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Fulltext Behavioral Pain Indicators in Patients with Traumatic Brain Injury Admitted to an Intensive Care Unit

Nazari R, Pahlevan Sharif S, Allen KA, Sharif Nia H, Yee BL, Yaghoobzadeh A

J Caring Sci, 2018 Dec;7(4):197-203.
PMID: 30607360 DOI: 10.15171/jcs.2018.030

Introduction: A consistent approach to pain assessment for patients admitted to intensive care unit (ICU) is a major difficulty for health practitioners due to some patients' inability, to express their pain verbally. This study aimed to assess pain behaviors (PBs) in traumatic brain injury (TBI) patients at different levels of consciousness. Methods: This study used a repeated-measure, within-subject design with 35 patients admitted to an ICU. The data were collected through observations of nociceptive and non-nociceptive procedures, which were recorded through a 47-item behavior-rating checklist. The analyses were performed by SPSS ver.13 software. Results: The most frequently observed PBs during nociceptive procedures were facial expression levator contractions (65.7%), sudden eye openings (34.3%), frowning (31.4%), lip changes (31.4%), clear movement of extremities (57.1%), neck stiffness (42.9%), sighing (31.4%), and moaning (31.4%). The number of PBs exhibited by participants during nociceptive procedures was significantly higher than those observed before and 15 minutes after the procedures. Also, the number of exhibited PBs in patients during nociceptive procedures was significantly greater than that of exhibited PBs during the non-nociceptive procedure. The results showed a significant difference between different levels of consciousness and also between the numbers of exhibited PBs in participants with different levels of traumatic brain injury severity. Conclusion: The present study showed that most of the behaviors that have been observed during painful stimulation in patients with traumatic brain injury included facial expressions, sudden eye opening, frowning, lip changes, clear movements of extremities, neck stiffness, and sighing or moaning.
The Relationship Between Spirituality Dimensions and Death Anxiety among Iranian Veterans: Partial Least Squares Structural Equation Modeling Approach

Pahlevan Sharif S, Sharif Nia H, Lehto RH, Moradbeigi M, Naghavi N, Goudarzian AH, et al.

J Relig Health, 2021 Apr;60(2):999-1014.
PMID: 31646425 DOI: 10.1007/s10943-019-00931-6

The purpose of the present study was to examine the relationship among spiritual intelligence, spiritual well-being and death anxiety among Iranian veterans. In this predictive correlational study, 211 veterans completed King and DeCicco's Spiritual Intelligence Scale, Paloutzian and Ellison's Spiritual Well-being Scale and Templer's Death Anxiety Scale-Extended. After confirming the reliability of the constructs using intra-class correlation coefficient, partial least squares structural equation modeling method was utilized to assess the impact of spiritual well-being and spiritual intelligence on death anxiety. This study found a significant positive relationship between spiritual intelligence and death anxiety after controlling for the effects of age, education level and disability. However, there was a significant negative relationship between spiritual well-being and death anxiety among Iranian veterans. Negative relationships were found between spiritual well-being and death anxiety among Iranian veterans. However, spiritual intelligence had a positive impact on death anxiety.
Religious coping and death depression in Iranian patients with cancer: relationships to disease stage

Sharif SP, Lehto RH, Nia HS, Goudarzian AH, Haghdoost AA, Yaghoobzadeh A, et al.

Support Care Cancer, 2018 Aug;26(8):2571-2579.
PMID: 29450638 DOI: 10.1007/s00520-018-4088-2

PURPOSE: The study investigated relationships among the extent of disease, religious coping, and death depression in Iranian patients with cancer.
METHOD: A descriptive cross-sectional study was conducted with a convenience sample of 482 Iranian cancer patients. Participants completed demographic and health, death depression, and religious coping surveys.
RESULTS: After controlling for demographic and health characteristics, positive and negative religious coping behaviors were significantly related to the experience of death depression. There was an interaction effect between negative religious coping and extent of disease with significant positive relationships to the experience of death depression.
CONCLUSIONS: Negative religious coping was found to be more closely associated with death depression in patients with earlier stage disease than those with advanced stages of cancer in this sample of patients with cancer from Iran. Findings support assessing patients for use of religious coping strategies. Muslim patients who are religiously alienated and have existential anguish may be vulnerable and need heightened support following diagnosis and during treatment of early stage cancer.
Fulltext Weather fluctuations: predictive factors in the prevalence of acute coronary syndrome

Sharif Nia H, Chan YH, Froelicher ES, Pahlevan Sharif S, Yaghoobzadeh A, Jafari A, et al.

Health Promot Perspect, 2019;9(2):123-130.
PMID: 31249799 DOI: 10.15171/hpp.2019.17

Background: Meteorological parameters and seasonal changes can play an important role in the occurrence of acute coronary syndrome (ACS). However, there is almost no evidence on a national level to suggest the associations between these variables and ACS in Iran. We aim to identify the meteorological parameters and seasonal changes in relationship to ACS. Methods: This retrospective cross-sectional study was conducted between 03/19/2015 to 03/18/2016 and used documents and records of patients with ACS in Mazandaran ProvinceHeart Center, Iran. The following definitive diagnostic criteria for ACS were used: (1) existence of cardiac enzymes (CK or CK-MB) above the normal range; (2) Greater than 1 mm ST-segment elevation or depression; (3) abnormal Q waves; and (4) manifestation of troponin enzyme in the blood. Data were collected daily, such as temperature (Celsius) changes, wind speed and its direction, rainfall, daily evaporation rate; number of sunny days, and relative humidity were provided by the Meteorological Organization of Iran. Results: A sample of 2,054 patients with ACS were recruited. The results indicated the highest ACS events from March to May. Generally, wind speed (18 PM) [IRR = 1.051 (95% CI: 1.019 to1.083), P=0.001], daily evaporation [IRR = 1.039 (95% CI: 1.003 to 1.077), P=0.032], daily maximum (P<0.001) and minimum (P=0.003) relative humidity was positively correlated withACS events. Also, negatively correlated variables were daily relative humidity (18 PM) [IRR =0.985 (95% CI: 0.978 to 0.992), P<0.001], and daily minimum temperature [IRR = 0.942 (95%CI: 0.927 to 0.958), P<0.001]. Conclusion: Climate changes were found to be significantly associated with ACS; especially from cold weather to hot weather in March, April and May. Further research is needed to fully understand the specific conditions and cold exposures.
Prevalence of Acute Myocardial Infarction and Changing Meteorological Conditions in Iran: Fuzzy Clustering Approach

Sharif Nia H, Gorgulu O, Pahlevan Sharif S, Froelicher ES, Haghdoost AA, Golshani S, et al.

Iran J Public Health, 2020 May;49(5):923-930.
PMID: 32953680

Background: The prevalence of Acute Myocardial Infarction (AMI) varies from region to region caused by seasonal climate changes and temperature variation. This study aimed to assess the relationship between changing meteorological conditions and incidence of AMI in Iran.
Methods: This retrospective prevalence study was based on medical records of the heart center of Mazandaran Province on all patients diagnosed with AMI in Mazandaran, northern Iran between 2013 and 2015. Patients' sex and the day, month, year and time of hospital admission were extracted from patients' records. Moreover, the meteorological reports were gathered.
Results: A statistically significant difference was found between the distributions of AMI cases across 12 months of the year (P < 0.01). Fuzzy clustering analysis using 16 different climatic variables showed that March, April, and May were in the same cluster together. The other 9 months were in different clusters.
Conclusion: Significant increase in AMI was seen in March, April and May (cold to hot weather).