Clinical Characteristics and Outcomes in Hospitalized Patients with COVID-19 and Cancer History: A Multicenter Cross-Sectional Study in Southwestern Iran.

Background: Cancer patients are more exposed to opportunistic infections, such as COVID-19, due to their poor health status. This study aimed to identify the clinical characteristics of cancer and non-cancer patients with COVID-19 that may lead to death, intubation, and ICU admission. Materials and Methods: A Multicenter Cross-Sectional study was conducted on confirmed COVID-19 adult patients with and without a history of cancer from March 2019 to March 2021. Demographic and clinical features, ICU admission, intubation, and discharge status have been extracted from patients' medical records. Chi-square, odds ratio, Mann-Whitney test, and logistic regression were used to analyze the data. Results: The death rate in 1332 cancer patients was 28% compared to the 91464 noncancer patients which was 9% with an odds ratio of 3.94 and p<0.001. ICU admission rates among the cancer group were 43%, while in the noncancer group, it was 17.9% (p<0.001). Moreover, intubation was done for 20.9% of cancer patients and 7.4% of non-cancer patients (p<0.001). However, no significant difference was observed between the two groups in terms of length of stay in the hospital. Multivariable logistic regression analysis showed that age, level of consciousness, SPO2, and autoimmune disorders were associated with mortality in cancer patients with COVID-19. Conclusion: This study showed that older age, loss of consciousness, low oxygen saturation, and suffering from autoimmune disorders were the predictors of death in cancer patients with COVID-19. These results can have important implications for the management and care of cancer patients with COVID-19.

Perceived clinical competence and predictive role of time management in nursing students.

AIM/OBJECTIVE: The purpose of this study was to determine the association between perceived clinical competence and time management among nursing students. BACKGROUND: Given the close relationship between clinical competence and nursing care quality, it is important to investigate the nursing students' status in relation to the acquisition of nursing skills. Time management also as a framework for planning, setting goals, prioritizing goals and activities can be regarded as an important factor contributing to the clinical competence of nursing students. DESIGN: A cross-sectional and correlational study SETTINGS/PARTICIPANTS: This study included 221 undergraduate nursing students in Ahvaz Jundishapur University of Medical Sciences in Iran in the 2022-2023 academic year. METHOD: The data were collected online through a demographic information questionnaire, the clinical competency inventory, and the time management questionnaire. RESULTS: Students' mean scores for the clinical-competency, and time management were 120.38 ± 22.15, and 77.91 ± 15.15, respectively. Regression models showed that overall time management (ß = 0.454, p < 0.001) and interest in the field of nursing (ß = 0.171, p = 0.004) were predictors for overall clinical competence in nursing students. This model explained 25 % of the variance in clinical competence (F= 38.707, p < 0.001). CONCLUSION: Time management can affect nursing students' competence in providing quality nursing care to patients. Therefore, it seems that holding training workshops on time management skills for nursing students can be an effective and pioneering step in improving these skills.

Sense of Coherence or resilience as predictors of psychological distress in nursing students during the COVID-19 pandemic.

Background: The COVID-19 pandemic lead to the occurrence of numerous psychological distress among students. This study aimed to determine the level of psychological distress as well as the predictive role of Sense of Coherence (SOC) and resilience in nursing students. Methods: A cross-sectional descriptive study was conducted on 310 nursing students in Ahvaz Jundishapur University of Medical Sciences, Iran. The data of the study was collected through the demographic information questionnaire, the General Health Questionnaire (GHQ), the Academic Resilience Inventory (ARI), and the Sense of Coherence Scale (SOC-13). Results: Students' mean scores for the GHQ, ARI, and SOC were 5.81 ± 1.37, 102.88 ± 11.91, and 54.54 ± 6.46, respectively. Regression models showed that two domains of SOC [meaningfulness (ß = -0.28, p < 0.001), manageability (ß = -0.19, p = 0.001)], female gender (ß = 0.12, p = 0.015), and overall ARI (ß = -0.12, p = 0.037), were significantly associated with the GH of nursing students. SOC domains [meaningfulness (ß = -0.19, p = 0.002), manageability (ß = -0.15, p = 0.006)], problem-oriented/positive thinking domain of ARI (ß = -0.15, p = 0.011), sex (ß = 0.12, p = 0.015), and history of death in first-degree relatives (ß = 0.12, p = 0.021) were significantly associated with social dysfunction domain of GH. Three domains of SOC [meaningfulness (ß = -0.26, p < 0.001), manageability (ß = -0.13, p = 0.032), and comprehensibility (ß = -0.13, p = 0.039)], were significantly associated with psychological distress domain of GH. Conclusion: Our results indicated that low SOC and resilience were predictors of psychological distress in nursing students. Accordingly, interventions such as teaching stress management skills, the skills of using positive coping methods in dealing with stressful situations, and self-management skills are necessary to improve the level of resilience and SOC in nursing students.

Sense of coherence or self-efficacy as predictors of health-related quality of life in sickle cell disease patients.

Patients with sickle cell disease (SCD) suffer from impaired health-related quality of life (HRQoL). This study aimed to determine the level of HRQoL, sense of coherence (SOC), and self-efficacy (SE) in a sample of SCD patients, and to explore predictors of their physical and mental HRQoL. A cross-sectional descriptive study was conducted on 83 SCD patients of one university hospital. The data of the study was collected through Persian versions of the Short-Form Health Survey SF-36 (RAND 36-item), the Sense of Coherence Scale (SOC-13), and the Sickle Cell Self-Efficacy Scale (SCSES). The mean age of the patients was 26.34 ± 8.19 years old. Patients' mean scores for the Physical Component Summary (PCS), Mental Component Summary (MCS), SOC, and SCSES were 40.57 ± 17.18 (range: 0-100), 50.44 ± 17.95 (range: 0-100), 52.40 ± 15.35 (range: 13-91), 26.40 ± 6.96 (range: 9-45), respectively. Regression models showed that the level of the patients' SOC, was the main predictor of the MCS (ß = 0.37, p < 0.001). However, the level of the patients' SE was the main predictor of the PCS (ß = 0.30, p = 0.004). Also, "blood transfusion history" in patients was a common predictor for both the PCS (ß = - 0.28, p = 0.008) and the MCS (ß = - 0.29, p = 0.003). These results can assist nurses and clinicians to plan clinical interventions for SCD patients by focusing on increasing the level of the SOC and SE and improving SCD patients' HRQoL. Furthermore, measuring the level of the SOC and self-efficacy as screening tests are useful to find patients with a greater risk of impaired HRQoL.

Perceived professional competence in spiritual care and predictive role of spiritual intelligence in Iranian nursing students.

AIM/OBJECTIVE: The aim of this study was to identify the relationship between perceived competence in spiritual care and spiritual intelligence among nursing students. BACKGROUND: One of the most important duties of nurses is to pay attention to the spiritual needs of patients and provide them with proper spiritual care. Therefore, professional competence in this area is essential for nurses and nursing students. Also, spiritual intelligence is a factor influencing the caring behaviors of nurses. DESIGN: A cross-sectional and correlational study SETTINGS/PARTICIPANTS: This study was included 510 undergraduate nursing students in two public faculties of nursing in Iran in the 2018-2019 academic year. METHODS: The samples were selected using a census method. A demographic information questionnaire, the valid and reliable Iranian questionnaire of nurses' competencies in spiritual care and the spiritual intelligence self-report inventory (SISRI) were used to collect data. RESULTS: A significant positive correlation was found between nursing students' competence in spiritual care and spiritual intelligence (p < 0.001, r = 0.26). No significant differences were found between the mean competence scores of spiritual care in terms of demographic characteristics. There were significant differences between the mean spiritual intelligence score in terms of age, marital status, history of clinical practice and academic year. The regression model indicated that for increased rates of spiritual intelligence, professional competence in spiritual care would rise as much as 0.39. CONCLUSION: Spiritual intelligence can affect the competence of nursing students in providing spiritual care to patients. Therefore, to promote students' spiritual intelligence, appropriate plans with the aim of promoting the level of critical thinking and spiritual self-awareness are recommended.

Experience of Uncertainty in Patients with Thalassemia Major: A Qualitative Study.

Background: Uncertainty leads to a stressful situation in patients with thalassemia major that can dramatically affect their psychosocial coping ability, treatment process and disease outcomes, and reduce patients' quality of life. As one of the important factors affecting the health of thalassemia patients, understanding the concept of uncertainty is of major importance to health care providers especially nurses as the first line of exposure to these patients. The present study aimed to explore the experiences of uncertainty in patients with thalassemia major. Materials and Methods: The present qualitative study was conducted through in-depth face-to-face semi-structured interviews held with 18 patients with major thalassemia selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analyzed with conventional content analysis method of Landman and Graneheim using MAXQDA10 software. Results: Two main themes, including 'living in the shadow of anxiety' and 'coping with uncertainty' emerged from patients' experiences of illness uncertainty of thalassemia. 'Living in the shadow of anxiety' included four categories of 'fear of complications', 'contradictory views on treatment', 'unknown future' and 'stigma'. 'Coping with uncertainty' included three categories of 'spiritual coping', 'psychosocial coping' and 'knowledge acquisition'. Conclusion: According to the results of this study, uncertainty is a major psychological stress in patients with thalassemia major. Healthcare providers should therefore consider the challenges and concerns faced by patients and, through utilizing appropriate training and communicational practices, plan interventions and strategies to empower patients for coping with uncertainty.

Predictors and Correlates of Fatigue in Sickle Cell Disease Patients.

Background: Although fatigue is the most important symptom of Sickle Cell Disease, the extent of it is unknown, and causal mechanisms are not well understood. This article explores biopsychosocial characteristics that can potentially contribute to fatigue in SCD. Materials and Methods: This cross-sectional, correlational study included 97 SCD patients who aged over 16 years and had records in Thalassemia Ward and Clinic of Shafa Hospital affiliated to Ahvaz University of Medical Sciences, Ahvaz, Iran. Data were collected from a self- reported demographic questionnaire, measuring depression, anxiety stress scale (DASS-21) and fatigue severity scale (FSS). Data analysis was done by descriptive statistics, independent sample t-tests, Pearson's correlation coefficient, one-way ANOVA and multiple stepwise regression. Results: More than 50% of study participants were mostly single women. A majority of patients had a diagnosis of HgbSS disease. Levels of depression, anxiety and stress were severe in more than half of the participants. About 65% of SCD patients reported signs of fatigue. Moreover, fatigue, depression, anxiety and stress had a high intercorrelation. Depression, blood transfusion, renal diseases and work status were predictors of fatigue according to the models used in this survey. Conclusion: The results of the study indicated that SCD patients who had depression, blood transfusions, SCD-related renal complications, students and working people experienced more fatigue. So, if fatigue is present, it is important to recognize the existence of these conditions or vice versa. Routine assessment and improved management of fatigue, effective interventions to reduce fatigue, are highly recommended for patients with SCD.

Psychometric Evaluation of the Persian Translation of the Thalassemia-Specific Quality of Life Questionnaire.

BACKGROUND AND PURPOSE: There is no Persian scale for assessing the quality of life of patients with thalassemia major. Thus, this study was conducted to translate and validate the 36-item thalassemia-specific Transfusion-Dependent Quality of Life (TranQoL) questionnaire. METHODS: The questionnaire was first translated into Persian and then was backward-translated into English. Afterward, panels of experts commented on the Persian translation, and then its face validity was confirmed and content validity index (CVI) and content validity ratio (CVR) were calculated. The factorial structure and the reliability of the translated questionnaire were assessed using exploratory factor analysis (EFA) and internal consistency method, respectively. RESULTS: The CVI and CVR of the questionnaire were .95 and .84, respectively. Five items were deleted during EFA, and 9 factors were extracted from the 31 remaining items. The reliability of the questionnaire was confirmed through a Cronbach's alpha coefficient of .9. CONCLUSION: The Persian translation of the TranQoL questionnaire is highly reliable and valid, and thus, it can be used as a specific measure for assessing the quality of life among patients with thalassemia.

The association between depression, socio-economic factors and dietary intake in mothers having primary school children living in Rey, south of Tehran, Iran.

BACKGROUND: According to the WHO report released in 2000, about 121 million people worldwide suffer from depression. The present study aimed to explore factors influencing depression in mothers from Rey, South of Tehran, Iran; who had elementary school children. METHODS: The cross-sectional survey was conducted in spring 2010. Four hundred thirty mothers who had elementary school children, were selected through a two stage cluster sampling. Beck Depression Inventory (BDI) was used to assess depression in the mothers and a 24-hour food recall was used to collect information regarding their dietary intake. General information regarding economic condition and socio-economic status were also gathered using a questionnaire. The data was analyzed using chi-square, one-way analysis of variance and simple regression tests. RESULTS: In our study, 51.4% of the mothers suffered from depression. There was an inverse correlation between the educational level of the mothers and the heads of household, their occupational status, their marital status, their socio-economic condition and depression. Conversely, any increase in the family size worsened the depression. The daily intake of different macronutrients, except for fat, was lower in individuals of depressed group. CONCLUSION: The present study emphasized the fact that more attention should be paid to the educational level and economic condition of the family in order to reduce maternal depression. Family size also plays an important role in this regard.

The association between depression, socio-economic factors and dietary intake in mothers having primary school children living in Rey, South of Tehran, Iran.

BACKGROUND: According to the WHO report released in 2000, about 121 million people worldwide suffer from depression. The present study aimed to explore factors influencing depression in mothers from Rey, South of Tehran, Iran; who had elementary school children. METHODS: The cross-sectional survey was conducted in spring 2010. Four hundred thirty mothers, who had elementary school children, were selected through a two stage cluster sampling. Beck Depression Inventory (BDI) was used to assess depression in the mothers and a 24-hour food recall was used to collect information regarding their dietary intake. General information regarding economic condition and socio-economic status were also gathered using a questionnaire. The data was analyzed using chi-square, one-way analysis of variance and simple regression tests. RESULTS: In our study, 51.4% of the mothers suffered from depression. There was an inverse correlation between the educational level of the mothers and the heads of household, their occupational status, their marital status, their socio-economic condition and depression. Conversely, any increase in the family size worsened the depression. The daily intake of different macronutrients, except for fat, was lower in individuals of depressed group. CONCLUSION: The present study emphasized the fact that more attention should be paid to the educational level and economic condition of the family in order to reduce maternal depression. Family size also plays an important role in this regard.