How might cancer patients experience existential guilt? A qualitative research.

OBJECTIVES: Existential guilt is a deep and multidimensional concept that is correlated with concepts, such as in/authenticity, existential anxiety, decisiveness, and personal and social responsibility. The aim of the present study is to investigate the experience of existential guilt among cancer patients. METHODS: The present research was conducted with a qualitative method with a content analysis design. A purposeful sampling method was used to select the participants and the sampling procedure went on until we reached data saturation. Data were obtained using semi-structured interviews with the participants. RESULTS: From a total of 18 interviews, 94 codes related to existential guilt were obtained. After the analysis, three main concepts were extracted: (1) incompleteness, (2) passivity, and (3) feelings of harm to self and others. Each of these had a number of subcategories. SIGNIFICANCE OF RESULTS: The participants of the present research were found to experience existential guilt in different ways. The research showed that it is necessary to find the sources of existential guilt in order that effective therapeutic attention can be given cancer patients.

Systematic review and meta-analysis of the quality-of-life of patients with Parkinson's disease.

Background: Parkinson's disease can adversely affect the quality-of-life. Aims: We conducted a systematic review and meta-analysis of global literature on the quality-of-life of patients with Parkinson's disease and examined the association between patient characteristics and quality-of-life. Methods: We searched Embase, PubMed, Scopus and Web of Science from January 2000 to January 2020. We included articles published in English that used the Parkinson's disease questionnaire to estimate the quality-of-life score and to identify the determinants of quality-of-life in patients with Parkinson's disease. Results: In total, 41 studies with data from 4060 patients who had Parkinson's disease met our inclusion criteria. The overall quality-of-life score was 32.37 (95% confidence intervals (CI): 28.72-36.01). Age and duration of disease were inversely related to quality-of-life (P < 0.001). South America had the highest score on the questionnaire (39.73, 95% CI: 28.66-50.79, P < 0.001), indicating the lowest quality-of-life of patients with Parkinson's disease. Of the 6 World Health Organization regions, the Eastern Mediterranean Region had the highest score (36.28, 95% CI: 23.44-49.13, P < 0.001). Conclusion: Although the global score in patients with Parkinson's disease indicated an acceptable quality-of-life, there is a possibility for improvements. The findings of this study can inform evidence-based strategies by health policymakers and clinicians to enhance the quality-of-life of patients with Parkinson's disease.

Planning and Implementing the Protocol for Psychosocial Interventions by Social Workers in Iranian Healthcare Centers against COVID-19.

The present study aims to plan the protocol for providing psychosocial support by social workers in Iranian healthcare centers and reaching consensus in terms of implementing and offering comprehensive service to individuals dealing with the COVID-19 pandemic. This qualitative study consists of four phases. The first phase, the literature review involved studying valid databases, while the second and third phases consisted of collecting data through the Focus Group Discussions with 23 specialists and experts in the field of social work and mental health. Having been designed, the protocol was then applied and assessed for two months in all the state health centers around Iran (633 hospitals). In the present study, Interventions used by the social workers were divided into 9 types: psychosocial assessment, counseling, training, working with the family, intervention in the crisis, intra- and extra-organizational support-seeking, referral and safe discharge. Interventions used by social workers were also divided based on the health center (psychosocial support for the target groups and bereavement intervention for the survivors) and the services offered in convalescent care facilities. This protocol leading social workers into the fields of bereavement interventions, inter-organizational interventions, working with families and working with the medical staff.

The Effectiveness of Group Hope Therapy Training on the Quality of Life and Meaning of Life in Patients with Multiple Sclerosis and Their Family Caregivers.

Objective: Multiple sclerosis is a chronic, progressive neurological disease that, due to its special nature, has various physical and mental influences on the patients and their family's lives, decreasing the quality of life and threatening the meaning of life. The purpose of the present study was to evaluate the effectiveness of the group hope therapy training on the quality and the meaning of life in patients with multiple sclerosis and their family caregivers. Method : This quasi-experimental study was performed using pretest-posttest and control group. Thirty patients with multiple sclerosis along with 30 family caregivers who got low to medium scores on the Meaning in Life questionnaire by Steger (MLQ), Multiple Sclerosis Impact Scale (MSIS-29), and the Iranian Quality of Life questionnaire (IRQOL) for the caregivers were selected purposively. Then, the patients were randomly divided into two groups of 15 individuals in experimental and 15 individuals in control groups. The caregivers were grouped in the same manner. The protocol of group hope therapy training was carried out through eight two-hour sessions in two weeks separately on two experimental groups (the patients and the caregivers), and finally the posttest was given to four experimental and control groups. Results: The results of the data showed that the meaning of life in both the patient and the caregiver experimental groups increased significantly (P < 0.001), but there was no significant change in the patient and the caregiver control groups. Conclusion: Group hope therapy training is an effective intervention for improving the meaning of life and the quality of life in patients with multiple sclerosis. Also, any psychological intervention that aims to improve the quality of life in patients in an advanced stage of the disease requires attention to both the physical and the mental issues at the same time. Although group hope therapy training has improved the meaning of life in such patients, it did not have a significant impact on the quality of life. Therefore, paying attention to the stages of multiple sclerosis and the physical condition of the patients during the therapeutic intervention and adopting necessary complementary interventions seems to be essential.