2026-08-08T13:05:02+03:30 http://jccs.yums.ac.ir/browse.php?mag_id=27&slc_lang=en&sid=1

27-416 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 3 F. Haghshenosabet G. Eslamian S.N. Kazemi B. Rashidkhani Aims: Hyperemesis gravidarum is a multifactorial pregnancy disorder characterized by severe nausea and vomiting, often necessitating hospitalization. While its etiology remains incompletely understood, dietary factors may play a significant role. This study investigated the association between pre-pregnancy consumption of ultra-processed foods and the incidence of hyperemesis gravidarum. Instrument & Methods: This hospital-based case-control study was conducted in Tehran, Iran, from April 2020 to June 2021, involving 45 newly diagnosed hyperemesis gravidarum cases and 126 controls. Hyperemesis gravidarum diagnosis followed the criteria set by the American College of Obstetrics and Gynecology. Pre-pregnancy ultra-processed food intake was assessed using a validated Semi-Quantitative Food Frequency Questionnaire, with foods classified according to the NOVA system. Multivariable logistic regression analyses, adjusted for potential confounders, were employed to evaluate the association between ultra-processed food consumption and hyperemesis gravidarum risk. Findings: After adjusting for covariates, significant inverse associations were observed between higher ultra-processed food intake and hyperemesis gravidarum risk. The multivariable-adjusted odds ratios for the highest versus lowest tertile of ultra-processed food consumption were as follows: Total ultra-processed foods (odds ratio: 0.31; 95% CI: 0.19-0.48; p-value=0.002), dairy beverages (odds ratio: 0.18; 95% CI: 0.09-0.52; p-value=0.048), and processed meats/fast foods (odds ratio: 0.13; 95% CI: 0.06-0.71; p-value=0.015). Conclusion: Lower pre-pregnancy ultra-processed food consumption is associated with reduced odds of developing hyperemesis gravidarum. Ultra-Processed Foods Hyperemesis Gravidarum Risk Factors Pregnancy Case-Control Study 2025 7 01 113 119 http://jccs.yums.ac.ir/article-1-416-en.pdf 10.58209/jccs.6.3.113

27-427 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 3 M. Ghaderzadeh C. Salehnasab Aims: Type 2 diabetes mellitus is a major global health challenge, and early prediction is key to prevention. This study compared three filter-based feature selection methods (ANOVA (f-classif), mutual information, and Chi-square test) for identifying predictors of type 2 diabetes and assessed their impact on the performance of logistic regression. Instrument & Methods: This retrospective study analyzed data from 3,203 adults aged 35-70 years from Yasuj, Kohgiluyeh and Boyer-Ahmad Province, Iran, gathered between 2020 and 2022 in the Dena-PERSIAN cohort, including 402 (12.55%) individuals with type 2 diabetes. Preprocessing included imputation, normalization, and class balancing using the synthetic minority oversampling technique. Each method ranked predictors, and the top five features were used to train logistic regression models. Model performance was evaluated on a test set using accuracy, precision, recall, and F1-score. Findings: Fasting blood sugar and age consistently emerged as dominant predictors across methods. ANOVA highlighted metabolic factors (triglycerides, fatty liver, and kidney stones), while mutual information emphasized high-density lipoprotein cholesterol and lifestyle behaviors, and the Chi-square test prioritized categorical comorbidities. Logistic regression achieved the strongest performance with ANOVA and mutual information (accuracy and F1=0.84), slightly outperforming the Chi-square test (accuracy and F1=0.82). Conclusion: ANOVA and mutual information produced clinically meaningful and stable feature subsets for type 2 diabetes prediction, centered on fasting glucose, age, and fatty liver. Type 2 Diabetes Life Style ANOVA Chi-Square Test Logistic Regression 2025 7 01 121 128 http://jccs.yums.ac.ir/article-1-427-en.pdf 10.58209/jccs.6.3.121

27-436 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 3 H. Choheili F.S. Marashian S. Safarzadeh P. Asgari Aims: The high relapse rate among individuals with stimulant use disorder necessitates effective psychological interventions to manage core challenges, such as craving and maladaptive coping strategies. This study aimed to compare the effectiveness of mindfulness-based cognitive therapy and schema therapy on emotion-focused coping strategies and craving in this population. Materials & Methods: This clinical trial utilized an extensive pre-test, post-test, and follow-up design. The statistical population included all individuals with stimulant use disorder at residential centers in Ahvaz in 2024. A convenience sample of 45 individuals was selected and randomly assigned to two experimental groups (n=15 for mindfulness-based cognitive therapy and n=15 for schema therapy) and a control group (n=15) that received no treatment. Data were collected using the Lazarus Coping Strategies Questionnaire and the Instantaneous Substance Craving Questionnaire. Both experimental groups participated in eight 90-minute sessions. Data were analyzed using repeated measures analysis of variance in SPSS software. Findings: Both mindfulness-based cognitive therapy and schema therapy were effective in significantly reducing emotion-focused coping strategies and craving in the experimental groups, with these effects sustained at follow-up (p<0.001). While both approaches were equally effective in reducing emotion-focused coping strategies, schema therapy demonstrated a relative superiority in reducing craving compared to mindfulness-based cognitive therapy. Conclusion: Both mindfulness-based cognitive therapy and schema therapy are effective interventions for reducing emotion-focused coping strategies and craving in individuals with stimulant use disorder..   Mindfulness-Based Cognitive Therapy Schema Therapy Coping Strategies Craving Clinical Trial 2025 7 01 129 135 http://jccs.yums.ac.ir/article-1-436-en.pdf 10.58209/jccs.6.3.129

27-431 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 3 F. Kouhi M. Bijani Zh. Fereidouni A. Dehghan A. Taghinezhad Aims: Hypertension remains a significant global health challenge, ranking among the most prevalent and enduring non-communicable chronic diseases. This study aimed to determine the impact of an educational program using Orem’s self-care model on improving the quality of life and health-promoting lifestyle in hypertensive patients in the south of Iran Materials & Methods: This randomized controlled clinical trial was conducted on 80 adults with hypertension from August 2022 to April 2023. Samples were randomly assigned to either an intervention group, which received the Orem-based educational program, or a control group that received standard care. Findings: The mean age of participants was 44.16±4.60 years. Baseline assessments indicated no statistically significant differences between the control and intervention groups in terms of quality of life, lifestyle behaviors, or self-care capacity. However, follow-up evaluations conducted immediately after the intervention, as well as at one-month and three-month intervals, revealed statistically significant improvements across all measured outcomes in the intervention group. Conclusion: The Orem-based self-care educational intervention leads to meaningful short-term improvements in quality of life and health-promoting behaviors among individuals managing hypertension.   Hypertension Quality of Life Self-Care Educational Intervention 2025 7 01 137 145 http://jccs.yums.ac.ir/article-1-431-en.pdf 10.58209/jccs.6.3.137

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 3 E. Nazar A. Abdollahi P. Afarinesh Khaki M. Norouzi Shadehi M.T. Beighmohammadi S. Nateghi Z. Panahi A. Nozheh Aims: Rising antibiotic resistance among prevalent pathogens poses a critical challenge, especially in intensive care unit patients. This study aimed to evaluate antibiotic susceptibility and resistance patterns in body fluid and urine samples from intensive care unit patients at a tertiary care center in Tehran, Iran. Instrument & Methods: This cross-sectional study analyzed cultures from body fluids and urine samples collected from intensive care unit patients at Imam Khomeini Hospital between 2019 and 2022. Cultures were processed according to standard protocols and interpreted based on growth inhibition zones to classify bacterial isolates as sensitive, intermediate, or resistant. Data analysis was performed using STATA 17. Findings: A total of 4,232 body fluid and 4,062 urine samples were examined; 2,400 body fluid and 2,824 urine cultures were negative. The most common bacteria in urine were Klebsiella pneumoniae (16.7%), Escherichia coli (15.43%), and Pseudomonas aeruginosa (6.08%), while body fluids predominantly grew Klebsiella pneumoniae (37.19%), Acinetobacter baumannii (25.52%), and Pseudomonas aeruginosa (8%). Klebsiella pneumoniae showed the highest sensitivity to Gentamicin (12.37% in body fluids, 17.93% in urine) and imipenem (9.72% in body fluids, 14.67% in urine). Resistance was notably high against ampicillin-sulbactam (over 90%), ciprofloxacin (85-89%), and cotrimoxazole or nitrofurantoin (84-88%), depending on the sample type. Conclusion: Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus have a high resistance against many antimicrobial agents.   Antibiotic Resistance Urine Antibiogram Intensive Care Unit Iran 2025 7 01 147 154 http://jccs.yums.ac.ir/article-1-424-en.pdf 10.58209/jccs.6.3.147

27-433 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 3 N. Ghodsi L. Manzouri A. Mousavizade M. Moradi-Joo Aims: Health literacy has the strongest association with adherence to screening programs. Therefore, this study was conducted to assess health literacy related to breast and cervical cancer screening. Instrument & Methods: This cross-sectional study was conducted on 294 women aged 20–69 years selected using computer-based simple random sampling from four urban health centers in Yasuj City during 2022–2023. Data collection was conducted using a demographic checklist (age, education, marital status, and occupational status) and the Assessment of Health Literacy in Cancer Screening. Data were analyzed using SPSS 25 software with Mann-Whitney, Kruskal-Wallis, and ordinal logistic regression tests. Findings: The mean age of participants was 33.00±7.88 years. The mean score of health literacy related to breast and cervical cancer screening was 42.55±5.43. The levels of health literacy were favorable, intermediate, and unfavorable in 145 (49.3%), 116 (39.5%), and 33 (11.2%) participants, respectively. Health literacy was significantly higher among participants with higher education (p=0.0001), employed participants (p=0.0001), and married participants (p=0.023). Based on ordinal logistic regression, only the level of education was a predicting factor for health literacy (p=0.0001). Conclusion: Half of the participants do not have adequate health literacy and education level is the strongest predictor of health literacy. Health Literacy Breast Cancer Cervical Cancer Screening 2025 7 01 155 160 http://jccs.yums.ac.ir/article-1-433-en.pdf 10.58209/jccs.6.3.155

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 3 N. Ameri Felihi S. Bavi A. Farashbandi Aims: Aggression is a growing global concern among adolescents, particularly female students, and it is associated with deficiencies in emotion regulation and frustration tolerance. This study aimed to compare the effectiveness of resilience and self-compassion training on emotion regulation and frustration tolerance in female students with clinical symptoms of aggression. Materials & Methods: This clinical trial, conducted in 2024, employed a pre-test, post-test, and one-month follow-up design. The sample included 45 female middle school students with symptoms of aggression, who were randomly assigned to two experimental groups (resilience training and self-compassion training, n=15 per group) and a control group (n=15) that received no intervention. Resilience training was conducted in 10 weekly sessions of 75 minutes each, while compassion-focused therapy was implemented in 8 weekly sessions of 90 minutes. Data were collected using the Affective Control Scale and the Frustration Discomfort Scale. Data analysis was performed using repeated measures analysis of variance with SPSS 27 software. Findings: Both resilience training and self-compassion training significantly improved emotion regulation and frustration tolerance compared to the control group (p<0.001). The effects of these interventions were sustained at the one-month follow-up, demonstrating their long-term effectiveness. However, the study found no significant difference in effectiveness between the two experimental groups. Conclusion: Both resilience and self-compassion training are effective strategies for improving emotion regulation and frustration tolerance in female students with aggressive tendencies.   Resilience Self-Compassion Emotion Regulation Aggression Students 2025 7 01 161 167 http://jccs.yums.ac.ir/article-1-430-en.pdf 10.58209/jccs.6.3.161

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 3 E. Tamoradi A. Afrasiabifar A. Ghadimimoghadam M. Salari Aims: Infantile colic is characterized by constant and often inconsolable crying in infants. Developing a treatment plan for pain control in infants with colic has always been a priority. This study was conducted to determine the effect of lullaby music on controlling and reducing pain and calming crying in infants with colic. Materials and Methods: The present semi-experimental investigation was performed on infants with colic referred to a specialized pediatric clinic in Yasuj in 2021. Ninety infants eligible for the study were selected through convenience sampling and were assigned to one of two intervention groups (lullaby music) and a control group based on a block random design. Data were collected using a demographic profile form, the Face, Legs, Activity, Cry, Consolability Scale for pain intensity, and the Infant Colic-Related Crying Scale for crying intensity, before and at the end of the fourth week of the intervention. Data were analyzed using SPSS 25, employing descriptive and inferential statistics with a 95% confidence interval at p<0.05. Results: At baseline, there was no significant difference between the groups in terms of crying duration, pain intensity, and crying intensity (p>0.05). However, after the intervention, a statistically significant difference was observed in the mean crying intensity (p=0.025), crying duration (p=0.0001), and pain intensity (p=0.008) between the two groups. Conclusion: Lullaby music reduces pain intensity, decreases crying intensity, reduces crying duration, and increases the duration of calmness in infants with colic. Music Colic Pain Crying 2025 7 01 169 175 http://jccs.yums.ac.ir/article-1-435-en.pdf 10.58209/jccs.6.3.169