A qualitative study exploring approaches, barriers, and facilitators of the HIV partner notification program in Kerman, Iran.

BACKGROUND: HIV partner notification services can help people living with HIV (PLHIV) to identify, locate, and inform their sexual and injecting partners who are exposed to HIV and refer them for proper and timely counseling and testing. To what extent these services were used by PLHIV and what are the related barriers and facilitators in southeast Iran are not known. So, this study aimed to explore HIV notification and its barriers and facilitators among PLHIV in Iran. METHODS: In this qualitative study, the number of 23 participants were recruited from November 2022 to February 2023 including PLHIV (N = 12), sexual partners of PLHIV (N = 5), and staff members (N = 6) of a Voluntary Counseling and Testing (VCT) center in Kerman located in the southeast of Iran. Our data collection included purposive sampling to increase variation. The content analysis was conducted using the Graneheim and Lundman approach. The analysis yielded 221 (out of 322) related codes related to HIV notification, its barriers, and its facilitators. These codes were further categorized into one main category with three categories and nine sub-categories. RESULTS: The main category was HIV notification approaches, HIV notification barriers, and facilitators. HIV notification approaches were notification through clear, and direct conversation, notification through gradual preparation and reassurance, notification due to being with PLHIV, notification through suspicious talking of the physician, and notification due to the behavior of others. Also, the barriers were classified into individual, social, and environmental, and healthcare system barriers and the facilitators were at PLHIV, healthcare staff, and community levels. Stigma was a barrier mentioned by most participants. Also, the main facilitator of HIV notification was social support, especially from the family side. CONCLUSIONS: The findings highlighted the multidimensionality of HIV notification emphasizing the importance of tailored support and education to enhance the notification process for PLHIV and their networks. Also, our results show that despite all the efforts to reduce stigma and discrimination in recent years, stigma still exists as a main obstacle to disclosing HIV status and other barriers are the product of stigma. It seems that all programs should be directed towards destigmatization.

Development and validation of the nurses sexual harassment scale in Iran.

INTRODUCTION: In recent years, the prevalence of sexual harassment has become a global problem, and nursing, like other professions, has not been immune to this issue. By having a valid and reliable instrument, healthcare personnel can be helped in preventing and managing this problem and reduce its negative consequences on mental health and well-being. The aim of this study was developing and psychometrically measuring the Nurses Sexual Harassment Scale. MATERIALS AND METHODS: This study is the second phase of a mixed method study. Initially in the first phase, a qualitative approach with conventional content analysis was used to explain nurses' experiences of sexual harassment in the workplace. To design the Nurses Sexual Harassment Scale, qualitative data and literature were reviewed. In the quantitative phase (second phase), the target scale was psychometrically evaluated using content validity (14 experts), face validity (12 nurses with being sexually harassed), construct validity (316 nurses working in hospitals affiliated to Kerman University of Medical Sciences), and reliability (internal consistency and repeatability). RESULTS: A 15-item scale with two components: "latent sexual harassment" (9 items) and "manifest sexual harassment" (6 items), which explained 68.4% of the total variance was developed. Also, due to the strong correlation between the Nurses Sexual Harassment Scale and the Impact of Event Scale-Revised (r = 0.67), convergent validity was confirmed. Also, the scale of the present study had good reliability (Cronbach's alpha coefficient = 0.94, Omega coefficient = 0.94, and ICC = 0.92). CONCLUSION: Given the importance of sexual harassment among nurses, measuring the dimensions of this problem may allow professionals to plan interventions to prevent it. Overall, the results of the present study showed that the psychometric properties of the " Nurses Sexual Harassment Scale" with 15 items are acceptable and this scale can be used in the clinical environment. A further study within the nursing community is recommended to confirm the findings.

Can internship programs affect nursing students' critical thinking disposition, caring behaviors, and professional commitment?

BACKGROUND: Nursing students are given opportunities to develop critical thinking disposition, caring behaviors, and professional commitment through clinical training. Therefore, nurse educators should move away from traditional methods toward new ones, such as internship programs in clinical training. This study assessed the effect of nursing internship programs on senior undergraduate nursing students' critical thinking disposition, caring behaviors, and professional commitment. METHODS: This quasi-experimental study was conducted using a pretest-posttest design but with no control group. The study sample included 46 senior students enrolled in nursing internship programs. A demographic questionnaire, the Critical Thinking Disposition Inventory (CTDI), the Caring Assessment Report Evaluation (Care-Q), and the Nursing Professional Commitment Scale (NPCS) were used to collect data before and five months after the nursing internship programs were implemented. RESULTS: The study findings revealed that the senior nursing students' caring behaviors improved, but the total scores of critical thinking disposition and professional commitment did not change significantly after the nursing internship programs (p > 0.05). CONCLUSION: According to the results, nurse educators are recommended to adopt strategies to improve the effectiveness of internship programs on critical thinking disposition and professional commitment among senior undergraduate nursing students.

Psychometric Evaluation of the Persian Version of Spiritual Self-Care Practice Scale in Iranian Patients with Cancer.

Spiritual self-care is defined as a set of patient-centered or family-centered spiritual activities aimed at promoting health and well-being. In chronic diseases such as cancer, the responsibility for care typically falls on the patient or their family, necessitating an accurate assessment of the patient's self-care practices to achieve this goal. The objective of this study was to translate, culturally adapt, and examine the psychometrics of the Persian version of the spiritual self-care practice scale (SSCPS) in cancer patients. This scale is designed to be administered directly to patients to assess their spiritual self-care practices. This cross-sectional study was conducted at the oncology ward in Afzalipoor Hospital, Javad Al-Aemeh Clinic, and Physicians Clinics affiliated with Kerman University of Medical Sciences in Kerman, southeast Iran. The study included qualitative and quantitative assessments of face validity, content validity, item analysis, exploratory and confirmatory factor analysis (construct validity), and reliability. Data collection took place between March 20, 2023, and December 30, 2023. The scale's content validity index was calculated to be 0.948, with mostly minor revision comments for most items. The item-content validity indices ranged from 0.7 to 1. Exploratory factor analysis revealed a five-factor solution with 23 items, explaining 61.251% of the total variance. The identified factors were labeled as 'personal and interpersonal spiritual practices,' 'shaping and strengthening relationship practices,' 'religious practices,' 'physical spiritual practices,' and 'reshaping relationship practices.' Most of the confirmatory factor analysis indices were satisfactory (χ2/df = 1.665, CFI = 0.934, IFI = 0.935, RMSEA = 0.058). The Cronbach's α coefficient for the total scale was 0.89, while it ranged from 0.596 to 0.882 for the subscales. The Persian version of SSCPS with 23 items demonstrates reliability and effectiveness in assessing the spiritual practice performance of Iranian cancer patients. Compared to the original version, the Persian adaptation of SSCPS is concise, making it a suitable instrument for future research and practice on spiritual self-care among Iranian cancer patients.

The effect of mindfulness-based stress reduction on rejection sensitivity and resilience in patients with thalassemia: a randomized controlled trial.

BACKGROUND: Thalassemia is a genetic and chronic congenital disorder composed of physical problems that severely impair patients' cognitive, psychological and social processes. The rehabilitation of patients is particularly important because they have a high rejection sensitivity and low resilience. The present study aimed to determine the effects of mindfulness-based stress reduction counseling on rejection sensitivity and resilience in patients with thalassemia referring to a dedicated disease center in Kerman, Iran. MATERIALS AND METHODS: We conducted this randomized controlled trial study on 66 patients with thalassemia referring to the Kerman Thalassemia Center in Kerman, Iran in 2022. Using convenience sampling and the stratified block randomization method, we divided the samples into two intervention (N = 33) and control (N = 33) groups. Patients in the intervention group received eight 60-min online mindfulness-based stress reduction counseling sessions (one session per week) and completed the Rejection Sensitivity Questionnaire, Adult Version (A-RSQ) and the Conner-Davidson Resilience Scale before and after the intervention. We collected data using the SPSS 25 trial and descriptive statistics (frequency, percentage, mean and standard deviation), Chi-Square test, Independent-samples t-test, Fisher's exact test, and Analysis of covariance. A significance level of 0.05 was considered. RESULTS: We found no significant difference in the mean scores of rejection sensitivity between the intervention (8.75 ± 4.86) and control groups (9.87 ± 5.16) before the intervention. Mean scores for rejection sensitivity were 10.23 ± 4.94 in the control group and 7.11 ± 4.13 in the intervention group after the intervention, the results of analysis of covariance showed that, there was a significant difference between two groups after the intervention (F = 7.52, p = 0.008). The mean resilience score in the control group was 63.69 ± 19.43, while it was 67.72 ± 17.98 in the intervention group before the intervention and there is no significant difference between them, but the mean resilience scores in the control and intervention groups were 58.06 ± 22.81 and 74.18 ± 17.46 after the intervention, respectively. the results of analysis of covariance showed that, there was a significant difference between two groups after the intervention (F = 9.28, p = 0.004). CONCLUSION: Our results showed that in addition to other physical treatments, mindfulness-based stress reduction counseling was effective in reducing the patient's rejection sensitivity and increasing the resilience of patients with thalassemia.

Anxiety, self-efficacy, and their determinants in school students during the COVID-19 pandemic: a survey in Southeastern Iran.

BACKGROUND: The COVID-19 pandemic has been linked to various psychological disorders, including anxiety, particularly among the general public. It is crucial to monitor the mental health of school students, who are considered a vulnerable group in society, and assess their self-efficacy, as it can significantly affect their mental health. This study aimed to investigate the levels of anxiety and self-efficacy among school students during the COVID-19 pandemic. METHODS: This cross-sectional study utilized convenience sampling to examine a sample of 335 school students from Sistan and Baluchestan province in southeastern Iran. An online questionnaire, distributed through social media platforms, was used to collect data. The questionnaire included demographic information, COVID-19 related items, the Multidimensional Anxiety Scale for Children-MASC, and the Self-Efficacy Questionnaire for Children-SEQ-C. Data analysis was conducted using IBM SPSS version 24, with a significance level set at < 0.05. RESULTS: The study revealed a significant negative correlation between children's anxiety and self-efficacy (r = -0.23, P < 0.001). Several factors were identified as predictors of anxiety, including low self-efficacy (ß = -0.29, P < 0.001), female gender (ß = 0.27, P < 0.001), concern about family members contracting COVID-19 (ß = 0.18, P < 0.001), persistent advice of others to adopt preventive measures (ß = 0.14, P < 0.005), level of education (ß = -0.12, P < 0.017), and perceived risk of COVID-19 infection (ß = -0.11, P < 0.030). These variables collectively accounted for 17% of the variance in anxiety. CONCLUSION: The findings of the study highlight the importance of addressing the mental health of school students, specifically their anxiety levels, during epidemics. The results also indicate that enhancing self-efficacy among students during a pandemic could be a beneficial strategy for promoting their mental health.

Hospital challenges and managerial approaches to combat COVID-19 outbreak: a qualitative study in southeastern Iran.

BACKGROUND: During the covid-19 pandemic, hospitals have faced several challenges, so they need to identify and address effective management strategies to cope with these challenges that enhance their current knowledge to deal with similar challenges in the future. This study aimed to identify managerial strategies for dealing with Covid-19 pandemic challenges at a hospital in southeastern Iran. METHODS: This qualitative content analysis study used purposive sampling to select eight managers, three nurses, and one worker from Shahid Bahonar Hospital. In this study, semi-structured interviews were used to collect data and Lundman and Graneheim's approach was used to analyze them. RESULTS: Three hundred fifty codes remained after constant comparison, compression, and merging. The results demonstrated one theme "Managerial reengineering in the healthcare system during the Covid-19 crisis", two main categories, seven subcategories and, 19 sub- subcategories. The first main category was "The difficulty of managing challenges," including "Insufficient resources and physical space", "Socio-organizational challenges" and, "Incompetence and unpreparedness of managers." The second main category was "Reforming the management duties." This category included "Planning and decision-making," "Organization," "Leadership and motivation," and "Monitoring and control." CONCLUSIONS: Hospitals and managers were less prepared to cope with the Covid-19 crisis challenges due to health system organizations' less attention to biological crises. Healthcare organizations can carefully evaluate these challenges, and the strategies managers adopt to deal with these problems. They also can identify the strategies' strengths and weaknesses and propose more effective strategies. As a result, healthcare organizations will be better prepared for similar crises.

The relationship between nurses' psychological resilience and job satisfaction during the COVID-19 pandemic: a descriptive-analytical cross-sectional study in Iran.

BACKGROUND: Job satisfaction and factors affecting them are among the most important social issues. Resilience has a moderating role in the relationship between stress and diseases, so it can affect a person's job satisfaction because it enables a person to deal with adverse conditions. This study aimed to investigate the relationship between nurses' psychological resilience and job satisfaction during the COVID-19 outbreak. METHODS: This descriptive-analytical cross-sectional study (2022) used convenience sampling to select 300 nurses. The Connor and Davidson Resilience Scale and Minnesota Satisfaction Questionnaire were used to collect data. The data were then analyzed with SPSS 22 and statistical methods (Independent t-test, Analysis of Variance, Pearson correlation coefficient, and Multiple linear regression). RESULTS: The study results showed a positive and poor relationship between resilience, some of its dimensions (trust in individual instincts, tolerance of negative affect (p = 0.006), positive acceptance of change and secure relationships (p = 0.01), spiritual influences (p = 0.04)) and job satisfaction (p < 0.001). In other words, nurses' high level of resilience increased their job satisfaction and vice versa. CONCLUSIONS: Enhancing the resilience of frontline nurses during the COVID-19 pandemic improved their job satisfaction and affected care provided by them. Nurse managers can control nurses' resilience and offer interventions that would strengthen it, especially at crises.

Nurses' clinical competency and its correlates: before and during the COVID-19 outbreak.

BACKGROUND: Clinical competency is the ability to integrate knowledge, skills, attitudes and values into a clinical situation and it is very important in nursing education, clinical settings, nursing management, and crises. This study aimed to investigate nurses' professional competence and its correlates before and during the COVID-19 pandemic. METHODS: We conducted this cross-sectional study before and during the COVID-19 outbreak and recruited all nurses working in hospitals affiliated to Rafsanjan University of Medical Sciences, southern Iran, so we included 260 and 246 nurses in the study before and during the COVID-19 epidemic, respectively. Competency Inventory for Registered Nurses (CIRN) was used to collect data. After inputting the data into SPSS24, we analysed them using descriptive statistics, chi-square and multivariate logistic tests. A significant level of 0.05 was considered. RESULTS: The mean clinical competency scores of nurses were 156.97 ± 31.40 and 161.97 ± 31.36 before and during the COVID-19 epidemic, respectively. The total clinical competency score before the COVID-19 epidemic was not significantly different from that during the COVID-19 epidemic. Interpersonal relationships (p = 0.03) and desire for research/critical thinking (p = 0.01) were significantly lower before the COVID-19 outbreak than during the COVID-19 outbreak. Only shift type had an association with clinical competency before the COVID-19 outbreak, while work experience had an association with clinical competency during the COVID-19 epidemic. CONCLUSION: The clinical competency among nurses was moderate before and during the COVID-19 epidemic. Paying attention to the clinical competence of nurses can improve the care conditions of patients, and nursing managers should improve the clinical competence of nurses in different situations and crises. Therefore, we suggest further studies identifying factors improving the professional competency among nurses.

Is nurses' clinical competence associated with their moral identity and injury?

BACKGROUND: The enhancement of nursing care quality is closely related to the clinical competence of nurses, making it a crucial component within health systems. OBJECTIVE: The present study investigated the relationship between nurses' clinical competence, moral identity, and moral injury during the COVID-19 outbreak. RESEARCH DESIGN: This cross-sectional study was carried out among frontline nurses, using the Moral Identity Questionnaire (MIQ), the Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP), and the Competency Inventory for Registered Nurse (CIRN) as data collection tools. PARTICIPANTS: and research context: The research population for this study consisted of all frontline nurses (n = 251) employed in a hospital in southern Iran. Sampling was conducted between May 1, 2021 and September 30, 2021, during the COVID-19 outbreak. ETHICAL CONSIDERATIONS: The present study received approval from the research ethics committee of Rafsanjan University of Medical Sciences, with project No. 99267 and code of ethics ID No. IR. RUMS.REC.1399.262, dated 15.02.2021. RESULTS: According to the study findings, 42.2% of the nurses demonstrated high clinical competence, while 51.4% exhibited moderate clinical competence. The results indicated a positive correlation between moral identity and clinical competence but a negative correlation between moral injury and clinical competence. Furthermore, the variables of moral identity and moral injury were found to predict 10% of the variance in clinical competence. CONCLUSION: According to the results, moral identity and moral injury had an impact on the clinical competence of nurses. Therefore, implementing a program aimed at enhancing moral identity and providing training strategies to address moral injury during crises like the COVID-19 pandemic can lead to improvements in nurses' clinical competence and the overall quality of care they provide.

Muscle strength/intensive care unit acquired weakness in COVID-19 and non-COVID-19 patients.

BACKGROUND: Intensive care unit acquired weakness (ICU-AW) affects both coronavirus disease 19 (COVID-19) and non-COVID-19 patients. ICU-AW can result in a variety of consequences, including increased patient mortality. AIMS: The current study aimed to compare muscle strength and ICU-AW in COVID-19 and non-COVID-19 patients. STUDY DESIGN: This was a cross-sectional, descriptive-analytical pilot study. METHODS: Fifteen conscious COVID-19 patients and 15 conscious non-COVID-19 patients admitted to the ICUs of a public hospital were selected by convenience sampling. Muscle strength in arms and legs was assessed by a hand-held dynamometer (HHD), and ICU-AW was measured with the medical research council sum score (MRC-SS) scale on the first, fourth, and seventh days of admission to ICUs. RESULTS: The results showed that muscle strength in the arms and legs of the COVID-19 patients assessed by a HHD and MRC was significantly lower than that of non-COVID-19 patients. On the fourth day of ICU admission, 80% of the COVID-19 patients and 40% of the non-COVID-19 patients had ICU-AW. All COVID-19 patients and 86.8% of the non-COVID-19 patients had ICU-AW on the seventh day of ICU admission. CONCLUSIONS: Decreased muscle strength and ICU-AW are more likely in COVID-19 patients who must stay in the ICU compared with non-COVID-19 patients. RELEVANCE TO CLINICAL PRACTICE: Health systems should plan to provide rehabilitation facilities for COVID-19 patients and prevent prolonged complications of COVID-19.

The Effect of Acupressure and Cryotherapy on the Pain of Patients on Hemodialysis During Arteriovenous Fistula Cannulation: A Randomized Crossover Clinical Trial.

Various pharmacological and non-pharmacological measures are used to reduce pain of patients on hemodialysis during an arteriovenous fistula (AVF) cannulation. In this randomized, crossover clinical trial, 39 patients randomly received acupressure and cryotherapy. In cryotherapy, an ice cube was used to massage the Hegu point in the hand without the fistula for 10 minutes before AVF cannulation. In acupressure, a moderate pressure with the thumb was applied. The pain score was mild after cryotherapy and acupressure, with no significant difference between the two methods. In addition, acupressure significantly reduced pain compared with routine care, but cryotherapy did not significantly reduce pain compared with routine care. Pain intensity was mild after acupressure and cryotherapy, and neither of these two methods was preferred over the other to reduce the pain during AVF cannulation.

Development and Validation of the Nurses' Spiritual Sensitivity Scale in Southeastern Iran.

Spiritual sensitivity refers to awareness and perception of the attitudes and feelings of others and helps nurses to recognize and take responsibility for the spiritual values and needs of patients. The dimensions of spiritual sensitivity remain unknown as there is no comprehensive and standardized scale for assessing nurses' spiritual sensitivity; therefore, the current research aimed to design and validate the nurses' spiritual sensitivity scale. We conducted this exploratory sequential study using eight stages suggested by DeVellis (2016) when developing the scale. We conducted this study among Iranian nurses from March 2021 to October 2022. Results suggested a 20-item scale with two components (nurses' professional spiritual sensitivity and nurses' internal spiritual sensitivity) that explained 57.62% of the total variance extracted. We were able to confirm convergent validity based on an acceptable correlation between the nurses' spiritual sensitivity scale and the King's spiritual intelligence scale (r = 0.66), which showed good stability (cronbach's alpha coefficient = 0.927, omega coefficient = 0.923, and icc = 0.937). Spiritual sensitivity in nurses is difficult to evaluate. Considering the acceptability of the psychometric properties of the "Nurses' spiritual sensitivity" scale, this scale can be used in clinical environments to evaluate nurses' spiritual sensitivity. Therefore, it is suggested that managers and policy makers should consider developing related guidelines to help nurses to become more spiritually sensitive and also to meet the spiritual needs of patients. We suggest further studies to confirm the study results in the nursing community.

Moral Injury and its Correlates among Iranian Nurses in the Second Year of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study.

The COVID-19 pandemic has been associated with various health-related issues among nurses, including mental health problems such as moral injury. This study aimed to evaluate the relationship between moral injury, general health, post-traumatic stress disorder (PTSD), and type of hospital among Iranian nurses working in different clinical settings during the COVID-19 outbreak. This cross-sectional study employed convenience sampling to recruit 334 nurses working in various clinical settings, including teaching and referral hospitals, in Kerman, Southeastern Iran from October 2021 to February 2022. The study used three measures, including the General Health Questionnaire (GHQ-12), the Impact of Event Scale-Revised (IES-R), and The Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP). Data analysis was conducted using SPSS25. The results indicated that moral injury was highly prevalent among Iranian nurses, with 47% of the participants reporting experiencing it. A total, 26.9% of the participants reported experiencing mental health disorders and 57.2% of the participants reported experiencing this disorder. Significant correlations were found between moral injury, general health, and PTSD. Specifically, moral injury levels were higher among female nurses with a history of mental disorders and those designated to treat all kinds of cases, compared to other participants. The results suggest that Iranian nurses are at a high risk of experiencing moral injury during the COVID-19 pandemic. Policymakers and health authorities should establish related health educational programs, provide counseling services to promote general health, and pay particular attention to moral injury and PTSD. Additionally, nurse educators should integrate materials related to moral injury into the nursing curriculum.

Fear of Cancer Recurrence and COVID-19 Anxiety Among Cancer Survivors: A Cross-Sectional Study in Southeast Iran.

Cancer survivors face numerous therapeutic and health challenges during the COVID-19 epidemic. These patients experience high levels of anxiety and stress due to illness, external stresses, and crises, such as the COVID-19 epidemic. The present study showed a positive relationship between FCR and COVID-19 anxiety as well as moderate levels of FCR (according to the midpoint score of the questionnaire) and COVID-19 anxiety among cancer survivors. Factors affecting the mental condition of cancer survivors can play an important role in completing treatment and preventing disease exacerbation.

COVID-19 cases, hospitalizations and deaths after vaccination: a cohort event monitoring study, Islamic Republic of Iran.

Objective: To investigate the incidence of coronavirus disease 2019 (COVID-19) cases, hospitalizations and deaths in Iranians vaccinated with either AZD1222 Vaxzevria, CovIran® vaccine, SARS-CoV-2 Vaccine (Vero Cell), Inactivated (lnCoV) or Sputnik V. Methods: We enrolled individuals 18 years or older receiving their first COVID-19 vaccine dose between April 2021 and January 2022 in seven Iranian cities. Participants completed weekly follow-up surveys for 17 weeks (25 weeks for AZD1222) to report their COVID-19 status and hospitalization. We used Cox regression models to assess risk factors for contracting COVID-19, hospitalization and death. Findings: Of 89 783 participants enrolled, incidence rates per 1 000 000 person-days were: 528.2 (95% confidence interval, CI: 514.0-542.7) for contracting COVID-19; 55.8 (95% CI: 51.4-60.5) for hospitalization; and 4.1 (95% CI: 3.0-5.5) for death. Compared with SARS-CoV-2 Vaccine (Vero Cell), hazard ratios (HR) for contracting COVID-19 were: 0.70 (95% CI: 0.61-0.80) with AZD1222; 0.73 (95% CI: 0.62-0.86) with Sputnik V; and 0.73 (95% CI: 0.63-0.86) with CovIran®. For hospitalization and death, all vaccines provided similar protection 14 days after the second dose. History of COVID-19 protected against contracting COVID-19 again (HR: 0.76; 95% CI: 0.69-0.84). Diabetes and respiratory, cardiac and renal disease were associated with higher risks of contracting COVID-19 after vaccination. Conclusion: The rates of contracting COVID-19 after vaccination were relatively high. SARS-CoV-2 Vaccine (Vero Cell) provided lower protection against COVID-19 than other vaccines. People with comorbidities had higher risks of contracting COVID-19 and hospitalization and should be prioritized for preventive interventions.

Quality of life in terminally ill cancer patients: what is the role of using complementary and alternative medicines?

BACKGROUND AND PURPOSE: Cancer is the world's second greatest cause of mortality and a leading cause of death in both developed and developing countries. Patients employ a number of complementary and alternative medicine (CAM) methods to deal with the problems and difficulties of cancer, which can have an impact on their quality of life (QOL). The aim of the present study was to assess the correlation between QOL and the use of different CAM methods in terminally ill cancer patients. METHODS: This was a cross-sectional study. In southern Iran, 238 individuals with advanced cancer were studied in oncology centers and doctors' offices. During the months of January to August 2021, patients were selected using convenience sampling. A demographic information questionnaire, the EORTC core quality of life questionnaire, and the CAM questionnaire were used to collect data. RESULTS: The results showed that terminally ill cancer patients had a good quality of life. Last year, 85.7% of participants used at least one kind of CAM. Furthermore, 45.4% of participants used only one form of CAM, 30.3% used two types of CAM, 6.7% used three types of CAM, and 3.4% used four to five types of CAM. When all CAM users were compared to non-CAM users, CAM users had significantly higher social QOL and overall quality of life. Two subscales of QOL symptoms and function were correlated with cancer history, income, and use of CAMs, and the scores of QOL symptoms and function were greater in CAM users compared to non-CAM users. Among all the study variables, only the usage of CAM was correlated to overall QOL among terminally ill cancer patients. CONCLUSION: The current study found that using CAM could affect different aspects of QOL in terminally ill cancer patients. As a result, it is feasible that using CAM could help these people enhance their health and QOL.

Postpartum depression and its correlates: a cross-sectional study in southeast Iran.

BACKGROUND: Postpartum depression has a negative impact on both infants and women. This study aimed to determine the correlates of postpartum depression in women in southern Iran. METHODS: This cross-sectional study was performed on 186 mothers who had recently given birth to a baby. Data were collected using the demographic form, Quality of Prenatal Care Questionnaire, Edinburgh Postnatal Depression Scale (EPDS), Depression, Anxiety and Stress Scale-21 items (DASS-21) 3 days after delivery and EPDS and DASS-21 6 months after childbirth. RESULTS: Postpartum depression (PPD) was 24.2% and 3.2% 3 days and 6 months after delivery, respectively. Anxiety, Prenatal Care Quality and educational level predicted 34.0% of the variance of PPD 3 days after delivery (R2 = 34.0%). Anxiety, type of delivery, and stress predicted 24% of the variance of PPD 6 months after delivery (R2 = 24.0%). CONCLUSIONS: With an increase in stress and anxiety and a reduction in the quality of prenatal care, the risk of postpartum depression increases. Therefore, attention to the quality of prenatal care and postpartum stress and anxiety should be carefully evaluated to prevent PPD. Psychological support and interventions are recommended to promote the mental health of women before and after childbirth.

Iranian psychosocial status and its determinant factors during the prevalence of COVID-19 disease.

COVID-19 disease has quickly become a major threat and epidemic in the world. Many people are experiencing psychological disorders due to the rapid spread of the COVID-19 disease. The present study aimed to investigate the psychosocial status of the Iranian citizens during the prevalence of COVID-19. One thousand one hundred and sixteen citizens of Rafsanjan city participated in the cross-sectional study from March 15 to 30, 2020. The data were collected using demographic and COVID-19 related-items, and Health General Questionnaire (GHQ -28). The results showed that 35% of the participant had mental health problems. All participants had social functioning disorder, while 22.8% had physical symptoms, 26.8 had anxiety symptoms and sleep disorders. In addition, the risk of psychosocial disorder was higher in females, those who were living in the city, earning less than 1 million, thinking of being at risk for infection with the coronavirus, and those whose most important concern about COVID-19 was death (P < 0.05). The results of the present study showed that all participants had social dysfunction. Therefore, health-care providers are suggested to evaluate the psychosocial consequences routinely, design and implement appropriate interventions to deal with these complications.

Death at home: Iranian nurses', cancer patients', and family caregivers' attitudes.

It is important to facilitate death at a place that is in accord with dying patients' preferences. To see if nurses and family members agreed with patients themselves, we asked about attitudes toward death at home of 96 nurses working in oncology departments, 274 cancer patients, and 278 family caregivers in southeastern Iran. Most of the participants saw death at home as a good way of dying and preferred patients to spend their end-of-life days at home. This study supports the argument that providing hospice home care services for terminally ill patients with cancer may facilitate a preference of home death.