University of Social Welfare and Rehabilitation Sciences

Type 2 diabetes mellitus (T2DM) presents significant comorbidity with emotional disorders, with approximately 25% of patients experiencing clinically significant depression and anxiety symptoms. While some disorder-specific interventions, such as cognitive-behavioral therapy, have demonstrated efficacy in addressing emotional symptoms in T2DM patients, they often do not fully address the interconnected nature between diabetes and emotional distress, highlighting the need for integrated, transdiagnostic treatment approaches. This study evaluated the efficacy of group-based transdiagnostic cognitive-behavioral therapy (gTCBT) for improving depression, anxiety, quality of life, and medication adherence in adults with T2DM and comorbid emotional disorders. This randomized controlled trial recruited 52 participants with T2DM and emotional disorders. Participants were randomly assigned to either a 12-session gTCBT intervention based on the Unified Protocol (n = 26) or waitlist control (n = 26). Primary outcomes included Beck Depression Inventory-II and Beck Anxiety Inventory. Secondary outcomes were assessed using the Diabetes Quality of Life questionnaire for quality of life and the Morisky Medication Adherence Scale for medication adherence. Assessments were conducted at pre-treatment, post-treatment, and one-month follow-up. 48 participants completed the study (23 intervention, 25 waitlist). Mixed-model ANOVAs revealed significant time × group interactions for all outcomes (p < .001). The intervention group demonstrated large effect sizes for depression (g = 2.48), anxiety (g = 1.65), quality of life (g = 1.72), and medication adherence (g = 1.66) improvements from pre- to post-treatment. Effects were sustained at one-month follow-up. gTCBT effectively reduced emotional symptoms and improved diabetes-related outcomes in patients with T2DM and comorbid emotional disorders. The transdiagnostic approach offers a effective intervention for addressing complex comorbidities in diabetes care settings. This randomized clinical trial comprised an intervention and a waitlist that was registered in the Iranian Registry of Clinical Trials (ID: IRCT20241116063741N1). (Registration Date: 05/07/2025).

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The strong and effective stewardship of rehabilitation services is mentioned as one of the critical elements for the success of efforts to improve access to rehabilitation services. Existing evidence indicates that fragmented and unclear multiple governance and leadership structures are a major barrier to equitable access to rehabilitation services in Iran. The lack of coordination and integration of rehabilitation services across different institutions has led to services being provided in a fragmented manner based on internal organizational policies. This study was conducted in four stages: a scoping review, analysis of documents, interviews, and collective brainstorming. Policy solutions were identified in six broad areas: health vision and strategies for achieving better health, influencing other sectors and advocating for better health, aligning the governance of the health system with prevailing values, methods for ensuring the design of the health system in line with health system goals, current legal and regulatory tools, and methods for collecting, disseminating, and applying information. From a governance perspective, establishing governance structures and centralizing the management of rehabilitation services is essential. Weak governance structures and the lack of coordination among responsible institutions are among the main problems in this area. Therefore, designing a system that clarifies the key roles of different stakeholders and allows for accountability and effective interaction is considered necessary. Ensuring the provision of comprehensive rehabilitation services requires aligning these services with various dimensions of the health system, including human resource quality, sustainable financing, appropriate distribution of services, and increased access to rehabilitation services. In this regard, it is recommended to revise educational policies to train a skilled and responsive workforce that meets the community’s needs. Furthermore, sustainable financing through an efficient insurance system and investment in this area is of particular importance. Finally, enhancing legal and regulatory tools, along with the government’s commitment to enforcing laws and strengthening supervisory infrastructure, is essential for achieving an effective rehabilitation system. Strengthening political commitment and investment in this sector will not only increase productivity but also help reduce health system costs. Overall, adopting a comprehensive and coordinated approach across all relevant sectors can pave the way for achieving better health outcomes through rehabilitation services.

Objective Diabetic polyneuropathy (DPN) is one of the most common complications of type 2 diabetes, characterized by diminished light touch and vibration perception, leading to impaired balance and increased fall risk among older adults. Despite its high prevalence, evidence on targeted sensory rehabilitation remains limited. This study aimed to evaluate the effectiveness of a Fall-Proof rehabilitation exercise software in improving sensory function in elderly patients with DPN. Materials &amp; Methods This study was a single-blind clinical trial conducted in 2025 at Sadeghieh Tahereh Hospital in Isfahan. A total of 96 patients diagnosed with diabetic peripheral neuropathy, confirmed using the michigan neuropathy screening instrument (MNSI), were randomly assigned via adaptive randomization into three groups: An in-person intervention group, a virtual intervention group (utilizing a dedicated software platform), and a control group. The intervention groups performed FallProof™ balance exercises for eight weeks (two sessions per week), either in person or virtually, whereas the control group received only standard care. Sensory function—including light touch sensation at the third and fifth metatarsal heads and the hallux, as well as vibratory sensation at the hallux—was assessed at four time points: pre-intervention, immediately post-intervention, and at 2- and 3-month follow-ups. Data were analyzed using non-parametric statistical tests, including the Friedman test, Wilcoxon signed-rank test, and Mann–Whitney U test, with significance set at P&lt;0.05. Results Both intervention groups showed significant improvements in all sensory indices (P&lt;0.05), with the greatest gains observed at the 5th metatarsal and hallux. Compared with controls, the digital intervention group demonstrated superior improvements in light touch at the 5th metatarsal (+1.80 units), hallux (+1.22 units), and vibration perception (+0.36 units). Importantly, these sensory improvements persisted for up to 3 months in the digital group, whereas the control group experienced progressive decline. Conclusion Fall-proof exercises, particularly when delivered through interactive rehabilitation software, produced significant, targeted, and sustained improvements in tactile and vibration perception in elderly patients with DPN. These findings underscore the potential of digital-based interventions in sensory rehabilitation and fall prevention, supporting their integration into home-based rehabilitation programs for high-risk populations.

Objective Optimal rehabilitation education can lead to the cultivation of expert and influential people. This study aimed is provide a conceptual model of rehabilitation education in Iran based on the grounded theory. Materials &amp; Methods This is a qualitative study using the grounded theory method. Participants were 32 professors and doctoral students of rehabilitation disciplines (including occupational therapy, physiotherapy, speech therapy, social work, technical orthopedics, and rehabilitation management) from the University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. They underwent semi-structured interviews. The collected data were analyzed using Corbin and Strauss’s method. Results Data analysis led to the emergence of 7 main categories (nature and requirements of rehabilitation education, improving learner motivation, process of rehabilitation education, rehabilitation education skills, rehabilitation education methods, rehabilitation education facilitators, rehabilitation education barriers/shortcomings) and 25 subcategories. Conclusion Rehabilitation education requires attention to its structure, nature, and requirements that shape its educational components, processes, and outcomes. Blending learning is emphasized in rehabilitation education, and learners’ motivation is an important factor in promoting rehabilitation education.

The Sendai Framework for Disaster Risk Reduction (SFDRR) 2015–2030 places health at the center of its agenda, calling for the protection of lives, livelihoods, and health services before, during, and after disasters. With over 30 health-specific references, it outlines four core priorities—understanding risk, strengthening governance, investing in resilience, and enhancing preparedness for recovery (“Build Back Better”)—all directly relevant to national health systems.

Effective risk communication is essential in addressing the complex challenges posed by biological events in the healthcare system. This scoping review study aims to identify key concepts, highlight existing gaps in risk communication, explore factors influencing risk communication during biological events, and uncover areas of insufficient knowledge. This study scoping review employed a domain review methodology following Arksey’s approach, utilizing five key stages: determining research questions, identifying relevant studies, selecting studies, recording data, and collecting, summarizing, and reporting findings. Data extraction sources included studies from some international databases including Scopus, Web of Science and PubMed, and Google Scholar Motor enjone from 2000 to 2023 Inclusion criteria encompassed studies on disaster risk communication, while exclusion criteria included non-English articles and those not focused on disaster risk communication. The study analyzed 18 articles on risk communication in disasters, revealing key factors such as cultural, technological, organizational, and socio-economic influences. Trust-building, transparent communication efforts and collaboration among experts and media professionals are essential for enhancing risk communication and fostering public dialogue. Comprehensive risk communication should address uncertainties, complex decisions, and shared responsibilities, resonate with individuals’ concerns, and ensure inclusivity for vulnerable populations. Risk communication is one of the important components of disasters management, which plays an important role in making informed decisions, changing positive behavior, and maintaining people’s trust during disasters, which becomes more important in biological events, so there is a need for policymakers and managers to take into account the identified factors. Plan to educate and increase the awareness of the public in order to reduce the vulnerability of society in the event of biological events. It is suggested that due to the importance of the issue of designing a local model of the communication of the risk of accidents and disasters in biological incidents, it should be done in the next studies.