The effect of virtual reminiscence therapy on depression and anxiety in patients with gastric cancer undergoing chemotherapy.

PURPOSE: To determine the effect of virtual reminiscence therapy on depression and anxiety in patients with gastric cancer (PwGC) undergoing chemotherapy. METHODS: In this quasi-experimental study, we randomly allocated 152 PwGC who met the inclusion criteria as 1:1 ratio to control (N = 76) and intervention (N = 76) groups. The patients in the control group received routine post-chemotherapy care, while those in the intervention group received reminiscence therapy over the phone in addition to routine care. The participants of both groups completed Beck's Depression Inventory and Zung's Self-rating Anxiety Scale before the study, 6 weeks after the beginning of the study, and 3 months after the intervention. RESULTS: Although the mean depression score before chemotherapy indicated moderate depression in both groups, the reminiscence therapy group showed a significant reduction in the depression score compared to the control group (P < 0.001) following intervention. The mean anxiety scores indicated mild to moderate anxiety in both groups, which was later placed within the normal range, there was a significant difference between the two groups. Intra-group comparison revealed that the mean depression and anxiety scores decreased significantly in the reminiscence therapy group (P < 0.001). CONCLUSION: This study indicated that virtual reminiscence therapy can decrease anxiety and depression in PwGC undergoing chemotherapy. Therefore, it can be a supportive psychological method for these patients.

Impact of integrated teaching-learning method on oncology clinical decision-making ability and cognitive learning of nursing students.

BACKGROUND: Innovative and student-centered teaching methods are required to improve critical thinking and clinical reasoning skills. The objective of this study was to determine the impact of an oncology internship training on learning outcomes of nursing students using an integrated teaching-learning method. METHODS: A pre- and post-test quasi-experimental study was conducted among 107 undergraduate nursing students in fourth year who were allocated to two groups (intervention group = 51 and control group = 55) to receive an integrated teaching-learning method and routine method respectively. Data was collected using the Clinical Decision Making in Nursing Scale (CDMNS) and the students' cognitive learning test. RESULTS: Difference in mean scores of cognitive learning test post-intervention was significant between the two groups (p < 0.001). Total CDMNS scores and its dimensions increased significantly for the intervention group post-intervention (p < 0.001). Analysis of covariance (ANCOVA) showed that when the effect of confounding variables, such as the student's Grade Point Average (GPA) and the pre-test scores of cognitive learning and decision-making scale were held constant, the effect of the independent variable (group) on students' cognitive learning test (p = 0.002) and CDMNS (p = 0.004) was significant. CONCLUSIONS: Nursing students' cognitive learning and clinical decision-making scores were improved as a result of the integrated teaching-learning method. Nursing educators can use this method in clinical education to improve students' cognitive and meta-cognitive skills, thereby improving nursing care quality.

Attitude, preventive practice and perceived barriers among perioperative and anesthesia nurses toward surgical smoke hazards during the COVID-19 outbreak.

BACKGROUND: Surgical smoke (SS), which is produced by the use of high-temperature devices for cutting and coagulation of tissue during surgical procedures, is considered a serious threat to the health of operating room (OR) staff due to the presence of hazardous substances and possibility of transmitting various infections such as HPV, HIV, COVID-19 and so on. This study was conducted to determine the Attitude, preventive practice and perceived barriers among perioperative and anesthesia nurses toward surgical smoke hazards. METHODS: In this cross-sectional descriptive study, conducted at hospitals of Tabriz University of Medical Sciences (Iran) in 2021, 262 perioperative and anesthesia nurses were included by stratified random sampling. Data were collected using a demographic questionnaire and an SS questionnaire consisting of questions on attitude (17 item), practice (8 item), and barriers (13 item). Collected data were analyzed using SPSS16. RESULTS: The mean attitude and preventive practice scores (49.52 ± 12.36 and 15.8 ± 2.05, respectively) of the operating room nurses were reported at moderate and weak levels, respectively. There was a direct and significant relationship between attitude and practice scores (r = 0.129, P = 0.019). The main barriers to the prevention and dealing with the hazards of SS in ORs were reported in management (3.68 ± 1.06) and equipment (3.24 ± 0.66) dimensions, respectively. CONCLUSION: It is recommended to adopt strategies to improve the attitude of OR staff regarding the preventive measures against surgical smoke hazards. Moreover, appropriate equipment and support of managers should be provided by explaining the policies and guidelines to prevent the complications of surgical smoke.

Disrupted mothering in Iranian mothers with breast cancer: a hybrid concept analysis.

BACKGROUND: Defining the disrupted mothering would contribute to developing strategies to support mothers with breast cancer. The aim of this study was to analyze the concept of mothering disruption using a hybrid model. METHODS: The Hybrid method for concept analysis was implemented consisting of three phases: theoretical, fieldwork, and final analysis. In the theoretical phase, the literature was searched using electronic databases including PubMed, ScienceDirect, Scopus, ProQuest, Google Scholar, CINAHL, Wiley, Ovid, Magiran, and SID from 2000 to 2020. Any quantitative or qualitative studies published in English or Persian, which were focused on mothering disruption in mothers with breast cancer were included in the study. In the phase of fieldwork, 20 mothers were interviewed to explore the aspects of mothering disruption. The interviews were transcribed and analyzed with conventional content analysis. In the final phase, an overall analysis of the two previous phases was performed. RESULTS: In the theoretical phase, the following attributes were determined: "disturbance in maternal identity and roles", "maternal insensitivity and unresponsiveness: disconnection physically and psychologically", "the career disruption process" and "biographical disruption". The fieldwork phase explored three themes including "the unbalance between multiple roles", "role failure", and "reduced maternal sensitivity". The final synthesis yielded that the main integrated elements of mothering disruption are "disease as threating maternal role and identity", "inability to interpret and respond to child behaviors and needs", and "support for transitioning from being patient toward maternal competency". CONCLUSION: With a deeper understanding of the term 'disrupted mothering' or 'mothering disruption', healthcare providers will have a foundation to improve cancer care, deliver effective communication and help such mothers cross this disruption and achieve restoration of their mothering role. Future research is needed to validate this concept and explore connections with health outcomes.

Patient-centred communication for women with breast cancer: Relation to body image perception.

AIMS AND OBJECTIVES: This study aimed to determine the predictive values of patient-centred communication (PCC) and patient's characteristics on the body image (BI) perception in postmastectomy patients. BACKGROUND: Patient-centred communication has been touted as a means of addressing BI issues, especially for postmastectomy patients. DESIGN AND METHODS: This predictive correlational study was conducted on 275 surgically treated breast cancer patients admitted to the Oncology Departments of two hospitals in Tabriz, Iran. These patients were selected using a convenience sampling method. The Body Image after Breast Cancer Questionnaire (BIBCQ) and patient-centred communication questionnaire (PCCQ) were used for collecting the data. Descriptive and inferential statistics were applied to the data. Reporting was in accordance with the STROBE guideline. RESULTS: A multivariable model significantly predicted BI perception in participants using surgery type and time elapsed following surgery. Participants' limitations were significantly affected by surgery type and participants' perception of the nurses' PCC skills. Arm concern was significantly affected by surgery type and nurses' PCC skills. CONCLUSION: Patient-centred skills in nurse-patient communication are critical for resolving BI difficulties such as arm concerns and limitations regarding the disease and its treatment. RELEVANCE TO CLINICAL PRACTICE: Patient-centred communication skills can be taught nurses in the clinical setting to help alleviate patients' BI problems.

Adolescent cancer survivors' experiences of supportive care needs: A qualitative content analysis.

Supportive care is an important strategy that can help cancer survivors manage changes and problems during their follow-up care. Identifying patients' care needs is one of the primary steps of the nursing process to plan effective nursing interventions. The aim of this study was to explore adolescent cancer survivors' supportive care needs. Purposeful sampling was adopted to select 49 participants from hospitals to participate in face-to-face, semistructured interviews. The qualitative content analysis method was conducted for data analysis. Ten subcategories and four main categories - empathetic care, information about survival period, instrumental support, and cooperation in care - were extracted from the data. These four categories formed a major theme, "supportive care", as the primary healthcare need. This study highlights that supportive care should be developed collaboratively by family and healthcare providers to meet the needs of adolescent cancer survivors. Survivors' strengths and limitations should be identified, and then supportive care can be provided, such as giving appropriate information, enabling survivors to access supportive networks, and improving survivors' confidence and autonomy with their self-management.

Experience of Adolescent Survivors of Childhood Cancer about Self-Care Needs: A Content Analysis.

OBJECTIVE: In cancer care management, patients or their family are usually responsible for continuing health care. Achieving this goal requires identification of their self-care needs. The purpose of this study is to explore the perception of self-care needs of adolescent cancer survivors. METHODS: This study was conducted by the qualitative content analysis method. Participants were 19 adolescent childhood cancer survivors and six parents, nurses, physicians, and charity institution staff from children teaching hospitals in Iran. Participants were selected through purposeful sampling, and individual semistructured interviews were used for data collection. Graneheim and Lundman stages of content analysis were employed for data analysis. Data were managed with the MAXQDA10 software. RESULTS: Content analysis revealed nine subcategories as follows: (1) nutritional protection, (2) prevention from infection, (3) prevention from physical damage, (4) control over cancer recurrence, (5) informational needs, (6) pain management, (7) releasing positive thoughts, (8) continuing routine life, and (9) family protection. The first six subthemes were related to protection against physical distress, and the final three ones were related to protection against psychological distress. These two categories form one theme: "protective self-care need" as an essential self-care need in adolescent cancer survivors. CONCLUSIONS: Pediatric and school health nurses can prepare strategies to meet these needs by providing effective informational and psychosocial supports, and healthcare providers are able to check periodically the status of survivors care to provide second or third level of care to prevent escalation and incidence of the adverse outcomes of the disease.

Caring Process in Hematopoietic Stem Cell Transplantation: A Grounded Theory Study.

Background: Caring is one of the main concepts in nursing and its modes of delivery in different diseases have been widely studied. Hematopoietic Stem Cell Transplantation (HSCT) is a novel, complex, and time-consuming clinical intervention which is applied as a final medical choice in several life-threatening diseases. The aim of the current study was to explore the process of caring for patients undergoing HSCT. Materials and Methods: In this article, we present a qualitative research study conducted between 2011 and 2013 in accordance with the procedures of grounded theory methodology. Data were gathered by interviewing and observing health professionals involved in HSCT process, as well as patients and their families. The study participants consisted of 18 HSCT nurses, 2 physicians, 12 patients, and 7 members of patients' families. The initial sampling in the study was purposeful, followed by theoretical sampling. Data were analyzed using the Corbin & Strauss (2008) method. Results: Four main categories, reflecting 13 sub-categories, were emerged by analyzing the data: struggling of patients between life and death, trying to reduce the chance of patient's death, enforcing patients' spirit and caring achievements. The core variable of study, defined as "supporting patients to go through the HSCT process successfully", represented the nature and efficiency of care delivered to HSCT patients in the study setting. Conclusion: HSCT patients enter the caring process in the context of life-and-death limbo. The caring strategy in HSCT patients is aimed at trying to reduce the chance of the patient's death, as well as enforcing patients' spirit. The HSCT process affects all areas involved in various ways and has some outcomes. The findings and the theoretical conclusions of this study are potentially valuable in improving nursing practice, designing of educational programs and setting of caring policies.

Cancer survivors' experiences of return to work: A qualitative study.

OBJECTIVE: The study aimed to explore Iranian cancer survivors' experiences of returning to work. METHODS: Semistructured interviews were conducted with 20 cancer survivors at their workplace and in a referral cancer center. Data were analyzed using a conventional content analysis technique. RESULTS: Three main categories were identified as important in cancer survivors' experiences of returning to work: (1) individual perspectives, (2) nature of disease, and (3) access to support system. Results showed that returning to work contained different meaning for men and women. Also, it was found that cancer survivors had limited information about the disease and return to work that made them doubtful about returning to work. CONCLUSION: Cancer survivors have different individual perspectives that affect their decision about returning to work. Their perspectives should be assessed before returning to work, and necessary support should be provided for them in returning to work process. In this regard, health care systems and rehabilitation specialists should inform cancer survivors about the disease and return to work. Also, employers should prepare work places for cancer survivors' entrance.

A Grounded theory study of the intention of nurses to leave the profession / Estudo utilizando a Teoria Fundamentada sobre a intenção das enfermeiras de abandonar sua profissão / Estudio utilizando la Teoría Fundamentada sobre la intención de las enfermeras de abandonar su profesión

ABSTRACT Objective: this study explores the process of the development of an intention to leave bedside nursing. Method: the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. Results: according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. Conclusion: the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them.

RESUMO Objetivo: este estudo explora o processo de desenvolvimento da intenção de deixar a enfermagem de cabeceira. Método: o processo foi estudado desde a perspectiva de 21 enfermeiras utilizando o método da Grounded Theory (Teoria Fundamentada). Os dados foram coletados utilizando entrevistas semi-estruturadas e o método comparativo constante de Corbin e Strauss se utilizou para analisar os dados. Resultados: segundo os participantes, duas categorias principais, "imagem social da enfermagem" e "cultura e estrutura de cabeceira", foram os fatores contextuais que influenciam as razões para que as enfermeiras estejam deixando o cuidado de cabeceira. A decepção com a percepção de falta de progresso ou melhora na experiência clínica cria preocupações psicossociais primárias para as participantes. A competência e o processo de autocontrole são passos dados pelas participantes. Isso associado a condições de intervenção foram os resultados da perda do compromisso profissional que as leva a deixar o cuidado de cabeceira. "O fracasso em integrar expectativas pessoais e expectativas da organização: em busca de uma saída" foi a categoria central do estudo que uniu as categorias. Conclusão: os achados deste estudo proporcionam informação útil sobre as necessidades das enfermeiras para superar as intenções de deixar o cuidado de cabeceira. A identificação deste processo pode ajudar a reconhecer os problemas emergentes e oferecer soluções para resolvê-los.

RESUMEN Objetivo: este estudio explora el proceso de desarrollo de la intención de dejar la enfermería de cuidado de cabecera. Método: el proceso fue estudiado desde la perspectiva de 21 enfermeras utilizando el método de la Grounded Theory (Teoría Fundamentada). Los datos se recogieron utilizando entrevistas semiestructuradas; para analizar los datos se utilizó el método comparativo constante de Corbin y Strauss. Resultados: según los participantes dos categorías principales ("imagen social de la enfermería" y "cultura y estructura del cuidado de cabecera ") fueron los factores contextuales que influenciaron las razones para que las enfermeras deseasen dejar el cuidado de cabecera. La decepción con una percepción de falta de progreso o mejora en la experiencia clínica causó preocupaciones psicosociales primarias en las participantes. La competencia y el proceso de autocontrol fueron considerados por las participantes, y esto asociado a las condiciones de intervención resultaron en la pérdida del compromiso profesional que las lleva a dejar el cuidado de cabecera. La categoría central del estudio que unió las categorías encontradas fue: "Fracaso para integrar las expectativas personales con expectativas de la organización: en busca de una salida". Conclusión: los hallazgos de este estudio proporcionan información útil sobre las necesidades de las enfermeras para superar las intenciones de abandonar el cuidado de cabecera. La identificación de este proceso puede ayudar a reconocer los problemas emergentes y ofrecer soluciones para resolverlos.

A qualitative exploration of facilitators and inhibitors influencing nurses' intention to leave clinical nursing / Análise Qualitativa dos Facilitadores e Inibidores que Influenciam a Intenção dos Enfermeiros de Abandonarem a Enfermagem Clínica / Análisis Cualitativo: Facilitadores e Inhibidores Influyentes Sobre Voluntad de Enfermeros Para Abandonar la Enfermería Clínica

Abstract OBJECTIVE The aim of this study was to determine the barriers and facilitators shaping the development of an intent to leave the nursing profession, from the perspective of Iran's clinical nurses. METHOD The study was completed using qualitative content analysis And included 21 Participants who were clinical nurses with a variety of work experience across a range of clinical posts. Semi-structured interviews were used to collect data and data obtained from the interviews were analyzed and interpreted utilizing a content analysis method. RESULTS During data analysis, 2 main themes, 5 categories and 12 subcategories were extracted as follows. Facilitators include: (I) spoiled identity (weak social status and violation of dignity), (II) frustration (feeling subordinate including a lack of appreciation), and (III) experience of hard labor (job stress, hard work and shift work). Inhibitors include: (I) positive management behaviors (rewards and support systems), and (II) being valuable (spiritual satisfaction, the efficient presence and professional capabilities development). CONCLUSION Based on the findings, it can be concluded that managers can prevent nurses from leaving clinical nursing by providing appropriate activities for them and increasing their motivation and satisfaction.

Resumo OBJETIVO Este estudo teve como objetivo determinar as barreiras e facilitadores que definem o desenvolvimento de uma intenção de abandonar a profissão de enfermagem, sob a perspectiva de enfermeiros clínicos do Irã. MÉTODO O estudo foi realizado através da análise de conteúdo qualitativo e incluiu 21 participantes que eram enfermeiros clínicos com vasta experiência de trabalho em uma variedade de cargos clínicos. A coleta de dados foi realizada através de entrevistas semiestruturadas, e os dados obtidos com as entrevistas foram analisados e interpretados através do método da análise de conteúdo. RESULTADOS Durante a análise dos dados, 2 temas principais, 5 categorias e 12 subcategorias foram obtidos como indicado a seguir. Os facilitadores incluem: (I) identidade debilitada (status social vulnerável e violação da dignidade), (II) frustração (sentimento de subordinação, incluindo falta de reconhecimento) e (III) experiência de trabalho árduo (estresse ocupacional, trabalho árduo e trabalho por turnos). Os inibidores incluem: (I) gestão de comportamentos positivos (recompensas e sistemas de apoio) e (II) ser útil (satisfação espiritual, eficiência e desenvolvimento de habilidades profissionais). CONCLUSÃO Com base nos achados, pode-se concluir que supervisores responsáveis podem impedir os enfermeiros de abandonarem a enfermagem clínica, delegando-lhes atividades pertinentes e aumentando sua motivação e satisfação.

Resumen OBJETIVO Estudio objetivando determinar obstáculos y facilitadores condicionantes del desarrollo de la intención de abandonar la profesión de enfermería, en la perspectiva de enfermeros clínicos de Irán. MÉTODO Se aplicó análisis cualitativo de contenidos. El estudio incluyó 21 participantes, todos ellos enfermeros clínicos con variada experiencia laboral en el campo de la enfermería clínica. Datos recolectados mediante entrevistas semiestructuradas, posteriormente analizados e interpretados por método de análisis de contenido. RESULTADOS Durante el análisis de datos fueron establecidos 2 temas principales, 5 categorías y 12 sub categorías, a saber. Los facilitadores incluyen: (I) identidad damnificada (status social debilitado y violación de la dignidad), (II) frustración (sentimiento de subordinación incluyendo falta de reconocimiento), y (III) percepción de alta carga laboral (estrés laboral, trabajo duro y turnos de trabajo). Los inhibidores incluyen: (I) comportamientos positivos de gestión (sistemas de recompensas y soporte), y (II) sentirse valorado (satisfacción espiritual, presencia eficiente y desarrollo de capacidades profesionales). CONCLUSIÓN En base a estos hallazgos, puede concluirse en que los gestores pueden prevenir el abandono de la profesión de los enfermeros clínicos brindándoles actividades apropiadas para ellos e incrementando su motivación y satisfacción.

Towards an understanding of clinical nurses challenges that leads intention to leave

Abstract Objective: Clinical nursing is the most important feature of the nursing profession and similar to the global community. The study objective was to identify and describe the challenges and why Iranian nurses leave their profession. Methods: Qualitative methods were applied to describe nursing practice challenges through in-depth and semi-structured interview of 16 Iranian nurses with 2 to 15 years of work experience in 2014 by asking: “Please tell me about your challenges at work and why nurses are leaving the nursing profession?” Obtained data were analyzed using conventional content analysis. Results: Analyzed data revealed four thematic categories as 1) unfriendly workplace, 2) lack of opportunity for professional advancement, 3) work stress, and 4) ethical issues. Conclusion: Recognizing nursing challenges in clinical setting can help faculty in academia and administrators in healthcare institutions to develop policies to reduce pitfalls and prevent attrition.

Design and Implementation Content Validity Study: Development of an instrument for measuring Patient-Centered Communication.

INTRODUCTION: The importance of content validity in the instrument psychometric and its relevance with reliability, have made it an essential step in the instrument development. This article attempts to give an overview of the content validity process and to explain the complexity of this process by introducing an example. METHODS: We carried out a methodological study conducted to examine the content validity of the patient-centered communication instrument through a two-step process (development and judgment). At the first step, domain determination, sampling (item generation) and instrument formation and at the second step, content validity ratio, content validity index and modified kappa statistic was performed. Suggestions of expert panel and item impact scores are used to examine the instrument face validity. RESULTS: From a set of 188 items, content validity process identified seven dimensions includes trust building (eight items), informational support (seven items), emotional support (five items), problem solving (seven items), patient activation (10 items), intimacy/friendship (six items) and spirituality strengthening (14 items). Content validity study revealed that this instrument enjoys an appropriate level of content validity. The overall content validity index of the instrument using universal agreement approach was low; however, it can be advocated with respect to the high number of content experts that makes consensus difficult and high value of the S-CVI with the average approach, which was equal to 0.93. CONCLUSION: This article illustrates acceptable quantities indices for content validity a new instrument and outlines them during design and psychometrics of patient-centered communication measuring instrument.

Experiences of patients with cancer and their nurses on the conditions of spiritual care and spiritual interventions in oncology units.

BACKGROUND: Although nurses acknowledge that spiritual care is part of their role, in reality, it is performed to a lesser extent. The purpose of the present study was to explore nurses' and patients' experiences about the conditions of spiritual care and spiritual interventions in the oncology units of Tabriz. MATERIALS AND METHODS: This study was conducted with a qualitative conventional content analysis approach in the oncology units of hospitals in Tabriz. Data were collected through purposive sampling by conducting unstructured interviews with 10 patients and 7 nurses and analyzed simultaneously. Robustness of data analysis was evaluated by the participants and external control. RESULTS: Three categories emerged from the study: (1) "perceived barriers for providing spiritual care" including "lack of preparation for spiritual care," "time and space constraints," "unprofessional view," and "lack of support"; (2) "communication: A way for Strengthening spirituality despite the limitations" including "manifestation of spirituality in the appearances and communicative behaviors of nurses" and "communication: Transmission of spiritual energy"; and (3) "religion-related spiritual experiences" including "life events as divine will and divine exam," "death as reincarnation," "trust in God," "prayer/recourse to Holy Imams," and "acceptance of divine providence." Although nurses had little skills in assessing and responding to the patients' spiritual needs and did not have the organizational and clergymen's support in dealing with the spiritual distress of patients, they were the source of energy, joy, hope, and power for patients by showing empathy and compassion. The patients and nurses were using religious beliefs mentioned in Islam to strengthen the patients' spiritual dimension. CONCLUSIONS: According to the results, integration of spiritual care in the curriculum of nursing is recommended. Patients and nurses can benefit from organizational and clergymen's support to cope with spiritual distress. Researchers should provide a framework for the development of effective spiritual interventions that are sensitive to cultural differences.

The nature of hope among Iranian cancer patients.

BACKGROUND: Hope is an important coping resource for cancer patients. Types and sources of hope and hope- inspiring strategies are not well investigated among Iranian cancer patients. The aims of present study were therefore to investigate the nature of hope and some demographic predictors of hope among Iranian cancer patients. MATERIALS AND METHODS: This descriptive-correlational study was undertaken among 200 cancer patients admitted to an educational center affiliated to Ardabil University of Medical Sciences, Iran. Participants were selected using a convenience sampling method. The Herth Hope Index and other validated questionnaires were used to investigate level of hope and types and sources of hope, as well as hope-inspiring strategies. Data were analyzed using SPSS statistical software. RESULTS: The overall score for hope was 31 from total scores ranging between 12 and 48. Some 94% of patients mentioned 'return to normal life' and 'complete healing of disease by drugs and physicians' as their main hopes. The most important sources of hope reported by patients include spiritual resources, family members, healthcare workers, and medicines and treatments available for the disease. Relationship with God, praying/blessing, controlling the signs and symptoms of the disease, and family/health care workers' support were the main hope-inspiring strategies. Patients who had a history of metastasis, or who were older, illiterate, divorced/widowed and lived with their children reported lower levels of hope. On the other hand, employed patients and those with good support from their families had higher levels of hope. CONCLUSIONS: The study findings showed moderate to high levels of hope among Iranian cancer patients. Accordingly, the role of spiritual/religion, family members and health care workers should be considered in developing care plans for these patients.

Association between Perception of Prognosis and Spiritual Well-being among Cancer Patients.

INTRODUCTION: Disclosure of cancer prognosis is one of the most difficult challenges in caring of cancer patients. An exact effect of prognosis disclosure on spiritual well-being of cancer patient was not completely investigated. Therefore, the present study aimed to investigate the relationship between perception of prognosis and spiritual well-being among cancer patients. METHODS: In this descriptive-correlational study, which conducted in 2013, two hundred cancer patients referred to Shahid Ghazi Hospital and private offices of two oncologists in Tabriz participated with convenience sampling method. Perception of prognosis was investigated by Perception of Prognosis Inventory and spiritual well-being of cancer patients was investigated by Paloutzian and Ellison Inventory. Data were analyzed using descriptive statistics and Pearson correlation test. RESULTS: Participants reported positive perception about the prognosis of their disease (score 11 from 15) and rated their spiritual well-being as high (score 99 from 120). There was a positive correlation between the perception of prognosis and spiritual health among cancer patients. CONCLUSION: Disclosure of cancer prognosis has negative effects on cancer patients. This result highlights the importance of considering cultural factors in disclosure of cancer prognosis. According to limitations of the present study approving these results need more studies.

Iranian cancer patient perceptions of prognosis and the relationship to hope.

BACKGROUND: The aim of this study was to investigate Iranian cancer patient perceptions of their prognosis, factors that influence perceptions of prognosis and the effect this has on patient level of hope. MATERIALS AND METHODS: Iranian cancer patients (n=200) completed self-report measures of their perceptions of their prognosis and level of hope, in order to assess the relationship between the two and identify factors predictive of perceptions by multiple linear regression analysis. RESULTS: Cancer patients perceived of their prognosis positively (mean 11.4 out of 15), believed their disease to be curable, and reported high levels of hope (mean 40.4 out of 48.0). Multiple linear regression analyses demonstrated that participants who were younger, perceived they had greater family support, and had higher levels of hope reported more positive perceptions of their cancer prognosis. CONCLUSIONS: Positive perceptions of prognosis and its positive correlation with hope in Iranian cancer patients highlights the importance of cultural issues in the disclosure of cancer related information.

Un-met supportive care needs of Iranian breast cancer patients.

BACKGROUND: Assessment of supportive needs is the requirement to plan any supportive care program for cancer patients. There is no evidence about supportive care needs of Iranian breast cancer patients. So, the aims of present study were to investigate this question and s predictive factors. MATERIALS AND METHODS: A descriptive- correlational study was conducted, followed by logistic regression analyses. The Supportive Care Needs Survey was completed by 136 breast cancer patients residing in Iran following their initial treatment. This assessed needs in five domains: psychological, health system and information, physical and daily living, patient care and support, and sexuality. RESULTS: Patient perceived needs were highest in the health systems and information (71%), and physical and daily living (68%) domains. Logistic regression modeling revealed that younger participants have more un-met needs in all domains and those with more children reported fewer un-met needs in patient care and support domains. In addition, married women had more un-met supportive care needs related to sexuality. CONCLUSIONS: The high rate of un-met supportive care needs in all domains suggests that supportive care services are desperately required for breast cancer patients in Iran. Moreover, services that address informational needs and physical and daily living needs ought to be the priority, with particular attention paid to younger women. Further research is clearly needed to fully understand supportive care needs in this cultural context.

Factors Influencing Communication Between the Patients with Cancer and their Nurses in Oncology Wards.

AIMS: The purpose of this study was to demonstrate the factors influencing nurse-patient communication in cancer care in Iran. MATERIALS AND METHODS: This study was conducted with a qualitative conventional content analysis approach in oncology wards of hospitals in Tabriz. Data was collected through purposive sampling by semi-structured deep interviews with nine patients, three family members and five nurses and analyzed simultaneously. Robustness of data analysis was evaluated by the participants and external control. RESULTS: The main theme of the research emerged as "three-factor effects" that demonstrates all the factors related to the patient, nurse, and the organization and includes three categories of "Patient as the center of communication", "Nurse as a human factor", and "Organizational structures". The first category consists of two sub-categories of "Imposed changes by the disease" and the "patient's particular characteristics". The second category includes sub-categories of "sense of vulnerability" and "perception of professional self: Pre-requisite of patient-centered communication". The third category consists of the sub-categories of "workload and time imbalance", "lack of supervision", and "impose duties in context of neglecting nurse and patient needs". Characteristics of the patients, nurses, and care environment seemed to be the influential factors on the communication. CONCLUSIONS: In order to communicate with cancer patients effectively, changes in philosophy and culture of the care environment are essential. Nurses must receive proper trainings which meet their needs and which focus on holistic and patient-centered approach.

Truth-telling and hematopoietic stem cell transplantation: Iranian nurses' experiences.

BACKGROUND: Hematopoietic stem cell transplantation is a potential cure for a range of life-threatening diseases, but is also associated with a high mortality rate. Nurses encounter a variety of situations wherein they are faced with discussing bad news with hematopoietic stem cell transplantation patients. RESEARCH OBJECTIVE: The aim of this study was to explore the experiences and strategies used by Iranian nurses related to truth-telling and communicating bad news to hematopoietic stem cell transplantation patients. RESEARCH DESIGN: A qualitative approach using content analysis of interview data was conducted. PARTICIPANTS AND RESEARCH CONTEXT: A total of 18 nurses from the main hematopoietic stem cell transplantation center in Iran participated in semi-structured interviews. ETHICAL CONSIDERATIONS: The Institutional Review Board of the Tabriz University of Medical Sciences and the Hematology-Oncology and Stem Cell Transplantation Research Center affiliated with the Tehran University of Medical Sciences approved the study. FINDINGS: In the first main category, not talking about the disease and potential negative outcomes, the nurses described the strategies of not naming the disease, talking about the truth in indirect ways and telling gradually. In the second main category, not disclosing the sad truth, the nurses described the strategies of protecting patients from upsetting information, secrecy, denying the truth and minimizing the importance of the problem. The nurses used these strategies to minimize psychological harm, avoid patient demoralization, and improve the patient's likelihood of a fast and full recovery. DISCUSSION: The priority for Iranian hematopoietic stem cell transplantation nurses is to first do no harm and to help patients maintain hope. This reflects the Iranian healthcare environment wherein communicating the truth to hematopoietic stem cell transplantation patients is commonly considered inappropriate and avoided. CONCLUSION: Iranian nurses require education and support to engage in therapeutic, culturally appropriate communication that emphasizes effective techniques for telling the truth and breaking bad news, thereby potentially improving patient outcomes and protecting patient rights.