@2024 Afarand., IRAN

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ISSN: 2008-2630    Iranian Journal of War & Public Health 2018;10(1):21-26

Background
The problems of injured spinal cord injuries significantly affect the psychological health of these people. On the other hand, the inability to move and, therefore, excessive difficulty travelling to health centers and attending therapeutic sessions, makes it necessary to carry out these interventions remotely. One of the most effective means of telecommunications is social networking which is more suitable than other telecommunications devices due to the availability of multifaceted features (visual text, video, conversation, etc.) and accessibility.
Previous Studies
… [1-3]. Some scholars such as Seligman and Rashid believed that not only signs of disease should be intervened, but that people's ability to adapt more to the difficult conditions of life should be strengthened [4]. … [5-7]. In accordance with the fourteenth-session protocol of psycho-therapeutic sessions proposed by Seligman and Rashid [8], in each of the sessions, a different subject is taken from positive psychology. Various studies have confirmed the efficacy of this treatment. For example, positive psychotherapy has been used as an effective intervention for the treatment of psychological disorders [9], rehabilitation of cognitive impairments [10], smoking cessation [11], and helplessness in patients with brain damage [10]. … [12-14]. The use of telegram for the transfer of psychological concepts is a new approach. This approach facilitates access to people who want to intervene. Research has shown that this is one of the easiest technique to access to the participants, and the falling of the participants is at the lowest level [15]. Researchers have used this emerging tool for training and psychological intervention. For example, to reduce nursing job stress, they trained positive thinking through telegram [16]. This tool was used to educate mothers who care for babies [17] and to change the attitude of women toward health behaviors [18]. In a research for internet treatment, the effect size was 53% i.e. the effect of internet psychotherapy was reported as moderate which is quite similar to the size effect of face-to-face traditional treatment [19]. … [20].
Aim(s)
So far, psychological interventions by social networks have not been used for spinal cord veterans. Therefore, the purpose of this study was to investigate the effectiveness of positive psychotherapy on reducing the psychological distress of veterans through virtual social networks.
Research type
The present research is a semi-experimental design with pretest-posttest design with control group.
Research society, place and time
This research was conducted among veterans with spinal cord injury in spring 2017.
Sampling method and number
38 veterans of spinal cord injury were randomly selected from the list of the Foundation of Martyrs and Veterans Affairs. Sample size was determined based on Morgan table. Then, the samples were randomly assigned into two experimental and control groups (each group was 19). The criteria for entry into the study were not having serious psychological problems, an interest in being present in the research, and a spinal cord injury of more than 75%.
Used devices&materials
To measure emotional disturbance, Beck Depression Inventory-Second Edition (BDI-II) and Beck Anxiety Inventory [23, 24] were used. Before each treatment intervention, the pretest was performed on both groups in a virtual way and Beck anxiety and depression questionnaires were provided for participants online. All participants were informed about the research objectives. It was explained to them that whenever they want, they can leave the research. However, nobody left the research until the end. The confidentiality of the research was also explained to the participants and they were emphasized that their personal information would remain reserved. Subsequently, for the experimental group, 14 sessions were implemented. This protocol has been adapted from Allen`s book [25]. Then, on both groups, the test was performed in a virtual way. Finally, the effectiveness of the treatment method was measured by comparing the two groups. Data were analyzed using SPSS 22 software and covariance analysis. Initially, the assumptions of covariance analysis including normality, homogeneity of variance, stability of convergent variables, homogeneity of regression and linearity of convergent variables and independent variables were investigated. To observe the assumptions of the equality of variance and covariance matrix of the two groups in the pretest of depression and anxiety dimensions, Levene test was, also, used.
Findings by Text
7 (18.4%) and 31(81.6%) of the participants were single and married respectively. The age of the most of the participants (97.4%) was over 40 years and only the age of one person (2.6%) was between 20 and 40. 13(34.2%), 11(28.9%), and 13(34.2%) of the participants had the age range of 41-50, 51-60 and over 60 respectively. 14(36.8%) of the samples had a diploma or lower education; 18(47.4%) had undergraduate education and 6(15.8%) had either master's degree or higher. In the experimental group, there was a significant difference between the pretest and posttest scores of depression and anxiety (p=0.001) and the intervention significantly decreased the scores of depression and anxiety, while there was no significant difference in the control group between the pretest and posttest scores of depression and anxiety (p=0.62; Table 1).
Main comparison to the similar studies
According to the findings, there was a significant difference between the two experimental and control groups after the intervention. Previous researches have been consistent with the findings of this study. For example, the research findings of Anderson [26], Ibert et al. [27], Dunker et al. [28] and Mir et al. [29] have shown that anxiety and different emotional disorders and stress are moderated by means of internet interventions. Blacktop et al. [30] have also shown the effectiveness of positive intervention in adults with emotional and mood disorder. In a randomized, controlled trial with a two-month follow up, psychological interventions for reducing helplessness and improving the well-being of patients with depression were more effective than the control group in the two groups of internet intervention and telephone intervention [31]. Similar results were obtained in another study that examined the effectiveness of self-leading intervention via the internet and mobile phone to reduce the symptoms of depression in patients with mild to moderate depressive symptoms [32]. Other researches have also shown that online interventions reduce the symptoms of anxiety, depression and stress in the control group. However, like previous studies, they have suggested that cautions be taken for data generalization. On the other hand, the study on the effectiveness of positive psychology that was provided on the internet for people aged 50 and older, showed that online intervention is beneficial for a 50-year-old age group, and this result confirms the results obtained in this study [33].
Suggestions
It is suggested that in future studies that interventions have the capability of detecting virtualization in the emotional setting of veterans and those who do not have wide access to the mental health system are being identified and their effectiveness be studied.
Limitations
One of the limitations of this study is not controlling all the disturbing variables. It was difficult to identify these variables because they were no attendant meetings. Psychotherapies that are performed through telegram, also have some limitations. There is no eye contact and verbal communication, and only virtual conversations. These interventions cannot replace true therapeutic relationships, but can be beneficial in their place.
Conclusions
Virtual-based positive psychotherapy psychological interventions (telegrams) are effective in reducing anxiety and depression in spinal cord injured veterans.
Acknowledgments
We sincerely thank the veterans of the Khuzestan Province who participated in the research and encouraged us to explore the future.
Conflict of interest
Non-declared
Ethical Permissions
Knowledge of research goals, the possibility of leaving research and keeping confidential information about the patients' personal information were the ethical cases included in the research.
Funding Sources
This research was supported by Research Department of the Foundation of Martyrs and Veterans Affairs.

TABLES and CHARTS

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