درخت حوزه‌های تخصصی

The purpose of the present study was to examine the relationship between psychological factors , Erectile Dysfunctional ( E D ) and quality of life ( Q O L) before and after Coronary Artery Bypass Graft ( C A B G ) and Percutaneous Transluminal Coronary Angioplasty ( P T C A ) procedures , in an Iranian sample of cardiovascular patients . To do so, one hundred ninety patients scheduled for CA BG and PTCA operations were selected and administered relevant questionnaires a day before the surgery . Subsequently , the same patients filled out the same questionnaires two months following the procedure . Data analysis showed an increase in Qol while revealing a decline in men’s sexual functioning after the PT CA procedure although no change was observed in women . Also , an improvement in psychological status of all patients was observed following both revascularization procedures .

Objective: A great number of patients leave psychotherapy prior to the end of treatment. The present study predicts the premature termination of individual psychotherapy based on patients’ expectations and tolerance and therapists’ competencies with the mediating role of therapeutic alliance. Method: In this descriptive cross-sectional study, 317 patients referred to Mental Health Clinics, Pain Clinics and Substance Use Treatment Centers in Mashhad, Iran were selected by random sampling. The data were collected by Distress/Endorsement Validation Scale, Working Alliance Inventory-Short Revised, the Milwaukee Psychotherapy Expectations Questionnaire, and Outcome Questionnaire. The data were analyzed by SPSS-19 and structural equation modeling with LISREL-8.80 software. Results: The examined model indicated good fitness for the data observed (RMSEA=0.02, GFI=0.99, AGFI=0.99, NFI=1, CFI=1, IFI=1, RMR=0.00253, P value=0.90). Psychotherapy expectations (γ=-0.40) and therapists’ competencies (γ=-0.29) directly influenced the premature termination of individual psychotherapy. Treatment tolerance (γ=-0.17) directly affected the premature termination of individual psychotherapy. Therapeutic alliance (β=-0.13) had an impact on the premature termination of individual psychotherapy. Psychotherapy expectations (γ=0.42) and therapists’ competencies (γ=0.54) significantly influenced the therapeutic alliance, thereby affecting the premature termination of individual psychotherapy. Conclusions: Psychotherapy expectations, treatment tolerance, therapists’ competencies and therapeutic alliance interactively effect in the premature termination of psychotherapy and therefore on the health outcomes of patients. This finding did develop insights into designing the tailored interventions to resolve premature termination and improve the outcomes of psychotherapeutic interventions. Furthermore, clinicians must be concerned with these factors in the clinics and healthcare centers to enhance the successful termination of psychotherapy.