Designing and validating of a questionnaire measuring perceived self-care ability (PSCA) in chronic stroke patients at home.

BACKGROUND: Patients with a stroke often cannot care for themselves after hospital discharge. Assessment of their self-care ability is the first step in planning post-discharge home care. This study aimed to design and validate a measure of perceived self-care ability (PSCA) in stroke patients. METHODS: A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2020-2021. The qualitative phase involved in-depth semi-structured interviews with 12 participants. Transcripts were content analyzed. The results guided the development of 81 items. psychometric properties such as face validity (Impact Score > 1.5), content validity ratio (CVR > 0.63), content validity index (Item Content Validity Index: ICVI > 0.78, Scale Content Validity Index/Average: SCVI/Ave > 0.8) and Kappa value (Kappa > 0.7), internal consistency (Cronbach's alpha > 0.7), relative reliability (ICC: inter class correlation coefficient), absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0.4-0.7), interpretability, responsiveness, feasibility, and ceiling and floor effects were assessed. RESULTS: Content analysis of the qualitative interviews yielded 5 major categories and 9 subcategories that reflected "Perceptual stability", "Cognitive fluctuations", "Sensory, Motor and Physical health"," The subjective nature" and "The dynamic nature" of PSCA. Results of face and content validity reduced the number of items to 32, capturing three dimensions of PSCA in chronic stroke patients; these dimensions included perceptual ability, threatened health status, and sensory, motor, and cognitive ability. The findings supported the reliability and validity of the measure. CONCLUSIONS: The PSCA questionnaire was developed and validated within the Iranian culture. It is useful in assessing the self-care of patients with stroke and in informing practice.

Factors affecting support: experiences of Iranian older spousal caregivers of people with Alzheimer's disease and their support resources.

OBJECTIVES: Older spouses are a significant part of family caregivers of patients with Alzheimer's disease (AD) and need support. Evidence suggests that different factors influence the support of older spousal caregivers. However, there is little evidence about these factors in developing countries like Iran. This study aimed to identify the factors affecting the support of Iranian older spousal caregivers of people with AD. METHOD: This qualitative study used Graneheim and Lundman's conventional content analysis approach. Through purposive sampling, 10 caregivers, three family members, and three professionals were recruited from various cognitive clinics and centers. In-depth and semi-structured interviews were used to collect data and continued until conceptual saturation was achieved. RESULTS: Two themes were derived from the data as factors affecting support, which included (1) caregiver's support-seeking (complexity of the patient's condition, caregiver's geriatric health, the burden of caring for a spouse with AD, marital bond quality, caregiver's support-phobic beliefs, caregiver's awareness of care) and (2) capacities of support resources (supportive family, supportiveness of society, formal systems' capability to provide support services). CONCLUSION: The present study provided practical information about the factors influencing the support of older spousal caregivers. Healthcare providers and policymakers can use these concepts to improve the support process by strengthening caregivers' support-seeking motivation and enhancing capacities in support resources.

Designing a Spiritual Health Model for the Muslim Elderly Living in Nursing Homes.

The spiritual health of elderly residents in nursing homes is an essential aspect of their overall health that has been overlooked. There are no specific practical models available in this area. Therefore, the present study aimed to design a model to promote the spiritual health of Muslim elderly residents in nursing homes. This qualitative study is part of a larger study conducted in Iran in 2021 to design a model for the spiritual health of elderly residents in nursing homes in Islamic countries. The first part of the study was conducted using a qualitative method and a grounded theory approach. In the second part, using the findings of the qualitative stage and the theoretical production approach of Walker and Avant (2011), which includes three stages of determining central concepts, reviewing texts, and organizing concepts and statements within a relevant whole, a model for the spiritual health of elderly residents in nursing homes was designed. The resulting model includes assumptions, concepts, objectives, and operational strategies. Some crucial strategies of this model include improving social and organizational infrastructure, spiritual needs assessment, improving the structure and facilities of nursing homes, providing spiritual support, empowering nurses, likewise caregivers, and monitoring and evaluating corrective spiritual care. This model can provide a framework for enhancing the spiritual health of elderly Muslim residents in nursing homes by emphasizing improving the social structure and elderly care centers, assessing spiritual needs, providing spiritual support, and evaluating implemented measures.

Challenges in addiction-affected families: a systematic review of qualitative studies.

BACKGROUND: The relative paucity of research on Addiction-Affected Families' (AAF) issues and the lack of attention given to their difficulties and treatment in interventions and clinical practices indicate that the primary focus consistently revolves around individuals with addictive disorders, even when the treatment process involves their families. However, it is believed that family members endure significant pressures that result in extensive negative consequences on the personal, familial, and social aspects of their lives. Aiming for a better understanding of the challenges and issues that AAF's experience, this systematic review explored qualitative studies with a focus on the impact of addiction on different aspects of families. METHODS: We searched Research Gate, Scopus, Web of Science, ProQuest, Elsevier, and Google Scholar Databases. We included studies of qualitative design which have investigated the effects of addiction on families. Non-English language studies, medical views, and quantitative approaches were excluded. Participants in the selected studies included parents, children, couples, sisters/brothers, relatives, drug users and specialists. The data from the selected studies were extracted using a standard format for the systematic review of qualitative research (the National Institute of Health and Care Excellence [NICE] 2102a). RESULTS: A thematic analysis of the findings of the studies identified 5 main themes: 1) initial shock (family encounter, searching for why), 2) family in the fog (social isolation, stigma and label), 3) sequence of disorders (emotional decline, negative behavioral experiences, mental disturbance, physical degeneration, family burden), 4) internal family chaos (instability of relationships, shadow people, erosive confrontation with the drug-using member, a newly emerging member, collapsing system, financial collapse), and 5) self-protection (attracting information, support, and protective sources, coping and adjusting the effects, the emergence of spirituality). CONCLUSION: This systematic review of qualitative research highlights the various and complex issues which addiction-affected families go through in terms of financial, social, cultural, mental and physical health problems, as a result of which experts of the field are needed to investigate and take measures. The findings can inform policy and practice and the development of interventions aimed to lighten the burdens which addiction-affected families carry.

Instability of emotional relationships and suicide among youth: a qualitative study.

BACKGROUND: Interpersonal problems are one of the factors for understanding the complex issues that result in suicide attempts and self-injury by poisoning. The quality of familial relationships is a predictor of the occurrence and outcome of suicide attempts. This study aimed to explore motives for self-poisoning suicide attempts amongst young adults. METHOD: This research was a qualitative study conducted using semi-structured interviews in 2019 in Kermanshah Province, Iran. Eighteen participants who had attempted suicide by self-poisoning were interviewed, and information was collected until data saturation was achieved. The interviews were recorded and transcribed, and the data were analyzed through content analysis. RESULTS: The results included the category of instability in emotional relationships with the three sub-categories of 1- Emotional failure, 2- Emotional trauma, and 3- Loss of emotional resilience (caused by emotional failure and emotional trauma within the previous few months). Instability in emotional relationships creates feelings of disgrace, humiliation, burdensomeness, worthlessness, and insignificance, which increases the chances of attempting suicide. CONCLUSION: The study results provided an in-depth understanding of romantic, and unstable familial relationships as a significant factor in suicide attempts, demonstrating the role of emotional stress in attempting suicide. The present study provided information on the risk factors and warning signs for psychiatrists and nurses dealing with suicidal patients to take effective measures to prevent suicide through social support.

The barriers to family-centered care in the pediatric rehabilitation ward: A qualitative study.

BACKGROUND: Family-centered care (FCC) is one of the fundamental principles of care provision to children with disability (CWD). It is based on the collaboration of healthcare providers, patients, and families. However, there is limited information about the barriers to FCC in pediatric rehabilitation settings in Iran. This study aimed at exploring the barriers to FCC in the pediatric rehabilitation ward. METHODS: This descriptive qualitative study was conducted in 2022. Participants were nine rehabilitation staff and twelve mothers of hospitalized CWD purposively selected from the pediatric rehabilitation ward of hospital Rofeideh, Tehran, Iran. Rehabilitation staff were three nurses, a head nurse, a nursing manager, a medical specialist, a social worker, a physical therapist, and an occupational therapist. Eleven semi-structured interviews and three focus group discussions were conducted for data collection, and conventional content analysis proposed by Graneheim and Lundman (2004) was used for data analysis. RESULTS: The three main categories of the barriers to FCC in the pediatric rehabilitation ward were family-related barriers (subcategories: knowledge about child rehabilitation, sociocultural background, and participation), staff-related barriers (subcategories: knowledge, ethical concerns, and collaboration), and organizational barriers (subcategories: factors related to FCC policies, managerial factors, environmental factors, and factors related to the coronavirus disease 2019 pandemic). CONCLUSION: The barriers to FCC in the pediatric rehabilitation ward are very diverse due to the long-term course of child disability and long-term interaction of families with rehabilitation centers. Data collection from both families and rehabilitation staff helped acquire an in-depth understanding about these barriers. More in-depth explorations of family-related barriers such as sociocultural factors are essential to determine the reasons for family resistance to healthcare providers' recommendations to develop more effective care plans.

Culture of discrimination in healthcare: A grounded theory.

BACKGROUND: Discrimination in health care is an international challenge and a serious obstacle to justice and equality in health. RESEARCH OBJECTIVE: The purpose of this study was to design a grounded theory of discrimination in health care based on the experiences and perceptions of Iranian healthcare providers and patients. RESEARCH DESIGN: This qualitative study was conducted using by the grounded theory method. PARTICIPANTS AND RESEARCH CONTEXT: Data were collected through semi-structured interviews with 18 healthcare providers including 11 nurses, two physicians, two nurse's assistants, and three patients in two general hospitals in Tehran, Iran. Participants were selected through purposeful sampling and analyzed simultaneously using the Corbin and Strauss (2015) approach. ETHICAL CONSIDERATIONS: The study was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (Ethics code: IR.USWR.REC.1398.023). Also, after explaining the objectives of the study, all the participants completed and signed the written consent form. FINDINGS: The "culture of discrimination" was the study's core category, reflecting the nature of discrimination in health care. The theory of "culture of discrimination in health care" is the result of five main categories: "individual social stimuli," "culture of discrimination," "unintentional discrimination," "conflict with discrimination," and "dissatisfaction with discriminatory behavior." These categories cover the underlying factors, strategies, and outcomes of the discrimination process in health care. DISCUSSION: The results of the study showed that nurses and other health care providers experience unintentional discrimination. Unintentional discrimination refers to discriminatory behaviors and practices of health care providers. CONCLUSION: The theory of culture of discrimination in health care can be used as a practical guide to describe and understand the role of health care providers, especially nurses. Further studies with a quantitative approach to applying this theory in medical settings are recommended.

Spiritual Needs of the Muslim Elderly Living in Nursing Homes: A Qualitative Study.

Paying attention to and meeting the needs of people who are elderly helps to improve their health. Caring for the elderly includes addressing their spiritual needs which has been less investigated. This study aimed to examine the spiritual needs of the Muslim elderly living in nursing homes. A qualitative study was conducted using conventional content analysis. Seventeen elderly people (nine women and eight men) were selected from four nursing homes in Iran using purposive sampling. The subjects were asked to participate in semi-structured interviews. The interview transcripts were analyzed using content analysis. First, semantic units were identified and then related codes were extracted and classified into categories and subcategories based on their similarities. Finally, themes were extracted from the data. The elderly's spiritual needs were classified into three main themes: religious needs, existential needs, and communication needs. Religious needs were divided into religious beliefs, individual religious practices, and collective religious practices. Existential needs were categorized as meaning of life, purpose of life, and need for peace. Communication needs were conceptualized to include relationship with God and relationship with others. It is argued that caregivers of the elderly should recognize the elderly's spiritual needs, including religious, existential, and communication needs, and attempt to maintain and promote the elderly's spiritual health.

Nurses' experiences of the causes of their lack of interest in working in psychiatric wards: a qualitative study.

BACKGROUND: The shortage of psychiatric nurses is a major healthcare challenge. Lack of interest (LOI) contributes to the shortage of psychiatric nurses. Nonetheless, there are limited studies in this area. The present study was conducted to explore nurses' experiences of the causes of their LOI in working in psychiatric wards. METHODS: This qualitative study was conducted in 2016-2019 using the content analysis approach. Participants were 27 nurses purposively recruited with maximum variation from the psychiatric wards of three referral hospitals in Iran. Data were collected via unstructured interviews and were concurrently analyzed using the conventional content analysis approach recommended by Graneheim and Lundman. RESULTS: The causes of participants' LOI in working in psychiatric wards were grouped into three main categories, namely inadequate professional skills for psychiatric care practice, negative public attitude towards psychiatric nurses, and concerns over patients. CONCLUSION: This study suggests that the causes of nurses' LOI in working in psychiatric wards are not only personal, but also social and organizational. Findings help managers and authorities develop strategies to increase psychiatric nurses' interest in working in psychiatric wards through improving their work conditions and professional knowledge and skills.

Rehabilitation of children with cochlear implant in Iran: A scoping review.

Background: Recovery of children does not appear on its own after cochlear implantation. Coherent, thoughtful, and comprehensive rehabilitation is needed to achieve complete success. The purpose of this study was to identify the types of rehabilitation interventions for children with cochlear implants that have been performed in Iran. Methods: A scoping review study was conducted. An electronic search was carried out both in English and Persian. In English, the following keywords were used: cochlear implantation, child, cochlear implants, auditory rehabilitation, deaf, hearing loss, comprehensive, interventions, rehabilitation, and telerehabilitation and a combination of them in ProQuest, PubMed, Science Direct, and Scopus databases, Web of Sciences, Medline and Embase. Persian electronic search was conducted in the Scientific Information Database (SID) of Jihad Daneshgahi, Iran Journals Database (MagIran), and Islamic World Science Citation Database (ISC). Searches were done using articles published until September 25, 2020, and a total of 902 articles were found, of which 14 were directly related to the purpose of the study. Interventional studies were included in the study, and the quality of studies was measured using the Structured Effectiveness Quality Evaluation Scale. Results: The results showed that using music and rehabilitation equipment, different methods of speech therapy and auditory training, story-based instruction, creative play, family-centered instruction, and occupational therapy are interventions in cochlear implant rehabilitation. Speech therapy accounts for 54% of the rehabilitation share. The mean number of rehabilitation sessions was 26. These interventions were all somehow effective in children with cochlear implantation; the longer the training duration, the better the results. Conclusion: The process of cochlear implant rehabilitation in children is multi-professional; auditory training and speech therapy possesses the highest share of rehabilitation. Therefore, it is recommended to develop speech therapy centers in Iran.

Iranian nurses' perceptions about using physical restraint for hospitalized elderly people: a cross-sectional descriptive-correlational study.

BACKGROUND: Using physical restraint (PR) for hospitalized elderly people is a major nursing challenge. It is associated with different physical and mental complications and ethical dilemmas, though many nurses still use it to ensure patient safety. Nurses' perceptions are one of the most important factors affecting PR use. This study aimed to evaluate Iranian nurses' perceptions about PR use for hospitalized elderly people. METHODS: This cross-sectional descriptive-correlational study was conducted from July to December 2019. Participants were 270 hospital nurses who were purposively recruited from intensive care units and medical and surgical wards of three teaching hospitals in Kermanshah, Iran. Data were collected using a demographic questionnaire and the Perceptions of Restraint Use Questionnaire (PRUQ). The SPSS software (v. 23.0) was used for data analysis through the independent-sample t test, the one-way analysis of variance, and the multiple regression analysis. RESULTS: The total mean score of PRUQ was 4.08 ± 0.12 in the possible range of 1-5. The most important reasons for PR use were to prevent patients from falling out of bed and to prevent them from pulling out catheters. The total mean score of PRUQ had significant relationship with participants' age, work experience, and history of receiving PR-related educations (P < 0.05), but had no significant relationship with their gender, educational degree, and affiliated hospital ward (P > 0.05). CONCLUSION: This study suggests that nurses attach high importance to PR use for hospitalized elderly people. Healthcare policy-makers at national and hospital levels are recommended to provide nurses with PR-related educations in order to reduce the rate of PR-related complications.

Antecedents and consequences of workplace violence against nurses: A qualitative study.

AIMS AND OBJECTIVES: To explore Iranian nurses' perceptions of and experiences with the antecedents and consequences of workplace violence perpetrated by patients, patients' relatives, colleagues and superiors. BACKGROUND: Workplace violence against nurses is a common problem worldwide, including in Iran. Although many studies have reviewed the antecedents and consequences of workplace violence, limited information is available on this topic. An understanding of the predisposing factors for violence and the consequences of violence is essential to developing programs to prevent and manage workplace violence. DESIGN: Qualitative descriptive design. METHODS: In this qualitative study, 22 unstructured, in-depth interviews were conducted with registered nurses who had experienced workplace violence and who were selecting using purposive sampling in nine hospitals. Inductive content analysis was used to analyse the data. RESULTS: Five categories emerged as predisposing factors: unmet expectations of patients/relatives, inefficient organisational management, inappropriate professional communication, factors related to nurses and factors related to patients, patients' relatives and colleagues. Individual, familial and professional consequences were identified as outcomes of workplace violence against nurses. CONCLUSIONS: Workplace violence by patients/their relatives and colleagues/superiors is affected by various complicated factors at the individual and organisational levels. In addition to negatively affecting nurses' individual and family lives, workplace violence may lead to a lower quality of patient care and negative attitudes towards the nursing profession. RELEVANCE TO CLINICAL PRACTICE: Identifying factors, which lead to workplace violence, could help facilitate documenting and reporting such incidents as well as developing the necessary interventions to reduce them. Furthermore, native instruments must be developed to predict and monitor violence.

Respecting the privacy of hospitalized patients: An integrative review.

BACKGROUND: Privacy is a complicated and obscure concept, which has special meanings in the healthcare environment; therefore, it is essential for healthcare providers to fully understand this concept. However, there is no universally accepted definition for this concept in the texts, and it has been interpreted differently, based on its application. AIM: To analyze and provide a clear and scientific definition for respect of privacy of hospitalized patients and identify the common aspects of this concept. RESEARCH DESIGN: This study was conducted using the Whittemore and Knafl's modified framework as a conceptual analysis method. Ethical consideration: This study was approved by the Research Council of the University of Social Welfare and Rehabilitation Sciences. We have respected the ethical requirements required regarding the sources and authorship. Research context and data sources: Using integrative review, a search was performed using national and international databases, including CINAHL, Scopus, Medline, Web of Science, and ISI (with no date restriction). The keywords employed during the search process were "privacy of patients," "confidentiality," "and patients' rights." In total, 1345 articles were retrieved from the databases. After the elimination of repetitive studies and with regard to the study objectives, 124 articles, 3 books, and 4 theses were entered into the study. The data were analyzed using the conventional content analysis approach. FINDINGS: The results were extracted in the form of four, seven, and two themes related to attributes such as physical, informational, social, and psychological and the antecedents and consequences of respecting patient privacy, respectively. CONCLUSION: Respect for hospitalized patient privacy contains multiple dimensions. Factors affecting the achievement of this concept include individual backgrounds, nature of the disease, and rule of paternalism. The fulfillment of patient privacy leads to such consequences as protection and improvement of human dignity as well as improved communication between the patient and the health team.

Family caregivers' experience of activities of daily living handling in older adult with stroke: a qualitative research in the Iranian context.

BACKGROUND: Patients with stroke require additional support from family to live independently in the area of activities of daily living. Family members are usually the main caregivers of stroke patients. Comprehensive explanation of ADL handling from family caregivers' view is lacking. AIM: This study explores and describes family caregivers' experiences about the strategies to handle activities of daily living (ADL) dependency of elderly patient with stroke in the Iranian context. METHOD: A qualitative content analysis approach was conducted to analyse data. Nineteen family caregivers participated in the study from multiple physiotherapy clinics of physiotherapy in Sari (Iran) between September 2013 and May 2014. Data were generated through in-depth interviews, and content analysis method was used to analyse the data and determine themes. FINDINGS: The findings show that family caregivers manage the ADL dependency of their elderly stroke patients through seven strategies including encouraging physical movements, providing personal hygiene, nutritional consideration, facilitating religious activities, filling leisure time, and facilitating transfer and assisting in financial issues. CONCLUSION: Family has an important role in handling of elderly stroke patients' ADL dependency. Health practitioners can take benefit from the findings to help the stroke families play more active role in the handling ADL dependency of their patients after stroke.

Effects of Spiritual Group Therapy on Caregiver Strain in Home Caregivers of the Elderly with Alzheimer's Disease.

INTRODUCTION: Care of patients with Alzheimer's disease is one of the most difficult types of care that exposes the caregiver to a high level of care strain. The present research aimed at determining the effect of spiritual care on caregiver strain of the elderly with Alzheimer's disease. METHODS: An experimental study was carried out on 100 caregivers who were selected by convenience sampling and randomly divided into intervention, control one and control two groups. Group spiritual therapy was performed on the intervention group for five weeks, Control one participate in the group sessions without any particular interventions, and control two received no interventions. Data was collected through a demographic questionnaire and Robinson's (1983) Caregiver Strain Index, and analyzed using the Chi-square, Fisher's Exact test, one-way analysis of variance and paired t-test. Statistical significance level was considered as 0.05. RESULTS: In the intervention group mean of the posttest care strain score 32.43±2.73 was significantly lower than pretest 37.16±1.26 (P<0.001). The mean posttest score of care strain was significantly lower in the intervention group compared to the two other groups (P<0.001). CONCLUSION: Spiritual care can reduce care strain in home caregivers of the elderly with Alzheimer's disease.

Human dignity and professional reputation under threat: Iranian Nurses' experiences of workplace violence.

Workplace violence against nurses is a challenging problem in both developed and developing countries. Because the concept of violence bears some cultural load, nurses' understanding is region-specific. This study explores Iranian nurses' perceptions of workplace violence. Using qualitative content analysis, 22 registered nurses underwent unstructured, in-depth interviews. The main themes of threats to human dignity and professional reputation emerged, plus four categories: physical violence, psychological violence, honor insults, and ethnic-religious insults. The term "honor insults," as a unique finding, was used instead of "sexual harassment." These findings may help to redefine workplace violence based on cultural background, design strategies for supporting nurses, and prevent and manage such violence.

Experiences of substance abusers from methadone maintenance therapy.

Background: Substance abusers are not able to withdraw drugs eternally despite the abundance of different treatments; therefore, withdrawal programs are not quite successful and notwithstanding all the successes of methadone maintenance therapy, there are some defects found in the manner this treatment is applied. Thus, this study was conducted to explore the experience of drug abusers regarding methadone maintenance therapy. Methods: This is a qualitative study using content analysis methodology. The research community includes drug abusers admitted to the treatment centers of the western cities of Mazandaran Province, Iran in 2016. The sampling was purposive and the data were collected by face-to-face single interviews with 20 patients. The interviews were continued up to data saturation. Finally, the Lundman and Grenheim method was used to analyze the interviews and the four criteria of Guba and Lincoln were applied to check data integrity. Results: "Buying time," "methadone dependence," and "looking from a narrow view to the patient" were the main three categories that fit the results. Conclusion: Governmental free services for drug abusers; paying attention to different aspects of treatment such as mental, emotional, and social recovery; lifelong support of the family and society members; and balance in prescribing and following the treatment process prescribed by health care providers can enhance both the quality and safety of the treatment process. Psychological consultation alongside social services can facilitate the recovery process in methadone maintenance therapy.

The Therapeutic Relationship in the Shadow: Nurses' Experiences of Barriers to the Nurse-Patient Relationship in the Psychiatric Ward.

The therapeutic relationship is widely accepted as the basic core and essence of the psychiatric nurse's role and is thus essential for providing quality mental health care. A detailed and clear perception of the issues that facilitate or obstruct this relationship is therefore important. The purpose of this study was to gain insights into the experiences of nurses working in psychiatry wards, of the barriers to the nurse-patient relationship. A qualitative content-analysis study was undertaken using a purpose-based sampling approach with the participation of 15 nurses employed in psychiatric wards in hospitals located in South Iran. Semi-structured interviews provided the source of data, and an inductive content-analysis approach was used for data analysis. The main concept extracted from the study was identified as 'the therapeutic relationship in the shadow', which captured the sense that this critical relationship is mostly unseen in the daily practice of the nurses interviewed. Factors that functioned as barriers to this relationship were classified into three main categories: nurse-related, patient-related and organization-related. The results of this study revealed that, despite the widely claimed importance of the nurse-patient relationship in psychiatric settings, this relationship is powerfully influenced by individual and organizational factors that have not been considered adequately in previous research. It is strongly recommended that greater consideration of these factors be given to care planning in psychiatric wards.

Patients' experiences of adapting to multiple sclerosis: a qualitative study.

Unpleasant, unpredictable symptoms, difficult treatment regimes, and uncertainty about the future of Multiple Sclerosis require the patients to adapt to new life changes and restrictions. This study aimed to explore patients' experiences of adapting to Multiple Sclerosis. A qualitative content analysis method was used to conduct this study. The study participants were 25 patients with Multiple Sclerosis, chosen through purposeful sampling. Data were analyzed by using content analysis. The analysis resulted in the emergence of seven themes and eighteen subthemes. The main themes were: religiosity, information seeking, seeking support, hope rearing, emotional reactions, concealing the disease, fighting the disease and disability. These themes can represent the perceived characteristics and difficulties of adaptation to Multiple Sclerosis by patients. These findings can help nurses and families to aid patients in increasing their abilities to adapt to the disease and enhance their quality of life.

Musculoskeletal disorders and working conditions among Iranian nursing personnel.

This study investigated the prevalence of musculoskeletal disorders (MSDs) and associations with organizational, physical and psychosocial working conditions among 520 nursing personnel in Tehran, Iran. The results of the cross-sectional study on aids and different educational levels of nurses showed that the participants experienced 88% of MSDs in at least one body region during the past 12 months. The 3 most prevalent body regions were the low back (65.3%), knee (56.2%) and neck (49.8%). The participants reported inflexible work schedule, poor quality of devices for transferring patients, overexertion and job dissatisfaction. Physical and psychosocial exposure revealed an elevated odds ratio (95% confidence interval) of MSDs. The results showed a combination of high physical and psychosocial work demands along with low control over the work which increased work-related stress and enhanced the risk of MSDs. This study findings could help to understand work-related MSDs among nursing personnel in a developing country where the work situation and sociocultural context differ from other countries.