Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 3 2026 07 01 The Comparison of the Diagnostic Value Between the Modified Heart Score and The Emergency Severity Index Triage in Elderly Patients with Chest Pain 1 12 118623 10.30483/rjm.2026.254706.1470 EN Hosein Ajamzibad Department of Aging Health, Social Development & Health Promotion Research Center, School of Nursing, Gonabad University of Medical Sciences, Gonabad, Iran Amir Mirhaghi Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran; AND, Prehospital Emergency Department, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Reza Aghilipour Department of Cardiac Surgery, Razavi Hospital, Imam Reza International University, Mashhad, Iran Atefeh ShirinZadeh Feizabadi Department of Anesthesiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Rasoul Gharaei M.Sc in Emergency Nursing, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Zahra Zandi Department of Cardiovascular Disease, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0002-1357-7605 Journal Article 2025 06 28 Background: Diagnostic triage using the Emergency Severity Index (ESI) in elderly patients with cardiac complaints is associated with significant triage errors. Objective: This study aimed to compare the diagnostic value of the Modified HEART Score, the overall Clinical Classification, and the Emergency Severity Index in identifying clinical deterioration in patients presenting with chest pain. Methods: This cross-sectional descriptive-analytical study was conducted in 2023 on 178 patients. Patients presenting with chest pain were triaged using two methods: the Modified HEART Score and the ESI. The outcomes of ward admission and length of stay were compared with the triage level using Fisher's exact test. The diagnostic accuracy and triage error for the Modified HEART Score and ESI were calculated based on admission outcomes to the Cardiac Care Unit (CCU) and low-risk outcomes, including admission to the internal cardiology ward or discharge from the emergency department. Data were analyzed using SPSS software version 21. A p-value of less than 0.05 was considered statistically significant. Results: For the Modified HEART Score, the total triage error based on the ward admission outcome was 12.9%, comprising 1.7% under-triage and 11.2% over-triage. The total triage error for the Emergency Severity Index was 41%, comprising 3.4% under-triage and 37.6% over-triage. There was no significant difference in under-triage error between the two methods, regardless of ward admission (p=0.26). However, a significant difference was found in over-triage error between the two methods (p<0.001). The sensitivity and specificity of the Modified Cardiac Triage Score were 91.89% and 85.82%, respectively. At the same time, for the ESI triage, they were 83.78% and 43.91%, respectively. Conclusion: The findings suggest that Cognitive-Analytic Therapy can be an effective therapeutic approach for enhancing psychological functioning and interpersonal skills among individuals with ASPD.

https://journal.razavihospital.ir/article_118623_b46e4d83eb0c080e114a32ee1f842b7d.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 3 2026 07 01 The Short-Term Complications Following Primary Total Hip Arthroplasty: A Retrospective Cohort Analysis in Iran 13 23 118624 10.30483/rjm.2026.254713.1477 EN Karim Pisoudeh Bone and Joint reconstruction research center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran Department of Orthopedics, School of Medicine, Bone and Joint Reconstruction Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran Hamidreza Dehghani Nazhvani Bone and Joint reconstruction research center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran Department of Orthopedics, School of Medicine, Bone and Joint Reconstruction Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran Omid Elahifar Bone and Joint reconstruction research center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran Department of Orthopedics, School of Medicine, Bone and Joint Reconstruction Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran Jaber Kazemi Bone and Joint reconstruction research center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran Department of Orthopedics, School of Medicine, Bone and Joint Reconstruction Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran Ali Tashakor Bone and Joint reconstruction research center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran Department of Orthopedics, School of Medicine, Bone and Joint Reconstruction Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran Journal Article 2025 03 10 Background: Total hip arthroplasty (THA) is a highly effective yet resource-intensive procedure. Understanding local epidemiology of short-term complications is crucial for optimizing outcomes, especially in diverse populations where data may be limited. Objective: This study investigates the incidence and demographic associations of key short-term complications following primary THA in an Iranian tertiary referral center. Methods: A retrospective cohort study was conducted on 92 consecutive patients who underwent primary THA at a major academic hospital in Tehran, Iran, between March 2019 and May 2024. The surgical approach was recorded, with the direct lateral approach being the most commonly used. Patient demographics, body mass index (BMI), surgical indication, and postoperative complications, specifically surgical site infection (SSI), prosthetic dislocation, venous thromboembolism (VTE), and leg length discrepancy (LLD), were extracted from medical records. Statistical analysis was performed using SPSS v22, with significance set at p<0.05. Results: The mean age was 49.2 ± 15.2 years, and the mean BMI was 25.6 ± 4.3 kg/m². Osteoarthritis (50.0%) was the most common indication. Regarding surgical approach, 24 patients (26.8%) underwent THA via an anterior approach, while 68 patients (73.2%) underwent THA via a direct lateral approach. The incidence of complications was: SSI 3.3% (n=3), dislocation 5.4% (n=5), and VTE 1.1% (n=1). All SSI cases occurred in male patients. Dislocation rates were numerically higher in patients under 50 years (8.0% vs. 2.4%, p=0.37) and in females (9.3% vs. 2.0%, p=0.17). The single VTE case occurred in an obese (BMI>30) female. No statistically significant association was found between BMI categories and complication rates. Mean LLD was 9.7 ± 5.7 mm, with no significant variation across demographic groups. Conclusion: In this small cohort, SSI and VTE rates were within internationally reported ranges. The dislocation rate (5.4%) was elevated despite the predominant use of the direct lateral approach, suggesting that factors beyond surgical approach, such as implant selection or patient-specific variables, may contribute to instability in this population. Larger, multicenter studies are needed to determine complication rates and risk factors accurately.

https://journal.razavihospital.ir/article_118624_9eddc1cdd2dbdc4fa8a9d12ed69f1d5b.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 3 2026 07 01 Enhancing Ego Strength, Emotional Stability, and Communication Skills in Prisoners with Antisocial Personality Disorder: Evaluating the Impact of Cognitive-Analytic Therapy 24 35 118622 10.30483/rjm.2026.254697.1463 EN Marzie Hashemi Department of Psychology and Education, Faculty of Humanities, Khatam University, Tehran, Iran 0000-0001-7502-0952 Mohammad Ali NajmZaadeh Department of Psychology and Education, Faculty of Humanities, Khatam University, Tehran, Iran Mandana Niknam Department of Psychology and Education, Faculty of Humanities, Khatam University, Tehran, Iran Journal Article 2025 11 03 Background: Antisocial Personality Disorder is a chronic and prevalent condition among incarcerated populations and is associated with impaired ego functioning, emotional instability, and deficient interpersonal communication. Objective: This study aimed to evaluate the effectiveness of Cognitive-Analytic Therapy on ego strength, emotional stability, and communication skills in male prisoners diagnosed with ASPD. Methods: This study explored the effectiveness of Cognitive-Analytic Therapy on ego strength, emotional stability, and communication skills in male prisoners with Antisocial Personality Disorder. A pre-test and post-test quasi-experimental design was employed, with an intervention group (n = 18) and a control group (n = 18), selected from male prisoners in Tehran with a confirmed ASPD diagnosis in 2023. The subjects were selected using purposive sampling and assigned to the groups randomly. Data were collected using standardized psychometric measures, including the Millon Clinical Multiaxial Inventory, the Psychosocial Inventory of Ego Strengths, the NEO Five-Factor Inventory – Short form, and the Communication Skills Test-Revised. The CAT intervention consisted of 10 sessions, held twice weekly for 2 hours each. Data were analyzed using SPSS, with descriptive statistics and covariance analysis. Results: revealed that there were considerable improvements in ego strength (F = 6.809, η = 0.180), communication skills (F = 31.221, η = 0.502), and emotional stability (F = 17.083, η = 0.355) in the intervention group compared to the control group (p < 0.05). Conclusion: The findings suggest that Cognitive-Analytic Therapy can be an effective therapeutic approach for enhancing psychological functioning and interpersonal skills among individuals with ASPD.

https://journal.razavihospital.ir/article_118622_0087839f9bd5cb109fa42295b309346d.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 3 2026 07 01 Association of all-cause and specific-cause mortality with diabetes mellitus in adults with vitamin D deficiency 36 46 118628 10.30483/rjm.2026.254709.1473 EN Sara Saffar Soflaei Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran. Soheyla Jafarpour Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Rasoul Alimi Department of Epidemiology and Biostatistics, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran. Toktam Sahranavard International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran. Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Emad Ghayour-Mobarhan Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran. Parsa Seyed Hosseini Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Hossein Hatamzadeh Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Mahmoud Ebrahimi Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Mohsen Moohebati Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Gordon A Ferns Brighton and Sussex Medical School, Division of Medical Education, Brighton, UK. Habibollah Esmaily Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran. Social Determinants of Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran. Majid Ghaour-mobarhan Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran. Journal Article 2026 01 02 Background: There is increasing evidence indicating that vitamin D deficiency may contribute to the development of Type 2 Diabetes Mellitus (T2DM) by affecting insulin sensitivity, insulin secretion, and inflammation. Objectives: We have investigated the association between vitamin D deficiency, T2DM, and mortality outcomes. Methods: The study was conducted on a sample of 846 subjects, derived from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study. Participants were considered as vitamin D deficient with vitamin D levels of less than 20 ng/ml. Over 10 years, participants were followed up every three years. The cause of death was identified using the death register of the Iranian Ministry of Health and Education and the death cause questionnaire. The study examined the relationship between T2DM and mortality using descriptive statistics, chi-square tests, and Cox proportional hazard regression analysis. Results: During the 10-year follow-up, 44 participants died from all causes, 15 from cancer, and 14 from cardiovascular causes. There was a significant association between diabetes and all-cause mortality, even after adjustment for age and sex yielding an HR of 2.07 (P=0.039). Vitamin D deficiency was associated with diabetes-related mortality (HR=3.16, P=0.038), but this link is not true for individuals who had vitamin D levels of more than 20 ng/ml. This association extends to mortality because of cancer (HR=3.64, P=0.025), but not cardiovascular mortality. Conclusion: Our findings underscore the potential role of vitamin D deficiency in the mortality risk of diabetics. Future research should further explore the mechanistic links between vitamin D deficiency, T2DM, and mortality outcomes to inform targeted interventions and improve clinical management strategies.

https://journal.razavihospital.ir/article_118628_261209d3a391e1b25377435d6cb41382.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 3 2026 07 01 A Virtual Reality-Based Software for Teaching and Assessing Disaster Triage: Design, Implementation, and Evaluation 47 61 118625 10.30483/rjm.2026.254715.1479 EN Ahmad Mahrooghi Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran 0009-0001-0120-4537 Mahdi Foroughian Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0002-3944-9361 Bita Abbasi Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0001-9162-2312 Seyed Reza Habibzadeh Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Raheleh Ganjali Clinical Research Development Unit, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0003-4584-9692 Navid Kalani Research Center for Social Determinants of Health, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran 0000-0003-1900-4215 Hamidreza Reihani Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0001-5582-9156 Reza Akhavan Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0002-2501-3815 Journal Article 2025 09 11 Background: Disasters cause extensive human casualties and disrupt communities, making triage a crucial component of crisis management. The START triage method rapidly assesses casualties and assigns them to color-coded categories, making it widely used in mass-casualty incidents. Traditional training lacks a stressful environment for skill assessment, while physical drills are costly. Virtual Reality (VR) provides an innovative, cost-effective solution by simulating crisis scenarios and enabling repeated practice. Objective: This study aimed to design and evaluate a VR-based software for teaching and assessing the START triage. Methods: This quasi-experimental pre-test and post-test study involved developing a VR-based crisis simulation software featuring Imam Reza Shrine and four culturally adapted casualty characters. After validation by emergency medicine specialists, 43 medical interns and 24 emergency medicine residents participated. All watched a START triage training video, completed a 10-question pre-test, and completed the Technology Readiness Index. They were randomly assigned to two groups: the control group received traditional training, while the intervention group practiced triage on four virtual cases with feedback. A post-test and Likert-scale satisfaction survey followed. Results: The VR group had significantly higher post-test scores (P<0.05). Participants with moderate to high VR technology readiness reported greater satisfaction than the control group. Conclusion: VR-based training enhances START triage learning and user satisfaction, making it a promising alternative to traditional methods.

https://journal.razavihospital.ir/article_118625_8b41d4b63a0977b2ecd1ba2cf4d5e259.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 3 2026 07 01 Unveiling the roadblocks: Explaining the Threatening Factors to Patient Safety in Hospitals Receiving COVID-19 Patients: A Qualitative Study 62 84 118626 10.30483/rjm.2026.254669.1439 EN Javad Moghri Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Rasoul Raesi Department of Public Health, school of Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran Razieh Jafari School of Health, Student research committee, Mashhad University of Medical Sciences, Mashhad, Iran Fatemeh Kokabi Saghi Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Mehrsadat Mahdizadeh Department of public Health, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Abdollah Reihany Yassavoli Director of Akbar Educational, Research and Superspecialty Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Seyed Saeed Tabatabaee Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2025 12 05 Background: With the COVID-19 outbreak, patient safety in hospitals has become a serious challenge. Identifying the factors threatening patient safety in this critical situation is crucial for improving the quality of healthcare services and reducing adverse outcomes. Objectives: To determine the factors threatening patient safety in hospitals that admit COVID-19 patients Methods: This qualitative study was conducted in hospitals in Iran that were receiving COVID-19 patients in 2023. 26 participants, including deputies, patient safety experts, nurses, head nurses, and nursing managers, were selected by purposive sampling until data saturation. The data were collected using a semi-structured, in-depth, face-to-face interview. A conventional content analysis approach was used for data analysis, and MAXQDA 2020 was used for data management. Results: The findings from the conventional content analysis showed that the factors threatening the safety of COVID-19 patients include four categories (factors related to the patient and disease, task-related factors, management factors, and organizational-infrastructural factors), 11 subcategories (factors related to the patient, factors related to the disease, communication factors with the patient, non-communication factors with the patient, medications and medical equipment, human resources, physical resources, planning and decision-making, supervision, maintaining human resources, processes and protocols), and 33 sub-subcategories. Discussion: The findings indicate the complexity of patient safety challenges during the COVID-19 pandemic and the need for comprehensive approaches to improve safety conditions in healthcare systems. Conclusion: These factors directly impact the quality of healthcare services and patient safety. Therefore, reforming policies and improving infrastructure are essential to promoting patient safety in critical care settings.

https://journal.razavihospital.ir/article_118626_5c391ff840d187ad6cea830fc7fb714e.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 3 2026 07 01 Toward Salutogenic Hospital Design for Health Promotion: A Mixed-Methods Study of Environmental Factors and Their Relationship with Patients’ Sense of Coherence 85 101 118627 10.30483/rjm.2026.254721.1485 EN Fatemeh Mehvar Faculty of Architecture and Urban Planning, Shahid Rajaee Teacher Training University, Tehran, Iran 0000-0002-2864-2975 Hamid Reza Azemati Faculty of Architecture and Urban Planning, Shahid Rajaee Teacher Training University, Tehran, Iran 0000-0002-1908-721X Bahram Saleh Sedghpour Faculty of Humanities, Shahid Rajaee Teacher Training University, Tehran, Iran 0000-0002-3251-2567 Journal Article 2026 01 17 Background: Health promotion emphasizes reducing stress and strengthening individual coping mechanisms. Hospitals, as pivotal healthcare settings, can advance this objective through salutogenic design, which targets the enhancement of patients' Sense of Coherence (SOC)—comprising comprehensibility, manageability, and meaningfulness. However, empirical evidence linking architectural design to SOC remains limited. Objectives: This study aimed to identify key architectural components supporting salutogenic hospital design and model their interrelationships with patients' SOC. Methods: An exploratory mixed-methods design was utilized. A qualitative phase involving documentary analysis and a Delphi expert panel identified initial factors. Subsequently, a 45-item questionnaire was administered to 210 inpatients at Shahid Rajaei Heart Hospital (January–March 2024). Validity and reliability were confirmed via expert review, Cronbach's alpha, and exploratory factor analysis. Data were analyzed using SPSS-27 and structural equation modeling (SEM) in AMOS. Results: Expert consensus refined seven initial factors into a six-factor user-validated model: legibility and functional performance, environmental comfort, naturalness, safety and hygiene, psycho-social comfort, and aesthetics. Reliability was acceptable (α = 0.726), and sampling adequacy was confirmed (KMO = 0.907). Correlation analysis revealed distinct associations: legibility correlated strongly with comprehensibility; environmental comfort and safety with manageability; and naturalness, aesthetics, and psycho-social comfort with meaningfulness. SEM confirmed significant interrelationships among all six factors with good model fit. Conclusion: The findings indicate the complexity of patient safety challenges during the COVID-19 pandemic and the need for comprehensive approaches to improve safety conditions in healthcare systems.Specific environmental design factors significantly contribute to patients' perceptual and psychological well-being. The six-factor model validates a salutogenic design approach, demonstrating that environmental quality can enhance comprehensibility, manageability, and meaningfulness in healthcare contexts.

https://journal.razavihospital.ir/article_118627_b2f6b02184f128cc3bb8f116d3a6a5b8.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 3 2026 07 01 The Effectiveness of Unified Transdiagnostic Therapy on Experiential Avoidance, Cognitive Fusion, and Self-Conscious Emotions in Patients with Obsessive-Compulsive Disorder 102 113 118629 10.30483/rjm.2026.254722.1486 EN Farzin Bagheri Sheykhangafshe Department of Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran. 0000-0002-3435-3870 Bita Ghafari Tavasoli Department of Clinical Psychology, Faculty of Humanities, Islamic Azad University, Science and Research Branch, Tehran, Iran. Seyyedeh Somayyeh Baradaran Department of Clinical Psychology, Faculty of Humanities, Islamic Azad University, Ardabil Branch, Ardabil, Iran. Vahid Savabi Niri Department of Clinical Psychology, Faculty of Humanities, Islamic Azad University, Ardabil Branch, Ardabil, Iran. Jafar Hasani Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran. Journal Article 2026 02 05 Background: Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and maladaptive emotional responses that significantly impair daily functioning. Objectives: This study aimed to evaluate the effectiveness of Unified Transdiagnostic Therapy (UTT) in reducing experiential avoidance, cognitive fusion, and self-conscious emotions in patients diagnosed with OCD. Methods: A quasi-experimental design with pre-test, post-test, and control group was employed. The statistical population comprised 65 patients referred to psychological clinics and medical centers in Ardabil City in 2024. From this population, 36 patients diagnosed with OCD were selected via convenience sampling and randomly assigned to either the experimental (n = 18) or control (n = 18) group. The experimental group received eight 90-minute sessions of UTT. Data were collected using the Obsessive-Compulsive Disorder Questionnaire (OCDQ), the Acceptance and Action Questionnaire (AAQ-II), the Cognitive Fusion Questionnaire (CFQ), and the Test of Self-Conscious Affect (TOSCA-3). Statistical analyses were conducted using multivariate analysis of covariance (MANCOVA) in SPSS version 27. Results: The findings demonstrated that UTT significantly reduces experiential avoidance (F = 86.36, η² = 0.74), cognitive fusion (F = 81.91, η² = 0.73), shame (F = 65.92, η² = 0.68), and guilt (F = 76.21, η² = 0.72) in patients with OCD (P < 0.01). Conclusion: This study underscores the efficacy of UTT as a transdiagnostic intervention for ameliorating the maladaptive cognitive and emotional processes prevalent in OCD. By fostering enhanced psychological flexibility and emotional regulation, UTT constitutes a viable and practical therapeutic option. These findings support the broader application of transdiagnostic approaches in targeting the fundamental mechanisms underpinning a range of emotional disorders.

https://journal.razavihospital.ir/article_118629_f6c317a5f72cea7bfbd1597f733b3fe8.pdf