Razi Journal of Medical Sciences

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Background: Given the prevalence of sleep disorders among patients with heart disease and importance of recognizing determinants of it, the purpose of this study was to determine the status of sleep self-efficacy and perceived social support in patients with poor sleep quality after coronary bypass surgery in 2013.

Methods: This is a cross-sectional study. First, 100 patients whit poor sleep quality referred to the cardiac rehabilitation clinic of Tehran Heart Center were selected through simple sampling method and completed questionnaires of sleep self-efficacy and interpersonal support evaluation list–short form. Data were analyzed by the SPSS and one way-ANOVA, independent samples t test and Pearson correlation coefficient.

Results: The results indicated that sleep self-efficacy of patients for performing various sleep health promoting behaviors was low. For example, only 37% of patients were confident to themselves ability for turning out negative thoughts after lying in bed. Some 34% of them were confident that not allow a poor night's sleep interfere with daily activities. About 27% of them stated that awake after a poor night's sleep without feeling upset about it. The result also showed that acquired tangible assets support domain of patients was low. Other domains of social support were satisfactory. There was a significant relation between perceived social support and sleep self-efficacy (p=0.004, r= 0. 28). Conclusion: In developing interventions for increasing sleep quality of patients may be increase their sleep self-efficacy to performing sleep health promoting behaviors.

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Background: Current research have shown that among psychological factors, sleep quality and chronic fatigue plays a role in the prevention and treatment of cardiovascular and gastrointestinal diseases. The purpose of this study was to predict the risk of cardiovascular and gastrointestinal disease through sleep quality and chronic fatigue in shiftworkers.

Methods: 195 shift workers of an industrial company were selected by stratified random sampling and they completed survey questionnaires. The scales used for this study were 18-item physical diseases questionnaire (with two subscales), 11-item sleep quality questionnaire and 10-item chronic fatigue questionnaire.

Results: The results showed that there is significant correlation between shift workers sleep quality and risk of physical disease and its subscales (p<0.0001). There is significant linear correlation between shift workers’ chronic fatigue and risk of physical disease and its subscales (p<0.0001). Multiple linear regression analysis showed that there are relationships between shiftworkers sleep quality and chronic fatigue with risk of physical disease (R²=0.266, p<0.0001).

Conclusion: Overall, , based on these findings, we can say that poor sleep quality and chronic fatigue of shiftworkers increases risk of cardiovascular and gastrointestinal diseases.

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Background: Students sleep pattern, due to the stress of studying and teaching workload are different with other non-student peers. The aim of this study was to determine the prevalence of poor sleep quality in college students of Iran by a meta-analysis study, to be as a final measure for policy makers in this field. Methods: In this meta-analysis study, the databases of PubMed, Science Direct, Scopus, Google Scholar and interior databases were searched up to November, 2014. Between the studies with regard to the inclusion and exclusion criteria, 15 studies were selected. Data analyzed by using Stata11 software. Publication bias was assessed by Begg and Egger tests. Also heterogeneity assessed by Cochran’s Q statistic and I2 index. Couse of heterogeneity was evaluated by using meta-regression. Results: Total samples in the 15 studies were 3260. Begg and Egger tests with the P-value of 0.88 and 0.15 respectively, indicated the absence of publication bias. Cochran’s Q statistic and I2 index revealed heterogeneity of the samples (Q=975.26, P-value <0.001 and I2= 98.6). Overall prevalence of poor sleep quality in student based on the random effect was obtained 56.0% (95% CI: 43.2 – 68.7). Conclusion: Considering the high prevalence of sleep quality and its increase in previous years, detection of affecting factors, intervention and preventive actions, and education about the importance of sleep and time management skills in students seem essential.

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Background: Operating room technologists are constantly exposed to sleep disturbances due to their occupationally sensitive nature and these disorders lead to physical and psychological complications. Job stress is one of the important factors of physical and mental complications, as well as reduction of efficiency in operating room technologists.
Methods: In this descriptive-analytical study, the sample size was 134, which was calculated using the sample size formula and included the operating room technologists working in educational hospitals of Iran University of Medical Sciences who were available and the questionnaires were given to them. The questionnaires included the following items: 1) Demographic information such as age, sex, work record, marital status and educational level, 2) Pittsburgh Sleep Quality Index (PSQI) 3) Kahen et al. job stress questionnaire.
Results: The quality of sleep and job stress did not have a significant relationship with any of the demographic variables. There is no significant difference in mean of sleep quality and occupational stress among single and married people.
Conclusion: Nursing managers are aware of the results of this study by properly communicating with the operating room technologists and supporting them and creating the right environment for the continuing professional activity of technologists to reduce occupational stress, as well as for operating room technology technologists, classes and workshops to increase Sleep patterns and stress management are organized periodically.
 

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Background & Aims: The use of smoking is considered as an important and widespread health problem in various sectors, including students in other parts of the world. Smoking, as one of the greatest threats to human health, causes the worst biological and psychosocial catastrophes and is one of the deadliest factors that increase the overall disease in the world, especially in relation to possible disease. Chronic diseases such as cardiovascular disease, respiratory disease, cancer and seizures have been reported (1). Of the world's 1.1 smokers, 80% are in low- and middle-income communities (2). In the study, 7.28 causes smoking in the age range of 18 to 24 years, which is the majority of students in the same age range (3). Findings of this study showed that 10.9% of students are smokers, 1.9% are women and 15.45% are men(4). Numerous factors have been investigated as possible causes of students' tendency to smoke; In the study of the existence of problems and incompatibilities with family members, especially spouses and parents, and increasing relationships outside the family, including friends, or feelings of loneliness increases the tendency to smoke (5). The feeling of loneliness is a common experienceamong all human beings that almost every person has experienced and experienc) 6).
Feeling lonely is a person's mental assessment of the situation in which he or she finds himself or herself, so that he or she will not feel as intimate in his or her friendly and intimate relationships as he or she would like. In other words, the feeling of loneliness can be considered as perceived social loneliness and not necessarily objective social loneliness. Feeling lonely as a threat to mental health (7); Increases stress and anxiety, dropping out of school, depression, shyness, low self-esteem, increases the risk of suicide and high-risk behaviors such as smoking and substance abuse in adolescents (5).
Another factor that seems to be the tendency to smoke is academic burnout. Academic burnout in students means feeling tired in doing homework and studying materials, having a pessimistic attitude towards education and feeling inadequate for education (10)
Burnout also occurs when a person experiences stress for a long period of time. The results of some studies indicate that academic burnout in students leads to despair and apathy (11). It seems that academic stressors provide the ground for students' tendency to smoke by creating grounds for emotional fatigue and feelings of academic inefficiency in students (12). Little research has been done on the relationship between the variables of academic burnout and the tendency to smoke. In studies of burnout, there was a positive correlation with personality traits of neuroticism and agreement and a negative correlation with personality traits of extroversion and openness, and no significant correlation was reported between conscience and burnout (13). . Research has shown that academic failure is a predictor of drug addiction (14). In a study, they found that drug use has negative effects on students' academic achievement (15).
Another variable that can be related to smoking tendency is sleep quality. Sleep quality refers to mental indicators of how you experience sleep, such as sleep satisfaction (16). Some studies on the young population have reported a higher prevalence of sleep problems in the sleep quality of the young population (17). The student population is a group that is particularly affected by sleep disorders (18) and sleep problems in this group are estimated to be 2 to 5 times the general population. They usually go to bed later, wake up later, and experience more boredom and fewer hours of sleep (19). They experience most of the conditions such as insomnia and insomnia, extreme fatigue, irritability and sensitivity, forgetfulness and neglect, difficulty concentrating and attention, physical complaints and personality-related disorders (20); It is clear that sleep-related problems and their diagnosis are an unknown public health problem among students (21).
Therefore, the present study aimed to investigate the role of loneliness, burnout and sleep quality in predicting smoking tendency in students.
Methods: The present study was a descriptive correlational study. The statistical population of this study consisted of all students of Mohaghegh Ardabili University in the academic year 1397-98. Among them, 181 people were selected using available sampling method and to collect data from the questionnaire on smoking attitude (this questionnaire includes a Likert scale to measure the attitude to smoking, which in a total of 32 items with The reliability coefficient is 0.871 in three cognitive dimensions of 9 items with a reliability coefficient of 0.739, the emotional dimension of 11 items with a reliability coefficient of 0.825 and the behavioral dimension of 12 items with a reliability coefficient of 0.876 (27) Ditomasu loneliness and Colleagues (this scale has 14 questions and its purpose is to assess the level of social and emotional loneliness of individuals (romantic loneliness, family loneliness, social loneliness). The scoring method is based on a 5-point Likert scale that respondents agree with. Or express their opposition to these questions on a scale of 5 options from strongly agree (5) to strongly disagree (1) In this questionnaire, except for question 14, all other questions are scored in reverse Cronbach's alpha coefficient was also used for its reliability and the value of this coefficient for the dimensions of this questionnaire is as follows: romantic loneliness 0.92, family loneliness 0.84, community loneliness 0.78 (28), Practical burnout (This is a modified questionnaire of the general burnout scale, which has been modified for use in student samples. This questionnaire has a total of 15 questions and includes three subscales. Emotional fatigue is measured by 5 questions. Doubt and pessimism through 4 questions examined, academic self-efficacy is measured by 6 questions. All questions are scored in a 7-point continuum from never (0) to always (6). Cronbach's alpha for the dimensions of this questionnaire is as follows; Emotional fatigue 0.89; Doubt and pessimism 0.84; Academic self-efficacy (0.29) and Petersburg quality of sleep (this questionnaire measures seven factors of mental quality, delay in falling asleep, duration of sleep, useful sleep, sleep disorders, use of sleeping pills and daily dysfunction, and It consists of 18 items.The subjects answer a range of answers from zero to 3. The total score of the index also ranges from 0 to 21 and high scores indicate poor sleep quality and a score above 5 indicates significant sleep disturbance. Validity of 86.5 and reliability of 89.6 were reported (30) and statistical methods of correlation coefficient and multiple regression on SPSS 22 software were used for data analysis.
Results: The results showed that the tendency to smoke with a total score of feeling lonely (R= 0.35, P= 0.01), burnout (R= 0.17, P= 0.05), sleep quality. (R= 0.15, P= 0.05) There is a positive and significant relationship. The regression results also showed that the combination of sleep quality, burnout and loneliness predicts 12% of the variance of smoking tendency scores. Also, the feeling of loneliness is the only variable that alone predicts the tendency to smoke.
Conclusion: According to the results, loneliness, burnout and sleep quality have important role  in students' tendency to smoke. By providing counseling, workshops, and intervention programs to reduce these factors to prevent smoking in students can be helpful.
 

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Background & Aims: Throughout human history, there have been structured games among all cultures. Playing can be enjoyable, fun, and relaxing and can be used as a way to escape from everyday life (1). In addition to being a fun pastime, gaming is a social activity in which people with common interests interact with each other. With the popularity of computers, tablets, and smartphones and the use of the Internet in recent years, playing online and offline games has become a common activity, especially for young people, and increasingly, as an important part of recreational activities (3). Numerous studies show that in parallel with the spread of the Internet, overuse of it can lead to problems such as addiction and dependence, so that even Internet addiction is defined as a 21st-century epidemic (4, 5).Online games are a type of Internet games that have become widespread due to increasing people's familiarity with the Internet, especially the youth, increasing the speed of the Internet, as well as the existence of high-speed and wireless connections (6). Addiction to online games is considered obsessive, extreme, uncontrollable, and physically and mentally destructive. Therefore, addiction to these games can be defined as: Extreme and impulsive use of online games, in a way that leads to social and emotional problems, and despite these problems, a person can not control his extreme use of the game Slowly Internet addiction is an impulse control disorder characterized by overuse of the Internet, which is associated with significant functional impairment, anxiety, depression, and other symptoms of psychiatric pathology (7). Internet addiction is sometimes associated with suicide, even after modulating potentially disturbing variables such as depression. Attention-Deficit/Hyperactivity Disorder (ADHD) is a developmental neurological disorder that has three main characteristics: Attention Deficit Hyperactivity Disorder, Hyperactivity Disorder, and Impulsivity. People with ADHD have abnormalities in parts of themselves (9). Some psychologists report about the related between depression, anxiety and symptoms of ADHD with Addiction to online games (10). Also relation is between internet addiction with d reducing of academic hope and sleep quality (20, 21).
Acceptance and Commitment Therapy: This follows a pattern of health, not illness, and assumes that human psychological problems are related to unhappiness and emotional disorders caused by language, thus helping human beings cope with Cognitive and emotional problems mainly work on language (26). The effectiveness of treatment based on acceptance and commitment on sleep quality, academic hope and anxiety in students with internet game disorder, with and without comorbidity of ADHD in Khorramabad in 2020 became necessary.
Methods: The statistical population was students with internet game disorder in Khorramabad city. The sample size was 42 people (14 people for each of the experimental and control groups) so that each group consisted of an equal number of students with internet game disorder with and without comorbidity of attention-deficit/hyperactivity disorder. Therapeutic intervention sessions were performed in 9 sessions of two hours and one session per week. To measure the research variables, questionnaires of Internet Gambling Disorder -20 test, mental health assessment of children and adolescents aged 6 to 14 years (CSI-4), Petersburg quality of sleep (PSQI), academic hope scale (date and waist), and Beck anxiety (1988) and an acceptance and commitment-based treatment package were used. Data analysis was performed using analysis of covariance in SPSS22 and Smart PLS.
Results: The results show that the univariate test is significant for each of the dependent variables in both post-test and follow-up stages (P <0.01). Also, the univariate test is significant only for dependent variables of academic achievement (P <0.05). And is not significant for other variables (P <0.05).
Conclusion: The effectiveness of acceptance and commitment-based therapy on sleep quality, academic hope and anxiety of students with internet gambling disorder has an effect and this effect persists over time. In explaining the present study, it can be said that the results of this study are consistent with the mentioned studies, meaning that the ACT treatment approach has an effect on the dependent variables and this effectiveness has continued and shows that the treatment is based It is an effective treatment approach for acceptance and commitment for different types of behavioral, psychological, mental, mood disorders, etc. Obviously, it is moderated by the individual's relationship to these experiences. Therefore, these people are taught that to the extent that they can accept and tolerate their experiences, they can act independently of the experiences. According to the results of the present study, it can be said that acceptance and commitment-based therapeutic education can reduce the symptoms of Internet gambling disorder and reduce the severity of dependence and thus the desire for treatment in a positive way. , Be effective. Therefore, by teaching these ACT skills, an effective step can be taken to treat students with internet game disorder with and without co-occurrence with ADHD. Acceptance and commitment therapy affect the quality of sleep and this effect persists over time. In the explanation of the present study, it should be said that according to Table 4-12, the treatment based on acceptance and commitment on the quality of sleep of students with internet game disorder is effective and this effectiveness has continued in a one-month follow-up period. Explaining the results of the present study, it should be said that the therapeutic approach based on acceptance and commitment of ACT is effective on students' academic achievement with internet gambling disorder and this effectiveness has continued in a one-month follow-up period. Acceptance and commitment therapy has an effect on anxiety and this effect has persisted over time.
According to the results of the present study, it can be said that therapeutic training based on acceptance and commitment can be effective in reducing the symptoms of internet gaming disorder and reducing the severity of mental disorders. Therefore, by teaching these treatment skills based on acceptance and commitment, an effective step can be taken in the direction of treating students with internet gaming disorder with and without comorbidity with attention deficit hyperactivity disorder.

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