Mental Health and Lifestyle Journal

Exploring the Lived Experiences of Family Caregivers of Patients with Newly Diagnosed Stroke

Laaya Alsadat Naghibi iD , Manijeh Firoozy ^* iD , Mohammad Hasanpoor iD

Stroke is a major cause of mortality and long-term disability and affects not only patients but also their families. Caring for a person with stroke creates a multidimensional and highly demanding experience for family caregivers. However, knowledge of caregivers' lived experiences remains limited, particularly within the cultural context and healthcare system of Iran. This study aimed to explore the lived experiences, challenges, and needs of family caregivers of patients with newly diagnosed stroke. This qualitative study used a descriptive phenomenological design. Participants were family caregivers of patients with newly diagnosed stroke who attended one of the hospitals affiliated with Iran University of Medical Sciences in Tehran Province during the first three months of 2025. Twelve primary family caregivers were selected through purposive sampling with maximum variation. Data were collected through in-depth semi-structured interviews and analyzed using Colaizzi's seven-step method. Lincoln and Guba's criteria of credibility, transferability, dependability, and confirmability were used to establish trustworthiness. Data analysis yielded six main themes: emotional burden of caregiving, caregiver burnout and strain, changes in individual and family life, caregivers' educational needs, support and supportive resources, and adaptation and hope. Despite substantial emotional, physical, and social challenges, caregivers gradually adapted by drawing on family support, support from the healthcare team, hope for recovery, and meaning-making in caregiving. Lack of specialized training and psychological support emerged as major barriers. Caring for a person with stroke is a multidimensional and dynamic process. Family caregivers require specialized education, psychological support, and supportive services to perform their caregiving role more effectively while protecting their own health and quality of life. These findings can provide a scientific basis for designing family-centered educational and supportive interventions tailored to caregivers' actual needs.

Investigating the structural pattern of Family function with Quality of life with Mediator roles of Family flexibility and Family empowerment

Leila Golsanamlou iD , Amir Qorbanpoor Lafmejani ^* iD

The quality of life of nurses is of particular importance due to the demanding nature of their profession, night shifts, and interpersonal pressures, as poor quality of life may affect their own health, patients’ health, family relationships, and quality of working life. The aim of the present study was to examine the structural model of the relationship between family functioning and quality of life, with family flexibility and family empowerment as mediating variables, among female nurses working in public hospitals in Khoy County. In terms of methodology, the present study was descriptive-correlational and employed structural equation modeling. The statistical population consisted of all female nurses working in public hospitals in Khoy County, from whom 210 nurses were randomly selected from four public hospitals. The research instruments included the World Health Organization Quality of Life Questionnaire (1996), the Epstein et al. Family Functioning Questionnaire (1983), Shakeri’s Family Flexibility Questionnaire (2003), and Sham et al.’s Family Empowerment Questionnaire (2001). The data were analyzed using descriptive statistical methods and structural equation modeling in SPSS 26 and AMOS 24, as well as the bootstrap test using the Preacher and Hayes (2008) macro. The results showed that the proposed model had a good fit and that family functioning had significant direct effects on quality of life (β=0.430), family flexibility (β=0.358), and family empowerment (β=0.282). In addition, family flexibility (β=0.301) and family empowerment (β=0.481) had significant direct effects on quality of life. The bootstrap results also indicated that the indirect effect of family functioning on quality of life through family flexibility (β=0.108) and family empowerment (β=0.134) was significant (p<0.01). Overall, family functioning may be associated with the quality of life of female nurses, while family flexibility and family empowerment may play mediating roles in this relationship. Therefore, attention to these family-related components may be important in understanding the quality of life of nurses working in hospital settings.

Assessment of Health Literacy Levels Among Women Visiting Comprehensive Health Centers in Gorgan in 2024

Maryam Maghsoodlo ^*

Health literacy comprises the knowledge and skills needed to obtain, understand, evaluate, and use health information appropriately. During pregnancy, adequate maternal health literacy may facilitate informed decision-making and appropriate use of prenatal care. This study assessed maternal and pregnancy health literacy and related factors among pregnant women attending rural Comprehensive Health Service Centers in Gorgan County, Iran, in 2024.

This descriptive-analytical cross-sectional study included 310 pregnant women selected through stratified random sampling with proportional allocation. Data were collected using a validated Maternal and Pregnancy Health Literacy Questionnaire and a demographic and clinical characteristics checklist. Statistical analyses included the Kolmogorov–Smirnov test, Pearson’s correlation coefficient, one-way analysis of variance (ANOVA), and linear regression. Statistical significance was defined as P < 0.05.

The mean age of participants was 32.13 years. Maternal health literacy was significantly inversely associated with the number of pregnancies (r = −0.357, P = 0.001) and positively associated with the number of prenatal care visits (r = 0.176, P = 0.002).

Maternal health literacy was associated with pregnancy history and utilization of prenatal care services. These findings emphasize the need for targeted educational strategies to strengthen pregnant women’s ability to access, comprehend, and apply health information, which may facilitate appropriate prenatal care and contribute to improved maternal and neonatal health.

Predicting Quality of Life Based on Social Cognition with the Mediating Role of Emotion Regulation in Patients with Traumatic Brain Injury

Hadis Jafari iD , Afsaneh Taheri ^* iD , Hamidreza Khayat Kashani iD

The present study aimed to predict quality of life based on social cognition and to examine the mediating role of emotion regulation in patients with traumatic brain injury. This descriptive-correlational study was conducted using structural equation modeling. The statistical population consisted of patients with traumatic brain injury referred to Imam Hossein Hospital in Tehran, Iran, during 2024–2025. A total of 300 patients were selected through convenience sampling. Data were collected using the World Health Organization Quality of Life-BREF questionnaire, the Reading the Mind in the Eyes Test, and the Emotion Regulation Questionnaire. Data were analyzed using Pearson correlation coefficients and structural equation modeling. Model fit was evaluated using χ²/df, IFI, CFI, NFI, GFI, RMSEA, and SRMR indices, and the significance of indirect effects was examined using bootstrap analysis. Social cognition was significantly and positively correlated with emotion regulation (r = 0.560, p < 0.01) and quality of life (r = 0.550, p < 0.01), and emotion regulation was significantly and positively correlated with quality of life (r = 0.583, p < 0.01). The structural model showed acceptable fit (χ²/df = 3.042, IFI = 0.922, CFI = 0.921, NFI = 0.908, GFI = 0.917, RMSEA = 0.071, SRMR = 0.059). Social cognition had a significant direct effect on quality of life (B = 0.123, β = 0.279, t = 4.213, p < 0.01). The indirect effect of social cognition on quality of life through emotion regulation was also significant (B = 0.049, β = 0.110, p < 0.01), indicating partial mediation. The findings indicate that social cognition is associated with better quality of life in patients with traumatic brain injury both directly and indirectly through emotion regulation. These results highlight emotion regulation as an important explanatory mechanism linking social-cognitive functioning to quality of life and support the inclusion of social-cognitive and emotion-regulation interventions in rehabilitation programs for patients with traumatic brain injury.

Effectiveness of Cognitive-Behavioral Play Therapy on Sleep Disturbances and Pain Tolerance in Children with Recurrent Pain

Shabnam Hazrat Hosseini ^* iD , Delara Abdi iD , Fatemeh Hooshmand iD , Maryam Shamsi Sayar iD , Mona Soleiman Heshmat iD , Samira Darvishi iD

This study aimed to determine the effectiveness of cognitive-behavioral play therapy in reducing sleep disturbances and increasing pain tolerance among children with recurrent pain. This randomized pretest-posttest controlled study with a two-month follow-up was conducted among children with recurrent pain in Tehran, Iran, in 2026. Thirty children aged 8–12 years who met the inclusion criteria were selected through purposive sampling and randomly assigned to an experimental group (n = 15) and a control group (n = 15). The experimental group received eight 60-minute sessions of cognitive-behavioral play therapy conducted twice weekly, while the control group continued routine care without receiving the intervention. Sleep disturbances were assessed using the Children’s Sleep Habits Questionnaire, and pain tolerance was measured through a standardized cold pressor task. Data were analyzed using mixed repeated-measures analysis of variance and Bonferroni-adjusted pairwise comparisons in SPSS version 27, with statistical significance set at p < .05. The mixed repeated-measures analysis showed a significant time × group interaction for sleep disturbances, F(1.65, 46.31) = 40.73, p < .001, partial η² = .593, and for pain tolerance, F(1.61, 45.04) = 57.68, p < .001, partial η² = .673. Bonferroni comparisons indicated significant reductions in sleep disturbance scores from pretest to posttest and from pretest to follow-up in the experimental group (p < .001), whereas posttest and follow-up scores did not differ significantly (p = .431). Pain tolerance also increased significantly from pretest to posttest and from pretest to follow-up (p < .001), with no significant decline between posttest and follow-up (p = .091). No significant changes were observed in the control group. Cognitive-behavioral play therapy was effective in reducing sleep disturbances and increasing pain tolerance in children with recurrent pain, and these improvements remained stable over a two-month follow-up period. The intervention may therefore be considered a useful developmentally appropriate adjunct to routine care for pediatric recurrent pain.

Structural Modeling of Quality of Life in Patients with Cardiovascular Disease Based on Illness Perception, Health Anxiety, and Perceived Social Support: The Mediating Roles of Emotion Regulation Difficulties and Resilience

Leila Asghari iD , Nahid Yousefpour ^* iD

This study aimed to develop and test a structural model of quality of life in patients with cardiovascular disease based on illness perception, health anxiety, and perceived social support, with emotion regulation difficulties and resilience as mediating variables. This cross-sectional analytical study was conducted on 420 adult patients with cardiovascular disease attending cardiology outpatient clinics and cardiac rehabilitation services at Rajaie Cardiovascular Medical and Research Center, Tehran, Iran, in 2026. Participants were selected through consecutive sampling. Data were collected using the Brief Illness Perception Questionnaire, Short Health Anxiety Inventory, Multidimensional Scale of Perceived Social Support, Difficulties in Emotion Regulation Scale-16, 10-item Connor-Davidson Resilience Scale, and WHOQOL-BREF. Structural equation modeling with robust maximum likelihood estimation was used to examine the measurement and structural models, and indirect effects were evaluated using 5,000 bias-corrected bootstrap resamples. The structural model demonstrated good fit, χ²(168) = 312.48, χ²/df = 1.86, CFI = .958, TLI = .949, RMSEA = .045, and SRMR = .041, explaining 52% of the variance in emotion regulation difficulties, 39% in resilience, and 63% in quality of life. Illness perception and health anxiety positively predicted emotion regulation difficulties and negatively predicted resilience, whereas perceived social support negatively predicted emotion regulation difficulties and positively predicted resilience (all p < .001). Emotion regulation difficulties negatively predicted quality of life (β = −.31, p < .001), while resilience positively predicted it (β = .36, p < .001). Illness perception (β = −.20, p = .002), health anxiety (β = −.17, p = .009), and perceived social support (β = .15, p = .004) retained significant direct effects on quality of life. All six specific indirect effects were significant, supporting partial mediation. Quality of life in patients with cardiovascular disease is influenced by interrelated cognitive, emotional, and interpersonal factors, with emotion regulation difficulties and resilience serving as significant mediating mechanisms. Interventions targeting maladaptive illness perceptions, health anxiety, emotional regulation, resilience, and social support may improve psychosocial adjustment and quality of life in cardiovascular populations.

The Relationship Between Emotional Suppression and Fear of Intimacy and the Manifestation of Psychosomatic Symptoms in Individuals With Psychosomatic Symptoms

Zahra Latifi iD , Sirvan Asmaee Majd ^* iD

The present study investigated the relationship between emotional suppression and fear of intimacy and the manifestation of psychosomatic symptoms in individuals with psychosomatic symptoms. In terms of its purpose, this study was applied research; in terms of the type of data, it was quantitative; and in terms of its nature, it employed a descriptive-correlational design. The statistical population consisted of individuals presenting with psychosomatic symptoms whose symptoms had been confirmed by psychologists at the selected centers. Given that the population size was considered unlimited, 30 participants were selected for each variable, yielding a total sample of 120 participants, using convenience sampling. To measure the study variables, the Emotional Suppression Questionnaire developed by Weinberger (1979), the Fear of Intimacy Scale developed by Descutner and Thelen (1991), and the Psychosomatic Symptoms Questionnaire developed by Lacourt et al. (2013) were used. Data were analyzed using SPSS version 26, Spearman's correlation coefficient, and stepwise regression analysis. The results indicated a significant relationship between emotional suppression and the manifestation of psychosomatic symptoms among individuals with psychosomatic symptoms (p < .05). A significant relationship was also found between fear of intimacy and the manifestation of psychosomatic symptoms in these individuals. Moreover, emotional suppression and fear of intimacy significantly predicted the manifestation of psychosomatic symptoms among individuals with psychosomatic symptoms (p < .05). In summary, individuals characterized by a constitutionally based behavioral inhibition system may interpret potentially threatening future events as ambiguous stimuli. This process may increase fear and emotional suppression, contribute to the manifestation of avoidant behaviors, and ultimately lead to psychosomatic symptoms in individuals who are prone to such symptoms.

The Mediating Role of Self-Esteem in the Relationship of Social Support and Resilience with Anxiety and Depression among Female Heads of Households

Shaghayegh Soleimani iD , Reza Mirzaei ^* iD

The present study aimed to investigate the mediating role of self-esteem in the relationship of social support and resilience with anxiety and depression among female heads of households in Shiraz. This descriptive-correlational study used a cross-sectional design. The statistical population consisted of all female heads of households in Shiraz in 2025, from whom 240 participants were selected through convenience sampling. Data were collected using the Rosenberg Self-Esteem Scale, the Multidimensional Scale of Perceived Social Support, the Connor-Davidson Resilience Scale, the Beck Depression Inventory, and the Good Existential Anxiety Questionnaire, and were analyzed using structural equation modeling. The findings indicated that the conceptual model had an acceptable fit. Social support had a direct negative effect on depression and a direct positive effect on self-esteem. Resilience also had a direct positive effect on self-esteem; however, its direct effect on anxiety was not significant. Self-esteem had direct negative effects on both depression and anxiety. Bootstrap analysis showed that self-esteem significantly mediated the relationships between social support and depression and anxiety, as well as the relationships between resilience and depression and anxiety. The findings suggest that self-esteem, as an important psychological mechanism, helps explain the relationships of external resources, such as social support, and internal resources, such as resilience, with the mental health of female heads of households. In addition, the non-significant direct effect of resilience on anxiety suggests that the association between resilience and anxiety may be explained through cognitive and self-worth mechanisms, including self-esteem.

Mental Health and Lifestyle Journal

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Modeling the Causal Relationships of Job Satisfaction Based on Self-Efficacy and Work–Family Conflict among Employees of the Red Crescent Society of Mazandaran Province with the Mediating Role of Mindfulness

The Effectiveness of Self-Compassion Therapy on Self-Esteem, Social Skills, and Communication Skills in Children

The Effect of Modified YouMed on Balance, Executive Functions, and Quality of Life in Older Women

The Role of Attachment Styles and Physical Activity in Predicting Quality of Life in Women with Breast Cancer: The Mediating Role of Resilience

Effectiveness of a Combined Virtual Reality–Based and Mindfulness Intervention on Pain Acceptance in Individuals with Spinal Cord Injury

Structural Modeling of Marital Satisfaction Based on Openness to Experience with the Mediating Role of Self-Compassion in Women with Breast Cancer

Presenting a Model of Emotional Divorce Based on Defense Mechanisms with the Mediating Role of Sexual Self-Efficacy in Women

Comparing the Effectiveness of Dialectical Behavior Therapy Combined with Lithium Carbonate on Illness Perception and Patient Treatment Adherence in Women with Bipolar I Disorder

The Relationship Between Alexithymia, Attachment Styles, and Interpersonal Problems in Female Lower Secondary School Students

Prediction of Internet Addiction Based on Distress Tolerance with the Mediating Role of Coping Strategies

The Effect of Different Emotional Inductions on Visual Search Behavior During Decision-Making in Skilled Female Soccer Players

Investigating the Effect of Engagement in Artistic Activities on Mental Health Considering the Mediating Role of Self-Acceptance

Comparing the Effectiveness of Acceptance and Commitment Therapy and Positive Psychotherapy on Perceived Stress and Health Anxiety in Women with Breast Cancer

Comparing the Effectiveness of Intensive Short-Term Psychodynamic Therapy and Emotion-Focused Therapy on Alexithymia in Patients with Psychosomatic Disorders

Risk Factors for PTSD After Trauma Exposure: A Systematic Review

Developing a Model of the Role of Social Networks in Women’s Participation in Leisure Activities and Public Sports with Emphasis on the Role of Social Adjustment

Presenting a Structural Relationship Model of Death Anxiety and Hypochondriacal Thoughts with Illness Perception in Older Adults: Examining the Mediating Role of Health-Promoting Behaviors

The Effectiveness of Acceptance and Commitment-Based Intervention Training on Marital Satisfaction, Marital Communication, and Sexual Relationships in Individuals with Obsessive–Compulsive Disorder

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