Journal of Preventive Medicine

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Introduction: Since the maternal death affects the family and society´s health, recognizing the causes and finding the preventive measures is essential in order to reduce this type of death. The aim of this study was to determine the prevalence and causes of mortality in pregnant women in Hormozgan province.
Methods: In this descriptive cross-sectional study, the study population was all pregnant mothers who died during the years 2011-2017. Data were collected from the records available at the hospitals and the health centers, the completed maternal death forms, and the interviews on maternal death. The data collection tool was a researcher-made questionnaire and the data were analyzed using descriptive statistics with SPSS software.
Results: The rate of maternal death in Hormozgan province during the study period was 32.76 cases per 100,000 live births and the frequency of maternal death was 100. The most common cause of death was postpartum hemorrhage. The majority of deceased mothers were 18-35 years old (73%), with pregnancy interval more than three years (80%), delivery times less than 5 (87%), rural residents (57%), and wanted pregnancy (86%). The type of delivery was the cesarean section in the majority of mothers who died (60%). In addition, 75% of the mothers were died in hospitals and specialists and midwives helped them to deliver (91%). The highest mortality rate was related to post-delivery period (65%).
Conclusion: In order to reduce the maternal mortality, it is recommended to provide high quality services to the villagers, promote the referral system, reduce the unnecessary cesarean sections, provide ambulance and hospital equipments, improve the level of knowledge and skills of staff, and follow up the mothers after delivery.
 

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Introduction: The death index and cause of mortality are considered as tools for measuring access to health service and assessing the efficiency of health systems in the contemporary communities. The aim of this study was to investigate the rate and causes of mortality in the population covered by Birjand University of Medical Sciences.
Methods: This descriptive-analytical study was performed in Birjand, Iran. All recorded cases of mortality in this region during 2018 were included in the study.  The data were obtained from death recording system. The SPSS software was applied to analyze the data. In this regard, the descriptive statistics and analytical tests were used. The significant level was set at 0.05.
Results: The results indicated that 3699 cases of death had been recorded in the studied population in 2018. The raw mortality rate in the study region was found to be 4.79 cases in one thousand individuals. The average age of death in the population was 66.74 years old. This was 64.73 years in males and 69.08 years in females.  Data analysis showed that cardiovascular (40.38%), cancer (13.52%), and respiratory (12.98%) diseases accounted for the highest number of mortality.
Conclusion: Three common causes of mortality were found to be cardiovascular, cancer, and respiratory diseases. The appropriate interventions in life style and food habits and controlling risk factors such as smoking, fatness, and stress could help to prevent many premature deaths.
 

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Introduction: The multiplicity and variety of stresses that people face in old age have made it necessary to pay attention to the issue of mental health, especially resilience in the elderly people. The aim of this study was to investigate the effectiveness of spiritual therapy on the quality of sleep, resilience, and death anxiety of the elderly.
Methods: The present research was a quasi-experimental study with pretest-posttest and control group. The statistical population of this study included all elderly people living in the nursing home in Shiraz in 2019. Out of them, 30 people were selected using the available sampling method and using simple randomization method assigned to two groups of spiritual therapy (n=15) and control group (n=15). The data were obtained using a resilience questionnaire (Connor-Davidson, 2003), Death Anxiety Scale (Collett Lester, 1969), and the Pittsburgh Sleep Quality Questionnaire (Buysse et al, 1989). Data were analyzed using repeated measurement and ANOVA tests by SPSS software. The significance level of tests was considered to be 0.05. 
Results: The results showed that spirituality therapy significantly improved the sleep quality (P-Value<0.001), resilience (P-Vvalue<0.001), and death anxiety (P-Value<0.001) in the experimental group. But the mean scores of sleep quality, resilience, and death anxiety did not not change significantly in the control group.
Conclusion: Based on the findings of this study, spirituality therapy can be used to improve the sleep quality, resilience, and death anxiety in elderly people.
 

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Objective: The present study aims to compare the effects of Cognitive-Behavioral Therapy (CBT) and Intensive Short-Term Dynamic Psychotherapy (ISTDP) on death anxiety of women with breast cancer.
Methods: This is a quasi-experimental study with a pre-test/post-test design. The study population includs all women suffering from breast cancer covered by the Imam Khomeini Relief Foundation in Gorgan, Iran in 2021. Of these, 30 were selected and randomly divided into two intervention groups of CBT and ISTDP and one control group. Ghorbani’s death anxiety scale in Persian was used to measure death anxiety before and after the interventions. The intervention groups received the interventions at 11 sessions each for 90 minutes, while the control group put on the waiting list. Data analysis was performed by the analysis of covariance in SPSS v. 26 software.
Results: Both CBT and ISTDP were effective in reducing the death anxiety of patients (P<0.05). There was no significant difference between them (P>0.05).
Conclusion: CBT and ISTDP can reduce the death anxiety of women with breast cancer. There is no significant diffrence between them.

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Introduction: Attention to the epidemic of Covid-19 disease and the mortality caused by it and the variation in the clinical characteristics and symptoms of the disease, the changes observed in the course of the disease symptoms, the importance of early diagnosis and early treatment measures, the possibility of different clinical characteristics in the residents of southern Iran with special weather conditions, and the lack of similar studies in this population, we considered it. To carry out the present study with the aim of investigating the clinical characteristics of patients suffering from covid-19 who referred to the Holy Prophet (PBUH) Bandar Abbas Hospital in 2019.
Methods:   The present study was conducted using a descriptive-analytical method on patients hospitalized in Bandar Abbas Hospital from June 1, 2019 to the end of August 2019. Then clinical symptoms, vital signs, laboratory findings, co-morbidities, duration of onset of symptoms, incidence of shortness of breath, current smoking and steroid use were also investigated. Then the severity of the disease was determined based on the guidelines for the treatment of patients with Covid-19 and finally the outcome of the disease (death or survival) was determined.
Results: The most common clinical symptoms were shortness of breath (57%), cough (46.9%), muscle pain (33.1%), weakness (28.5%), anorexia (28%). Headache (17.5%), nausea (15.1%), fever (14.6%) and vomiting (14.1%). The most common comorbidities were high blood pressure (31%), diabetes (21.9%) and coronary artery disease (16.2%), respectively. Multivariate regression analysis showed that severe disease increased the chance of death by 8.2 times (P=0.039) and vital system disease increased the chance of death by 7.5 times (P=0.024).
Conclusion:  As seen, the results of this study showed that shortness of breath, cough, and muscle pain were the most common clinical symptoms and hypertension, diabetes, and coronary artery disease were the most common associated diseases in the examined patients. Almost one fifth of patients died. Severe and critical illness was recognized as the most important predictor of mortality and the presence of muscle pain as the most important predictor of severe or critical illness.