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Background Although many studies have been conducted on the efficacy of behavioral activation in depression, there are few sources that have evaluated the efficacy of this treatment in depressed patients with anxiety through telecare. The study is designed aiming to determining the Effects of a telenursing scheduled intervention of brief behavioral activation therapy on depression and anxiety symptoms of patients with mixed anxiety and depression Disorder (MADD). Methods The study was a randomized clinical trial in which 30 subjects with MADD were randomly assigned to an intervention and a control group based on inclusion criteria. The 8-session person-centered behavioral activation was delivered twice weekly via tele-nursing. Depression and anxiety symptoms severity were assessed using the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale at baseline, end, and 1 month after the intervention. Data were analyzed by independent t-tests, chi-square tests, and repeated-measures tests using SPSS version 24. Results The results showed that after the implementation of the intervention, the depression score in the intervention group had decreased from 19.86 (± 8.56) to 17.21 (± 6.71). In contrast, it increased from 18.67 (± 9.72) to 19.47 (± 7.33) in the control group. For anxiety symptoms, there was a clinically significant decrease after the intervention only in the intervention group (p = 0.01). Conclusion The results showed the effects of brief behavioral activating tele-nursing on a non-significant reduction in depression symptoms and a significant clinical reduction in anxiety symptoms after the intervention in MADD patients. It seems that brief BA tele-therapy could be a good alternative for discharged patients and a good complementary method for long-term treatment in primary care nursing. Trial registration: IRCT20151003024312N6 Date of first registration: 13/09/2021

Background: Previous studies have shown that spiritual experience may reduce cardiovascular disease (CVDs). However, little is known about the relationship between spiritual health and the gender-specific risk of CVDs in communities with different cultures.Methods: A total of 3249 individuals (53.7% female, 75.0% middle-aged) participated in the Tehran Lipid and Glucose Study (TLGS) from 2015 to 2017 were included. Based on the ACC/AHA pooled cohort equation, CVD risk over ten years was examined. Spiritual health was measured using a developed tool for measuring spiritual health in Muslim populations (SHIMA-48). Linear regression models were used to assess the association between spiritual health and ACC/AHA risk scores. The natural logarithm scale was calculated to consider the normal distribution hypothesis of the regression model. Results:The current results suggest a slight but significant increase in the mean of spiritual health in women compared to men in both cognitive/emotional and behavioral dimensions (P < 0.001). In both sexes, a higher prevalence of smoking was observed in participants with lower levels of spiritual health (P < 0.004). In men, compared to those with a low level of spiritual health (the first tertile), the logarithm of the ACC-AHA risk score was reduced by 0.11 (P = 0.004) and 0.18 (P < 0.001) for those in the second and third tertiles of spiritual health, respectively. This result may be attributed to higher cigarette smoking among the latter group. Similar results were not observed in women. Conclusions:Current results indicate a gender-specific association between spiritual health and cardiovascular disease risk. Our findings imply that promoting spiritual health can be considered an effective strategy in future preventive interventions, primarily by controlling the desire to smoke in men.