Communal coping and its association with marital relations and psychological outcomes among healthcare professionals during the COVID-19 pandemic.

Background: Communal coping is a type of interdependency in which couples dealing with a health threat share assessment of a threat and respond together to the stress. The present study investigated communal coping in the COVID-19 pandemic and its association with psychological and relational outcomes among healthcare professionals. Methods: In the present cross-sectional survey study, 242 healthcare professionals from hospitals and health centers were recruited via convenience sampling between August and October 2020. Communal coping with working conditions during the COVID-19 pandemic, dyadic adjustment, psychological distress, and fear of COVID-19 along with demographic and professional characteristics were assessed via an online survey. Results: Multivariable linear regression showed that dyadic adjustment (ß = 0.73), psychological distress (ß = 0.16), fear of COVID-19 (ß = 0.11), and support gap (ß = -0.04) were significant independent variables associated with communal coping among healthcare professionals. Conclusion: Healthcare professionals coped communally within the family in dealing with working conditions during the COVID-19 pandemic. Dyadic adjustment was the strongest predictor of communal coping among healthcare professionals.

Factors Associated With Hope and Quality of Life in Patients With Coronary Artery Disease.

BACKGROUND: Psychological resources such as hope have been suggested to affect quality of life (QoL) positively in patients with heart disease. However, little information regarding the relationship between these two constructs is available. PURPOSE: This work was aimed at examining the factors associated with hope and QoL in patients with coronary artery disease. METHODS: In this descriptive work, perceived QoL and hope were assessed in 500 patients with heart disease. The information was collected using the McGill QoL Questionnaire, demographic variables, and the Herth Hope Index. The Pearson correlation test and general linear model were used to examine correlations through SPSS Version 22. RESULTS: A considerable correlation was discovered between QoL and hope (r = .337, p < .001). Multivariate analyses with regression revealed that religious beliefs and social support both had significant and positive effects on the total perceived hope of patients and that patient age had a considerable negative impact on QoL (p < .05). None of these factors had a significant impact on hope (p < .05). In addition, the total QoL had a significant and positive effect on patient feelings and thoughts, whereas the physical problems component of QoL had a significant and negative effect on hope (p < .05). Participants with higher levels of education reported more hope. CONCLUSIONS: QoL relates significantly to self-perceived hope in patients. Understanding QoL and hopefulness in patients with coronary artery disease has implications for nurses and other healthcare professionals.

Predictive factors associated with death depression in women with breast cancer.

A cross-sectional study with a convenience sample of 241 patients with breast cancer was conducted to investigate death depression and its explanatory factors in Iranian women who were diagnosed and undergoing treatment for breast cancer. Patients with significantly higher death depression were those who were housewives (ß = 0.6, p = 0.016), unskilled workers (ß = 15.8, p = 0.002), and retired (ß = 13.1, p = 0.002) as compared with those who were professionally employed with higher socio-economic status (ß = 17.4, p = 0.002); and those receiving combination therapy as compared to surgery only (ß = 6.3, p = 0.02). For patients with higher spiritual health scores, death depression was significantly lower (ß = -0.2, p < 0.001).

The effect of psychoeducational intervention, based on a self-regulation model on menstrual distress in adolescents: a protocol of a randomized controlled trial.

INTRODUCTION: Menstrual distress caused by primary dysmenorrhea is associated with physical and psychological symptoms-before, after, and during menstruation. Leventhal's self-regulation educational model is based on the cognitive and emotional experiences of threat responses to symptoms and relates to coping responses. This study aims to investigate the effect of the implementation of a psychoeducational intervention, based on the self-regulation model of menstrual distress in adolescents. METHODS/DESIGN: In this randomized controlled trial, 120 adolescent girls with moderate to severe menstrual pain (based on visual analog scale (VAS) ≥ 4) from twelve randomly selected high schools in Qazvin City will be enrolled in the study and will be randomly assigned to either a 3-session psychoeducational intervention (n = 60) or control (n = 60) groups. The sessions will be between 60 and 90 min apiece, and they will run for three consecutive weeks (one session per week). The data collection tools will include questionnaire eliciting menstrual information and demographics, the VAS, the Moos Menstrual Distress Questionnaire, and the illness perception questionnaire. One month prior to the intervention, both groups will participate in an initial assessment to assess the severity of their pain and level of menstrual distress. Finally, all questionnaires will be completed for three consecutive months after the intervention is completed. DISCUSSION: It is anticipated that findings of this study will provide evidence for the effectiveness of the Leventhal self-regulation model. Implications for improved practice, understanding, and treatment for menstrual distress may also arise. ETHICAL CONSIDERATIONS: The research protocol will be reviewed by the ethics committee, which is affiliated with the Qazvin University of Medical Sciences (Decree code: IR.QUMS.REC.1398.043). TRIAL REGISTRATION: IRCT20190625044002N1 . Registration date: 2019-09-03.

Death anxiety in patients with cancer: A systematic review and meta-analysis.

PURPOSE: The present study was designed to estimate the rate of death anxiety and the factors influencing its occurrence in cancer patients using a systematic review and meta-analysis approach. METHOD: Five academic databases, including Scopus, PubMed, Science Direct, Embase, and ProQuest, were searched systematically from inception until the end of January 2020. Observational studies that reported mean score of death anxiety in cancer patients, regardless of language restriction, were eligible to be included. The Newcastle-Ottawa Scale was used to assess the methodological quality of included studies. A meta-analysis was performed using a random effect model with the DerSimonian and Laird weighted method. Publication bias was assessed using the funnel plot and Begg's and Egger's tests. RESULTS: The estimated pooled mean for death anxiety among cancer patients was 6.84 (CI95% = [5.98, 7.69]). Publication bias and small study effects were not detected. Subgroup analysis and a meta-regression showed that the estimated pooled mean was higher in Asian studies (M = 7.57) compared to European (M = 6.47) and North American studies (M = 5.57); in breast cancer patients (M = 9.68) compared to studies examining different types of cancers; in female only participants (M = 7.37) compared to studies with both genders (M = 6.60); and in married participants compared to non-married participants. CONCLUSIONS: The findings suggest that death anxiety in patients with cancer is moderate and is influenced by socio-demographic factors such as region, type of cancer, sex, and marital status.

Validity and Reliability of the Flourishing Scale in a Sample of Older Adults in Iran.

BACKGROUND: Flourishing is related to positive outcomes for physical and mental health, as well as overall wellbeing. The aim of the present study was to determine the validity and reliability of the Flourishing Scale (FS) among a sample of older participants in Iran. METHODS: In this validation study, 300 older people were selected by cluster sampling method. Data were collected using a checklist for demographic characteristics, the FS, and the Oxford happiness questionnaire. The validity (face, content, convergent, and construct) and reliability (Cronbach's alpha, test-retest) of the FS was evaluated in this cross-sectional study. RESULTS: The exploratory factor analysis demonstrated a one-dimensional structure consisting of 8 items with an eigenvalue of 3.583. The model had a good fit [χ2 = 52.983, p < 0.001, χ2/df = 2.944, GFI = 0.958, CFI = 0.915, IFI = 0.949, TLI = 0.919, AGFI = 0.948, and RMSEA = 0.081, SRMR = 0.086] with all factor loadings greater than 0.5 and statistically significant. A test of concurrent validity showed a direct and significant association between the FS and the Oxford happiness questionnaire (r = 0.647, p < 0.001). The results of the reliability tests confirmed that the values of Cronbach's alpha coefficient (0.819) and test-retest (0.821) were acceptable. CONCLUSION: The Persian version of the FS demonstrated suitable validity and reliability among a sample of older participants.

Predictors of Quality of Life in Patients with Heart Disease.

Individuals with heart disease have been found to have more negative psychological and physical effects that impact their quality of life (QoL) than the general population. Spiritual well-being is considered a protective factor associated with QoL in people with heart disease. Therefore, the current research seeks to evaluate whether sociodemographic factors and spiritual well-being predict QoL among patients with heart disease. A total of 500 patients who were selected through a convenient sampling method from an Iranian hospital participated in this descriptive-correlational study. Data were collected using the McGill QoL Questionnaire, the Spiritual Well-being Scale, and demographic variables. The data analysis included descriptive and inferential statistics powered by SPSS (v. 23). Following multivariate analyses, findings revealed that those participants with their main source of income derived from family or a government pension and with College or intermediate educational levels were more likely to have higher QoL. Those participants with average or poor socioeconomic status reported higher QoL than those who were more affluent. Furthermore, younger patients (- 0.2, 95% CI - 0.3 to - 0.003, p = 0.016) and those with higher social support (0.7, 95% CI 0.2 to 1.3, p = 0.006) and spiritual well-being (0.2, 95% CI 0.1 to 0.3, p < 0.001) had significantly better QoL. In the current study, spiritual well-being and social support led to reduced negative psychological sequelae and improved QoL in cardiac patients.

Predictors of death anxiety among patients with heart disease.

Objective: This research examines whether or not socio-demographic factors and hope predict death anxiety among patients with heart disease.Materials and Methods: Our sample consisted of 500 respondents who were hospitalized in a medical institution in Iran. Data were collected using the Templer Death Anxiety Scale (TDAS) and the Herth Hope Index (HHI).Results: The results of current study indicated that higher economic status, having one's main source of income from friends, increased age, increased religious belief, and increased hope were associated with lower death anxiety.Conclusion: These results highlight that improving hope, and religiosity among cardiac patients may be an effective means by which to reduce their death anxiety.

Psychometric Properties of the Death Anxiety Scale-Extended among Patients with End-Stage Renal Disease.

This study aimed to evaluate the validity and reliability of the Persian version of Death Anxiety Scale-Extended (DAS-E). A total of 507 patients with end-stage renal disease completed the DAS-E. The factor structure of the scale was evaluated using exploratory factor analysis with an oblique rotation and confirmatory factor analysis. The content and construct validity of the DAS-E were assessed. Average variance extracted, maximum shared squared variance, and average shared squared variance were estimated to assess discriminant and convergent validity. Reliability was assessed using Cronbach's alpha coefficient (α = .839 and .831), composite reliability (CR = .845 and .832), Theta (θ = .893 and .867), and McDonald Omega (Ω = .796 and .743). The analysis indicated a two-factor solution. Reliability and discriminant validity of the factors was established. Findings revealed that the present scale was a valid and reliable instrument that can be used in assessment of death anxiety in Iranian patients with end-stage renal disease.

Spiritual well-being and moral distress among Iranian nurses.

BACKGROUND: Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. OBJECTIVE: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses. RESEARCH DESIGN: A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. ETHICAL CONSIDERATIONS: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. FINDINGS: Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress (r = -.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. DISCUSSION AND CONCLUSION: This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and spiritual well-being.

Psychometric evaluation of the Moral Distress Scale-Revised among Iranian Nurses.

BACKGROUND: Experiencing moral distress is traumatic for nurses. Ignoring moral distress can lead to job dissatisfaction, improper handling in the care of patients, or even leaving the job. Thus, it is crucial to use valid and reliable instruments to measure moral distress. OBJECTIVE: The purpose of this study was to determine the reliability and the validity of the Persian version of the Moral Distress Scale-Revised among a sample of Iranian nurses. RESEARCH DESIGN: In this methodological study, 310 nurses were recruited from all hospitals affiliated with the Qazvin University of Medical Sciences from February 2014 to April 2015. Data were collected using a demographic questionnaire and the Moral Distress Scale-Revised. The construct validity of the Moral Distress Scale-Revised was evaluated using principal component analysis and confirmatory factor analysis. Internal consistency reliability was assessed with Cronbach's alpha. ETHICAL CONSIDERATIONS: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. FINDINGS: The construct validity of the scale showed four factors with eigenvalues greater than one. The model had a good fit (χ2(162) = 307.561, χ2/df = 1.899, goodness-of-fit index = .904, comparative fit index = .927, incremental fit index = .929, and root mean square error of approximation (90% confidence interval) = .049 (.040-.057)) with all factor loadings greater than .5 and statistically significant. Cronbach's alpha coefficients were .853, .686, .685, and .711for the four factors. Moreover, the model structure was invariant across different income groups. DISCUSSION AND CONCLUSION: The Persian version of the Moral Distress Scale-Revised demonstrated suitable validity and reliability among nurses. The factor analysis also revealed that the Moral Distress Scale-Revised has a multidimensional structure. Regarding the proper psychometric characteristics, the validated scale can be used to further research about moral distress in this population.

Sexual distress and sexual function in a sample of Iranian women with gynecologic cancers.

PURPOSE: This study aims to examine the correlation between sexual function and sexual distress, and to determine the predictive factors of sexual function and sexual distress in women with gynecologic cancers. METHODS: In this cross-sectional study, 387 subjects were referred to Velayat Hospital in Qazvin, Iran, using convenience sampling method between June and August 2016. Data were collected using a demographic questionnaire, the Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale-Revised (FSDS-R). RESULTS: Mean scores of sexual function and sexual distress were 19.4 ±â€¯6.7 and 29.2 ±â€¯12.9, respectively. There was no significant correlation between sexual function and sexual distress. Multivariate predictors of FSFI were cancer stage (p = 0.023), cancer type (p = 0.025), duration of disease (ß = -0.10, 95% CI [-0.17, - 0.02], p = 0.017) and social support (ß = 0.53, 95% CI [0.24, 0.83], p < 0.001). Predictors of FSDS-R were economic status (p = 0.040) and type of cancer (p = 0.016). There was a negative relation between the overall score on FSDS-R and FSFI sub domains of desire (ß = -1.4, p = 0.033) and arousal (ß = -2.1, p = 0.024). CONCLUSIONS: This study did not support a relation between sexual function and sexual distress. Other factors, however, including cancer type, economic status and social support may affect sexual function and sexual distress. Future studies needed to determine further factors which can affect the sexual distress and sexual function of gynecologic cancer patients.

Exploring the Relationship Between Spiritual Well-Being and Death Anxiety in Survivors of Acute Myocardial Infarction: Moderating Role of Sex, Marital Status and Social Support.

Previous empirical studies have shown that both spiritual well-being (SWB) and death anxiety (DA) significantly affect the mental health of patients with acute diseases. In this regard, our paper contributes to the extant literature by scrutinizing the conditional relationship between SWB and DA as well as the various mechanisms underpinning such a relationship in patients with acute myocardial infraction (AMI). A descriptive, correlational methodology was utilized. Our main sample consisted of 300 patients with acute myocardial infraction who were hospitalized in a specialized medical institution in Iran throughout a two-month period (i.e. August-October 2015). Patients completed Spiritual Well-Being Scale (SWBS) and Templer's Death Anxiety Scale (TDAS). Even though our study showed that the relationship between SWB and DA in patients with AMI is non-significant, we found that (1) single patients with higher SWB have lower DA, (2) single patients with higher SWB as well as social support have significantly lower DA, and (3) for single men/men without social support, there is a negative relationship between SWB and DA. The relationship between SWB and DA is influenced by factors such as sex, marital status and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences. Result revealed that although relationship between SWB and DA is non-significant, this is influenced by factors such as sex and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences.

Relationship Between Spiritual Well-Being and Hope in Patients with Cardiovascular Disease.

Spirituality and hope have been identified as important constructs in health research, since both are thought to enhance a person's ability to cope with the consequences of serious illness. The aim of this study was to examine the relationship between spiritual well-being and hope in patients with cardiovascular disease. Using descriptive, correlational methodology, the investigator gathered data on a convenience sample of 500 patients with cardiovascular disease who were hospitalized in a medical institution in Iran. The study was conducted over a four-month period. Participants completed a demographic questionnaire, the Spiritual Well-Being Scale (SWBS) and the Herth Hope Index (HHI). The mean score on the SWBS and HHI was 86.21 (SD 12.46) and 34.80 (SD 5.05), respectively. Multivariate predictors for spiritual well-being were female gender (p = 0.047), religiosity (p = 0.018), and hope (p < 0.001). Significant predictors of hope were marital status (p < 0.001), educational status (p < 0.001), economic status (p < 0.001), and spiritual well-being (p < 0.001). Findings suggest that multiple factors may impact spiritual well-being and hope. Therefore, this study has implications for those providing care to patients with cardiovascular disease.

The Factor Structure of the Spiritual Well-Being Scale in Veterans Experienced Chemical Weapon Exposure.

This study aimed to determine the factor structure of the spiritual well-being among a sample of the Iranian veterans. In this methodological research, 211 male veterans of Iran-Iraq warfare completed the Paloutzian and Ellison spiritual well-being scale. Maximum likelihood (ML) with oblique rotation was used to assess domain structure of the spiritual well-being. The construct validity of the scale was assessed using confirmatory factor analysis (CFA), convergent validity, and discriminant validity. Reliability was evaluated with Cronbach's alpha, Theta (θ), and McDonald Omega (Ω) coefficients, intra-class correlation coefficient (ICC), and construct reliability (CR). Results of ML and CFA suggested three factors which were labeled "relationship with God," "belief in fate and destiny," and "life optimism." The ICC, coefficients of the internal consistency, and CR were >.7 for the factors of the scale. Convergent validity and discriminant validity did not fulfill the requirements. The Persian version of spiritual well-being scale demonstrated suitable validity and reliability among the veterans of Iran-Iraq warfare.

Psychometric Properties of the Persian Version of Death Depression Scale-Revised in Iranian Patients with Acute Myocardial Infarction.

Objective: Limited research has examined the psychometric properties of death depression scales in Persian populations with cardiac disease despite the need for valid assessment tools for evaluating depressive symptoms in patients with life-limiting chronic conditions. The present study aimed at evaluating the reliability and validity of the Persian Version of Death Depression Scale - Revised (DDS-R) in Iranian patients who had recent acute myocardial infarction (AMI). Method: This psychometric study was conducted with a convenience sample of 407 patients with AMI diagnosis who completed the Persian version of the DDS-R. The face, content, and construct validity of the scale were ascertained. Internal consistency, test-retest, and construct reliability (CR) were used to assess reliability of the Persian Version of DDS-R. Results: Based on maximum likelihood exploratory factor analysis and consideration of conceptual meaning, a 4-factor solution was identified, explaining 75.89% of the total variance. Goodness-of-fit indices (GFI), Comparative Fit Index (CFI), Normed Fit Index (NFI), Incremental Fit Index (IFI), and Root Mean Square Error of Approximation (RMSEA) in the final DDS-R structure demonstrated the adequacy of the 4-domain structure. The internal consistency, construct reliability, and Intra-class Correlation Coefficients (ICC) were greater than .70. Conclusion: The DDS-R was found to be a valid and reliable assessment tool for evaluating death depression symptoms in Iranian patients with AMI.

Effect of Face-to-face Education, Problem-based Learning, and Goldstein Systematic Training Model on Quality of Life and Fatigue among Caregivers of Patients with Diabetes.

BACKGROUND: Education is a fundamental component for patients with diabetes to achieve good glycemic control. In addition, selecting the appropriate method of education is one of the most effective factors in the quality of life. The present study aimed to evaluate the effect of face-to-face education, problem-based learning, and Goldstein systematic training model on the quality of life (QOL) and fatigue among caregivers of patients with diabetes. MATERIALS AND METHODS: This randomized clinical trial was conducted in Hajar Hospital (Shahrekord, Iran) in 2012. The study subjects consisted of 105 family caregivers of patients with diabetes. The participants were randomly assigned to three intervention groups (35 caregivers in each group). For each group, 5-h training sessions were held separately. QOL and fatigue were evaluated immediately before and after the intervention, and after 1, 2, 3, and 4 months of intervention. RESULTS: There was a significant increase in QOL for all the three groups. Both the problem-based learning and the Goldstein method showed desirable QOL improvement over time. The desired educational intervention for fatigue reduction during the 4-month post-intervention period was the Goldstein method. A significant reduction was observed in fatigue in all three groups after the intervention (P < 0.001). CONCLUSIONS: The results of the present study illustrated that the problem-based learning and Goldstein systematic training model improve the QOL of caregivers of patients with diabetes. In addition, the Goldstein systematic training model had the greatest effect on the reduction of fatigue within 4 months of the intervention.

The relationship between anxiety, depression and risk behaviors in adolescents.

Aim Adolescence is a developmental period often associated with high-risk behaviors. While some risk-taking behavior is considered normative in adolescents, research has indicated an association between risky behaviors and mental ill-health. The current research aimed to examine the relationship between anxiety and depression with the occurrence of high-risk behaviors in adolescents and also determine the predictive factors of these main variables. Methods A descriptive, cross-sectional, correlational design was used to collect data from 399 adolescents between the ages of 14 and 19 residing in Qazvin, Iran using the Revised Child Anxiety and Depression Scale (RCADS) and the Iranian Adolescents Risk-taking Scale (IARS) between the period of October and November 2015. Data analysis included descriptive and inferential statistics powered by SPSS (v. 23). Results Mean scores for anxiety, depression and risky behaviors were 37.70 ± 21.11 and 80.76 ± 31.30, respectively. Participants' frequency of suicidal thoughts (ß = 0.126, p < 0.05) positively predicted anxiety and depression, while age (ß = -0.126, p < 0.01) and self-confidence (ß = -0.307, p < 0.001) negatively predicted anxiety and depression. Moreover, having friends that smoke (ß = 0.366, p < 0.001), suicidal thoughts (ß = 0.127, p < 0.01), and the strength of suicidal thoughts (ß = 0.100, p < 0.05) were positive predictors of occurrence of risky behaviors. Furthermore, religious belief (ß = -0.204, p < 0.001) negatively predicted occurrence of risky behaviors in Iranian adolescents. Male respondents were more likely to have higher level of occurrence of risky behaviors than females (ß = -0.193, p < 0.001). Conclusion Findings of the present study suggest that anxiety and depression positively and significantly predict the occurrence of risky behaviors in addition to having friends that smoke, suicidal thoughts, and strong suicidal thinking. The implications of these findings have relevance for screening, prevention, and treatment interventions targeting mental health in adolescents.

Effect of acupressure on pain in Iranian leukemia patients: A randomized controlled trial study.

Nonpharmacological methods of pain relief such as acupressure are becoming increasingly popular worldwide. Practitioners often claim that such methods are highly effective and less invasive than analgesic drugs, but available empirical evidence is largely inconclusive. This study aimed to test the hypothesis that, postacupressure intervention, the amount of pain experienced by sampled leukemia patients, who received acupressure in addition to standard care, will reduce substantially compared to patients who received only routine treatment. This controlled trial was undertaken with hospitalized leukemia patients between February and June 2015. Our primary sample consisted of 100 participants who were randomly allocated to 2 groups. One (intervention) group underwent 12 acupressure sessions in addition to standard treatment while the control group received no intervention apart from being given the standard treatment for leukemia. The visual analogue scale was used to measure the levels of pain experienced. No significant differences were found between the 2 groups across 12 interventions. However, each group reported significantly different pain level changes before and after each intervention, suggested that the acupressure method was effective in reducing pain in the short term. Nurses are able to apply this complementary therapy alongside other procedures to manage these patients' pain. It is recommended that further studies be conducted to better understand the specific conditions under which acupressure can provide effective pain relief.