year 2022-2023. A total of 215 individuals were selected using multi-stage cluster sampling. Data were collected using the Beck Anxiety Inventory (BAI), the Five Facet Mindfulness Questionnaire (FFMQ), and the Metacognitions Questionnaire (MCQ-30) to assess anxiety, self-awareness, and metacognitive beliefs, respectively. The data were analyzed using Pearson’s correlation coefficient, simultaneous regression, and a multilayer perceptron model, performed with SPSS version 27 and MATLAB version 2019.
Results: The results revealed a significant negative correlation between self-awareness and anxiety in adolescent girls (r = -0.60). Furthermore, metacognitive beliefs also showed a significant negative correlation with anxiety in adolescent girls (r = -0.53). Additionally, a significant combined predictive effect was found for self-awareness and metacognitive beliefs on anxiety in adolescent girls (P<0.001). The results of the multilayer perceptron model indicated that self-awareness had the strongest predictive power in relation to anxiety in adolescent girls.
Conclusion: Higher self-awareness and stronger metacognitive beliefs correlate with lower anxiety levels in adolescent girls. Interventions aimed at improving these cognitive factors, such as mindfulness and cognitive restructuring, could effectively reduce anxiety. Integrating these strategies into clinical and educational settings can empower adolescent girls with crucial coping mechanisms. By fostering self-awareness and healthier metacognitive beliefs, we can equip them to manage anxiety, improve their overall mental well-being, and enhance their academic and social functioning.

Abstract Background: Nursing is stressful, especially for female nurses, due to workload and emotional labor. These stressors can contribute to negative emotional states, including meta-worry, irritable mood, and difficulties processing emotions effectively.
Objectives: The purpose of the present study was to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) in reducing meta-worry, irritability, and improving emotional processing in anxious female nurses.
Methods: A quasi-experimental pre-test, post-test control group design was employed.  The target population comprised all female nurses at Imam Khomeini Hospital, Ahvaz, Iran, experiencing anxiety in 2023. A convenience sample of 30 nurses was randomly assigned to either the ACT intervention group (n = 15) or the control group (n = 15). The intervention group received an eight-week ACT program each lasting for 90 minutes. Anxiety-related outcomes were assessed using the Meta-worry Questionnaire, The Irritability Questionnaire, and The Emotional Processing Scale. Data were analyzed using ANCOVA with SPSS-25 software.
Results: Prior to the intervention, no statistically significant differences were identified between the control and experimental groups on measures of meta-worry, irritable mood, and emotional experience processing. Following the ACT intervention, the experimental group demonstrated significant improvements (P <0.001) compared to the control group. Specifically, ACT led to a decrease in meta-worry scores and positive changes in both irritable mood and emotional experience processing among anxious female nurses.
Conclusion: The findings demonstrated that ACT positively improved meta-worry, irritable mood, and emotional experience processing among the participants. These results suggest that ACT may be a valuable intervention for reducing anxiety-related symptoms and improving emotional well-being in female nurses experiencing anxiety.

Abstract Background: Pandemics such as COVID-19 create heightened fear and anxiety, causing deterioration in the behaviours, social and psychological well-being of people. It can be thought that the anxiety levels of healthcare workers will increase more because they have a higher risk of contamination, work under COVID-19 isolation-measures and heavy workload.
Objectives: The aim of this study is to determine the COVID-19-related anxiety levels of individuals, the ways of coping with, the demographic factors affecting anxiety, and whether the anxiety level of healthcare workers is different from others.
Methods: This study was carried out with data obtained from 1017 participants via google forms between May-July 2020. In the collection of data, the 12-item COVID-19-related anxiety scale, which was developed by researcher and analysed for validity and reliability; 13 items for ways of coping; some demographic questions were used. The COVID-19-related anxiety scale consisted of three dimensions: “cognitive”, “physiological and emotional”, “behavioural”, which explained 71% of the variance. The Cronbach alpha of scale was 0.85.
Results: The COVID-19-related anxiety levels of participants were slightly above the moderate level (2.83±0.72). The anxiety levels of healthcare workers were not different from others. There was a difference in anxiety levels according to demographic characteristics of participants, such as age, gender, living in Turkey or abroad, working status/type, and smoking addiction. Cognitive coping, social support, distraction, relaxation techniques were identified as ways of coping with anxiety.
Conclusion: COVID-19 pandemic created anxiety in people. More studies need to understand the long-term effects of the pandemic.

Abstract Background: Hospitalization due to any reason or medical condition is associated with fear, anxiety, and depression. Psychological and physiological factors have a significant impact on hospitalization outcomes.
Objectives: Given the functional importance of inflammatory cytokines and studies in previous studies on the relationship between inflammatory cytokines and major depressive disorder, we will focus more on studies on the role of interleukin 2 (IL-2) in the pathophysiology of major depressive disorder in hospitalized patients.
Methods: We used PubMed, Scopus, and Elsevier databases to search for articles from 1999 to 2021, emphasizing the studies of the last five years.
Results: In general, there was no consistent pattern in the observed relationships between cytokine concentrations or changes and clinical signs of significant depression. IL-2 and IL, two receptors in the body, play an essential role in the treatment and the pathophysiology of depression and major depression.
Conclusion: Finally, it can be concluded that hospitalization generally exposes the patient to inflammation. Studies show an increased risk of inflammation following hospitalization of patients, and many studies confirm the association of major depression with inflammatory cytokines and, more concentrated, IL-2.