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Introdution: Incidence of childhood asthma and diabetes type 1 is being increased in children. Considering evidences which indicate a probable correlation between maternal depression and childhood chronic physical illness, this study aimed to compare relative frequency of depression in mothers with asthmatic, diabetic and normal children and to assess the time priority between maternal depression and the onset of the child’s illness. Methods and  Materials: In a cross-sectional study, mothers of diabetic children, asthmatic children & normal children were enrolled in 3 groups of participants, each consisting of 100 mothers. Using the Beck Depression Inventory-Second Edition (BDI-II), depression was assessed in all participants & mothers of ill children who were detected to be depressed according to the inventory, were referred to a psychiatrist for a DSM.IV clinical interview for approving the diagnosis, assessing co morbidities & evaluating the onset-time of the first depression episode. Relative frequency of depression was compared in the three groups & the time priority between onset of maternal depression and onset of child illness were compared between the two groups of mothers with chronically ill children. Data were analysed using the analysis of variance (ANOVA), Chi-square and Kruskal-Wallis tests, running the SPSS-11 software. Findings: Relative frequency of depression in mothers of normal children, diabetic children & asthmatic children was reported to be 16%, 30% and 27% respectively. Mothers with ill children had a significantly higher rate of depression compared to mothers of normal children (P Discussion: The higher rate of depression among mothers with chronically ill children & the higher rate of time priority of maternal depression relative to the child’s disease onset in mothers of asthmatic children indicate the necessity of preventive mental health programming for mothers with chronically ill children. It also sets a probable causal link between maternal depression & childhood asthma forth for discussion & further investigation. 

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Normal 0 false false false MicrosoftInternetExplorer4 Introduction: A chronic illness, such as diabetes mellitus, creates changes in the life style and requires constant adjustment. The onset of a chronic illness can be a stressful event in any life stage including adolescence.. The interaction between the illness related problems and the psychosocial changes associated with normal adolescence makes it difficult for the patient to cope with the chronic illness in a constructive way.. Poor adherence to medical treatment and poor drug compliance are common concerns of the families and physicians dealing with diabetic adolescents. It is of an urgent importance to study effective, culturally appropriated interventions which focus on the high-risk diabetic adolescents with severe adherence difficulties and/or chronically poor metabolic control . Methods: This was a randomized controlled trial (Experimental design). The sample consisted of sixty randomly selected male and female diabetic adolescents living in Esfahan, with an age range between 12 to 18 years old. They were randomly assigned to four groups with different subjects of training including: personal self-efficacy, communication skills, both subjects and no training (control group). The scale of self-efficacy in diabetes and Family Assessment Device (FAD) were then administered to all participants. Treatment adherene was also evaluated using laboratory tests for Hemoglobin A1C (HbA1c) index. Data were analysed using the one-way Analysis of the Variance (one-way ANOVA). Findings: Significant difference was found between the groups regardind the scores of self-efficacy (F=3.725, P=0.017), FAD (F=4.151, P=0.01) and communication (F=8.302, P=0.000), as well as HbA1c results (F=3.088, P=0.035). Discussion: For preventing the short and the long term side effects of the diabetes mellitus, patients’ treatment adherence should be improved. Psychological interventions for enhancing self-efficacy and improving communication skills can be effective in this respect.

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Aim and Background: The purpose of this study was to determine the effect of treatment based on acceptance and commitment therapy (ACT) on depression and mental health in patients with diabetes. Methods and Materials: Experimental research method was used in this study. Statistical population consisted of diabetic patients from diabetes center in Isfahan, Iran. A total of 30 patients were randomly selected and assigned to either experimental or control groups. Beck Depression Inventory (BDI II) was completed before and after the intervention. Experimental group received 8 training sessions of ACT, with 120 minutes duration, in Diabetes Charitable Center of Isfahan. The control group received no training at all. Findings: Results showed that ACT significantly increased scores on the BDI II compared to the control group (P < 0.001). Conclusions: ACT may be considered to be an effective intervention approach for treating depression in diabetic patients.

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Abstract Aim and Background: This study aims to predict self-care behavior based on the characteristics of Hardiness , hope and dysfunctional attitudes in patients with type 2 diabetes. Methods and Materials: Study design was a descriptive correlation method. The target population was all patients with diabetes type 2 who referred to Isfahan Endocrine and Metabolism Centers. The sample consisted of 120 patients. The multi-stage cluster sampling was used for the sample selection . The instrument employed in this research was Self &ndash; care Scale, hardiness Questinnaire, Hope Scale and Dysfunctional Attitudes Scale . The Pearson correlation and multiple regression analysis with stepwise method were used to analyze the data. Findings: Analysis of the data showed that the only interaction between hope and dysfunctional attitudes have been able to predict self-care (r=0.191,p<0.05). But separately there is no relationship between hardiness , hope, dysfunctional attitudes and self-care. Conclusions: Interaction of dysfunctional attitudes and hope are able to predict self-care behavior. Therefore, the program which modify dysfunctional attitude and enhance Life Expectancy seems to increase self-care behavior.

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Aim and Background: Today, diabetes is one of the most common chronic diseases. Previous researches indicate the effect of lifestyle on the increased incidence of the disease. The purpose of the study was to assess the efficiency of lifestyle modification training on psychological symptoms and glycemic control among patients with type II diabetes. Methods and Materials: This was an experimental clinical trial with a pretest-posttest design, control group, and follow-up period. The statistical population included all patients with type II diabetes referred to the Glands and Metabolism Research Center in the Medical Science University of Isfahan, Iran, in 2013. Accordingly, a sample of 42 diabetics was selected using convenience sampling and they were randomly allocated to experimental (n = 21) and control (n = 21) groups. The Symptom Checklist-90-R (SCL-90-R) and blood test for HbA1c were utilized in pre-test, post-test, and 3 months after the intervention (follow-up). The study was implemented during 6 months. The interventions were performed in the experimental group within 8 weekly sessions lasting 90 minutes for 2 months. The data were analyzed using MANCOVA in SPSS software. Findings: Lifestyle modification training had significant effects on psychological symptoms (on physical complaints, obsession-compulsion, interpersonal obsessive disorder (IOD), depression, anxiety, aggression, paranoid, and melancholia, except phobia), blood sugar levels of patients with type II diabetes at post-test and follow-up stages (P < 0.05). Conclusions: According to the results, it can be concluded that lifestyle modification training is effective on the reduction of mean psychological symptoms scores and blood sugar levels in patients with type II diabetes. In addition, planning and holding educational courses according to the educational package of the present study is effective on the improvement of these patients. Thus, it is suggested that the efficacy of this intervention be evaluated in other chronic illnesses. Moreover, the results of this study can be exploited by doctors, nutritionists, counselors, and psychologists.

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Aim and Background: Self-care is one of the most important factors in improving the quality of life (QOL) of individuals with diabetes. Mindfulness-based interventions can have an important role in increasing self-care in individuals with diabetes. The aim of the current research was to evaluate the effectiveness of mindfulness training on increase in self-care in women with type II diabetes. Methods and Materials: This quasi-experiment was conducted with a pretest-posttest design and a control group. The statistical population consisted of women with diabetes referring to the Diabetes Society of Tehran, Iran, in 2015. Initially, the subjects were selected through convenience sampling method, and after completing the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire, they were randomly divided into experimental and control groups (12 individuals per group). The experimental group participated in 8 sessions of mindfulness training, but the control group received no intervention. The gathered data were analyzed using ANCOVA. Findings: There was a significant difference between the pretest and posttest scores of the experimental group (P < 0.01). Therefore, it seems that mindfulness training increased self-care in women with diabetes. Conclusions: The results suggest that mindfulness training increased self-care in women with diabetes. Thus, in diabetes centers and clinics, in addition to the available medical treatments for diabetes, mindfulness-based interventions could be used in order to increase self-care in individuals with diabetes.

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Aim and Background: Type 2 diabetes (diabetes mellitus type 2) is a long-term metabolic and physiologic disorder which has a relationship with the pattern of behavior and lifestyle. This study aimed to determine the effectiveness of cognitive therapy on the reduction of glycated hemoglobin among people with type 2 diabetes. Methods and Materials: This study was a quasi-experimental research with an experimental and control groups in a pretest, posttest, and follow-up design. The statistical population of the research included all patients with type 2 diabetes, aged from 25-45, who were under treatment in the Diabetes Clinic of Dr. Ganjavian Hospital, Dezful, Iran, and had been diagnosed for at least one year. The sample size consisted of 40 men selected by convenience sampling method. Allocating the individuals in the experimental and control groups was done randomly. Ten group-sessions were held weekly for 2 hours for the experimental group, while the control group was on the waiting list.  In order to examine the changes made by the cognitive therapy program, analysis of covariance (ANCOVA) was recruited. Findings: Cognitive therapy led to a reduction in glycated hemoglobin of the experimental group in the posttest and follow-up phases. However, the control group did not show a significant change in the posttest as compared to the pre-test. Conclusions: Teaching cognitive therapy can be effective in controlling blood sugar (HbA 1 c) among patients with type 2 diabetes.

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Aim and Background: Today, due to changes in lifestyle and weight gain, the age of diabetes is reduced, and the prevalence of diabetes is increasing. The aim of this study was to determine the effectiveness of cognitive-behavioral group therapy on weight loss, and blood glucose level in women with type 2 diabetes mellitus. Methods and Materials: In a semi-experimental, and pretest, posttest study with control group, 40 obese (body mass index of more than 30 kg/m 2 ) women with an age range of 30-65 years and with type 2 diabetes mellitus were randomly selected and divided into two equal groups of experimental and control. The patients were referred to the Iranian Diabetes Association (Central Branch), Tehran, Iran. The experimental group participated in a program of 24 sessions of 60 minutes based on cognitive-behavioral obesity intervention, that included two phases of reduction and weight retention; but the control group did not receive any training. Weighing and taking blood samples (for evaluation of the average level of three-month blood glucose) were performed at the first and last session of the intervention. Findings: The cognitive-behavioral obesity therapy led to weight loss in patients with type 2 diabetes mellitus, and also reduced the level of blood glucose in them. Conclusions: The results indicate the effectiveness of cognitive-behavioral therapy in patients with type 2 diabetes mellitus. These findings are of great importance in controlling the weight, and blood glucose level in these patients; since it is possible to use alternative therapies, such as cognitive-behavioral therapy in treatment of obesity, as non-conventional medical treatments.

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Aim and Background: One of the most important challenges for chronic disease is treatment adherence. Many factors are affected on adherence. This study focuses on emotion regulation, self-compassion and spiritual wellbeing as predictors of treatment adherence in diabetic patients.

Methods and Materials: This was a descriptive and correlational study. The sample consist of 210 diabetic patients whom selected by convenient sampling method in clinics of Shahid Beheshti university hospitals. Participants responded to General Adherence Scale (GAS), Difficulties in Emotion Regulation Scale (DERS), Self-Compassion Scales (SCS) and Spiritual Well-Being Scale (SWB). Collected data were analyzed via SPSS 21 software and by linear multiple regression method.

Findings: Results of stepwise multiple regression analysis showed that difficulty in emotion regulation and self-compassion are significantly predicted treatment adherence of diabetic patients. But spiritual wellbeing was not significant in regression model.

Conclusions: The results of this study showed that most of diabetic patients have moderate levels of treatment adherence. By considering the importance and high prevalence of diabetes, enhancing self-compassion and emotional regulation skills as effective factors in self-care and treatment adherence of diabetic patients, should come under scrutiny.

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Aim and Background: Diabetes mellitus is one of the most common chronic diseases and is one of the biggest health problems in all countries. The most important strategy for controlling chronic patients is self-care behaviors. The purpose of this study was to compare the effect of Interactive Diabetes Management Training (IDMT) and Stress Inoculation Training (SIT) on self-care in type II diabetic patients.

Methods and Materials: This was a semi-experimental research and the population of this study included 2450 diabetic patients in Isfahan's Um Al-Benin Clinic, 39 of whom were selected through a convenient sampling method and randomly assigned to two groups of control and one control group. Groups Summary of Diabetes Self-Care Activities (SDSCA) for diabetic patients completed before and after education. Experimental group one, (SIT), and two groups of (IDMT) training received a weekly and group-based 90-minute training session. But the control group did not receive these training. The research findings were analyzed using Multivariate Analysis of Covariance (MANCOVA) and SPSS-19 software.

Findings: IDMT and SIT were effective in diabetic patient’s self-care and both training increased self-care for participants. But there was no significant difference between the two methods of intervention (p ≤.319).

Conclusions: SIT and IDMT can be used as an effective interventional method for increasing self-care in diabetic patients.

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Aim and Background: The World Health Organization stressed on the importance of social health as well as physical health, so social health has become the common concern of sociologists and social planners in each community. The present study was conducted to determine the role of irrational beliefs, mindfulness and perceived social support in predicting the social health in diabetic patients.

Methods and Materials: This study was a descriptive-correlational study. The statistical population of the study included all type 2 diabetes patients referred to the diabetes clinic of Imam Khomeini Hospital of Ardabil in 2019. One hundred twnety patients were selected by convenience sampling method. For data collection, the irrational beliefs scale, mindfulness scale, multidimensional scale of perceived social support and social health scale were used. Data analysis was made using Pearson correlation coefficient and multiple regression and using SPSS version 16 software.

Findings: According to the results a significant relationship was observed between irrational beliefs (r=-0.54, p<0.05) and mindfulness (r=0.51, p<0.05) with social health in diabetic patients. Also, a significant relationship was observed between social support perceived by the family (r=0.64, p<0.05), friends (r=0.62, p<0.05) and others (r=0.59, p<0.05) with social health in diabetic patients. The results of multiple regression indicated that irrational beliefs, mindfulness and perceived social support predict a total of 0.60 in social health among the diabetic patients (p<0.05).

Conclusions: According to the results of this study, irrational beliefs, mindfulness and perceived social support are effective in improving the social health in patients with type 2 diabetes patients.

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Aim and Background: Diabetes is a factor of many physical and psychological disorders. Nowadays, the concept of adherence in diseases be attention and has been developed due to changing the illness pattern from acute to chronic, changing its ideology from cure to prevention, limited economical resource and shortening the Duration of hospitalization of patients. In order to, the aim of this study was to survey of effectiveness of acceptance and commitment therapy on health related beliefs among patients with type 2 diabetes.

Methods and Materials: research method was semi experimental with pretest, posttest and control group design. From patients with type 2 diabetes who referred to Assaluyeh health centers, 30 subjects were selected purposely and were assigned in control and experimental groups randomly (15 subjects each group). To collect the data the Health Beliefs Questionnaire (HBQ) was used. The data analyzed using MANCOVA.

Findings: Results of data analyzing showed that acceptance and commitment therapy on health related beliefs of patients with diabetes type 2 is effective (p<.05).

Conclusions: Results of the research showed that acceptance and commitment therapy is effective on health related beliefs. Theoretical and practical considerations of the results showed that the ACT as an effective therapy for patients with type 2 diabetes in medical centers could be applied.

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Aim and Background: Type 1 diabetes is one of the chronic disorders in childhood that can have a negative effect on various physical and psychological aspects of affected children. The purpose of this study is to investigate the role of play therapy in improving the mental health of children with type 1 diabetes.
Methods and Materials: The present study is a narrative review. Keywords type 1 diabetes, children and adolescents diabetes, play therapy, game and their English equivalent in domestic (Sid, noormags, magiran, civilica) and foreign (science-direct, springer, Scopus, google scholar) databases. Various data were searched. The result of the initial comprehensive search included many articles in all the databases, and by applying filtering, inclusion/exclusion criteria, finally 12 articles that were published between 2014 and 2020 were selected.
Findings: The results of the present study showed that play therapy can be significantly effective in reducing depression and anxiety scores. Also, children who regularly benefited from play therapy had a higher psychological well-being and quality of life than children without play therapy.
Conclusions: It can be said that play therapy is one of the effective treatments for reducing the psychological problems of children with type 1 diabetes. Therefore, this treatment can be used to reduce the psychological problems of these children.

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Aim and Background: Epidemiology of psychological problems of children with type 1 diabetes is particularly important due to the ever-increasing prevalence of its sufferers in the world and difficult and stressful conditions of living with this disease and also the long-term negative effects it can have on the physical, psychological, social, and spiritual development of people. Because knowing the current condition of these children is essential for any psychological planning and intervention; the present study was conducted with the aim of epidemiology of psychological problems of children with type 1 diabetes.
Methods and Materials: In this descriptive-cross-sectional study, 100 children aged 8 to 12 years with type 1 diabetes in Isfahan province who were cared for in medical centers of the University of Medical Sciences in 2022 were investigated. Psychological problems including emotional-behavioral problems were measured by Children's Behavior Inventory (CBCL). The data was analyzed through SPSS software version 26 and with descriptive (mean, standard deviation and percentage) and inferential (chi-square, one-sample t-test and one-way analysis of variance) indicators.
Findings: 68.7% of children examined in this research had psychological problems at the clinical level (55.2%) or borderline (13.5%).Some psychological problems were significantly related to gender and economic and educational level of the family (p ≤ 0.05).
Conclusions: Children with type 1 diabetes have internalized psychological problems such as anxiety, depression, somatization, as well as externalized problems such as rule-breaking and aggressive behaviors at the clinical and borderline levels. It is necessary to design and implement a context by strengthening the relationship between the medical team and the consultants to facilitate the acceptance of life with diabetes and help the children and their families express emotions properly.

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Aim and Background: One of the common problems in type 2 diabetes patients with depression symptoms is emotional distress, which causes many negative consequences for these people, so present study was conducted to comparison of the effectiveness of Autobiographical Memory Specificity training and acceptance and commitment therapy to the emotional distress of diabetic patients with depression.
Methods and Materials: The research method was quasi-experimental with a pre-test-post-test design and a follow-up period of three months. The statistical population of the study included people with type 2 diabetes and depression who were referred to medical centers in Isfahan city in the first six months of 1400. The final sample of the study included 50 Patients with type 2 diabetes and depression, who were selected through convenience sampling method and randomly assigned to experimental and control groups. Then, the experimental groups received training on personalization of historical memory (8 sessions of 90 minutes) and therapy based on acceptance and commitment (7 sessions of 90 minutes) separately during two months. This is even though the control group did not receive the interventions and was waiting to receive these interventions. The tools used included an emotional distress questionnaire. Data analysis was done by software (SPSS-23) and mixed analysis of variance and Bonferroni post hoc test.
Findings: The results showed that Autobiographical Memory Specificity training and acceptance and commitment therapy have a significant effect on the emotional distress of diabetic patients with depression (p<0.001). Also, the follow-up test results indicated no significant difference between the effectiveness of the two treatments on emotional distress (p≤0.05).
Conclusions: The research findings indicated that therapists could use the Autobiographical Memory Specificity and acceptance and commitment therapy to reducing the emotional distress of diabetic patients with depression.

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Aim and Background: What is important in the treatment of a chronic disease such as diabetes is to improve the patient's quality of life in addition to control the symptoms of the disease. The trouble that a child with a chronic disease such as diabetes imposes is a problem that cannot be recognized only from the doctor's point of view and depends on what the mother of the sick child feels. Therefore, it seems necessary to identify the care factors of children with diabetes. In this research, the aim was to identify the care factors of children with diabetes based on the lived experiences of their mothers.
Methods and Materials: This study was conducted using a qualitative method and a phenomenological approach. The participants were 16 mothers with diabetic children whose information was collected through a semi-structured interview. Sampling was done in a purposeful way and the data was analyzed by the Colaizzi method.
Findings: The findings obtained in 3 main themes and 6 sub-themes including individual characteristics (psychological-physical functioning and emotional-social functioning), family (interpersonal interactions and psychological and social problems), educational issues (concerns and needs) classification became.
Conclusion: The results of the present study showed that knowing the care factors in children with diabetes can provide the basis for adopting supportive and therapeutic measures for them.

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Aim and Background: Diabetes is one of the non-communicable diseases that cause many effects on the body. Today, the chosen lifestyle and daily behaviors of the individual, especially sports activities, are used a lot to reduce the complications caused by it. The purpose of this study was to evaluate the effect of eight weeks of combined exercises on the plasma levels of kynurenine and body composition of type 2 diabetic men.
Methods and Materials: In this research, subjects included 24 men with type 2 diabetes with an age range of 60.29 ± 4.00 (years), weight 87.37 ± 6.83 (kg), height 57.57 ± 0.11. 1 (m), body mass index (kg/m2) 36.12 ± 9.09, fat mass (percent) 28.77 ± 1.94, muscle mass (kg) 26.82 ± 1.66, average blood sugar Three months (A1C) 7.74 ± 0.41, fasting blood sugar (mg/dL) 163.79 ± 2.14, medical history (years) 3.92 ± 0.50, voluntarily They were selected and randomly divided into two groups, the experimental group (12 people) and the control group (12 people). The experimental group for eight weeks, three sessions of 60 to 80 minutes each week, combined exercises including resistance exercises (four exercises for the upper and lower muscles with an intensity of 60 to 70%, one maximum repetition) and aerobics (with an intensity of 60% of the maximum oxygen consumption for 15 minutes) and the control group had no training during this period. In order to measure research variables, blood sampling was done 48 hours before the start of the first training session and also 48 hours after the last training session while all subjects were fasting. ELISA method was used to measure kynurenine plasma levels. To analyze the data, the statistical test of correlated t-test, independent t-test and Shapiro-Wilk test was used to normalize the data at a significance level of 0.05, with SPSS version 22 software.
Findings: The results of the present study showed that eight weeks of combined exercises reduced the plasma levels of kynurenine. In addition, combined training led to a decrease in fat mass and body mass index and an increase in fat-free mass.
Conclusions: Based on the results of this research, it is suggested to use combined exercises to reduce the plasma levels of kynurenine and improve the body composition of type 2 diabetic men.

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Aim and Background: Type 1 diabetes (T1D) is a common endocrine disease in children that can have significant physical and psychological consequences for the individual and their family. The aim of the present study was to investigate the effectiveness of Mentalization-Based Treatment for Children (MBT-C) on reflective function and emotional awareness in children with T1D.
Methods and Materials: In this quasi-experimental study with a pretest-posttest design with two experimental and control groups, and a two-month follow-up period, children with T1D who referred to the pediatric endocrinology clinic were included. The study participants were randomly divided into two groups: experimental and control. The experimental group received MBT-C in ten 60-minute sessions, as well as 30-minute weekly sessions with their mothers. The control group received no intervention during this period and was on the waiting list. In the pretest stage, both groups completed the Reflective Functioning Questionnaire and the Emotional Awareness Questionnaire. After the treatment sessions, both groups completed the questionnaires in the posttest and follow-up stages, and the results were compared.
Findings: In this study, 30 children with T1D were evaluated in the experimental and control groups. The results of repeated-measures ANOVA showed that mentalization treatment for children had a significant effect on improving reflective functioning and emotional awareness in 8-12-year-old children with T1D, and the treatment effects were maintained in the follow-up stage p<0.001.
Conclusions: The results of this study indicate the effectiveness of MBT-C in improving reflective functioning and emotional awareness in children with T1D. These positive effects were also stabilized after the completion of the treatment. MBT-C helps children develop self-awareness and self-regulation, enabling them to better identify and manage their emotions. This highlights the importance and application of MBT-C in the effective management of chronic childhood diseases such as T1D.

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Aim and Background: The aim of this research was to investigate the structural model of self-care based on disease perception, social support and collaborative decision-making with the mediating role of self-efficacy in patients with type 2 diabetes.
Methods and Materials: In a cross-sectional study, the number of 800 patients with type 2 diabetes (331 men and 469 women) in the hospitals of Qom province, they were selected by random sampling method. The data were collected using the questionnaire of cognitive population and disease perception, family social support questionnaire, self-efficacy in diabetic patients, diabetes self-care questionnaire and patient participation in treatment decision making questionnaire and by the model. Finding the structural equation (SEM) with AMOS24 and SPSS26 software were analyzed. Also, correlation, t-test and chi-square were used at the descriptive level and to compare the data. After evaluating the fit of the model, the coefficients between the variables were examined. Most of the paths with significant coefficients were kept in the final model, and the paths with non-significant coefficients or some path coefficients with weak significance were deleted from the final model for theoretical reasons.
Findings: The findings were as follows 1- The measurement model of research variables has a good fit. 2- Disease perception has a direct and indirect effect on the self-care of type 2 diabetic patients. 3-Social support has a direct and indirect effect on the self-care of type 2 diabetic patients. 4- Participatory decision-making has a direct and indirect effect on the self-care of type 2 diabetic patients.
Conclusions: Most of the relationships between these variables in this research were consistent with previous studies and existing theories