Moral Distress and Related Factors among Nurses Working in the Emergency Departments: A Cross-sectional Study.

Objective: The present study aimed to determine the prevalence and severity of moral distress (MD) and its associated factors among emergency department nurses. Methods: This cross-sectional study was conducted in 2023 on 172 nurses from the emergency departments of medical training centers affiliated with Mazandaran University of Medical Sciences. The census method was used to collect the data, which included demographic variables and Corley's MD questionnaire. The Data were analyzed using SPSS software (version 22), using an independent T-test, analysis of variance (ANOVA), and multiple regressions. Results: Out of 172 nurses, 60.5% were women, with an average age of 32.52±6.88 years. The results demonstrated an average MD score of 69.73±25.68. In terms of frequency and intensity, around 53.5% of the participants experienced MD at a low level (0-72), while the remaining 46.5% reported experiencing it at a medium level (14-73). A significant association was found between MD and age (p=0.037), workplace hospital (p=0.005), and history of mental disorders (p=0.005). Furthermore, linear regression analysis revealed a statistically significant association between MD, marital status, and occupational type (p<0.05). Conclusion: The results showed that nurses had low to moderate levels of MD. Several factors, including age, history of mental disorders, marital status, employment type, workplace hospital, and education, were associated with the overall MD score. To reduce MD and its negative effects on nurses, it is necessary to address these factors and develop an effective strategy for identifying and managing MD to improve nursing care quality.

Missed Nursing Care and Relationship to Burnout and Leave the Profession.

Nurses are at high risk of burnout, desire to leave the profession, and possibly missed nursing care due to the exhausting nature of caring. Missed nursing care may also affect nurses' burnout and desire to leave the profession. Therefore, the objective of this study was to determine the missed nursing care and its relationship with burnout and desire to leave the profession among intensive care unit nurses. The participants of this descriptive analytical study were 249 Iranian nurses working in intensive care units in 2022. The data were collected using a Demographic Information Questionnaire, Kalish's Missed Nursing Care Questionnaire, Maslach Burnout Inventory, and desire to leave the profession questionnaire. The majority of nurses (71%) were females. The generalized linear regression model showed that there was a significant relationship between missed care with gender (B = 5.55, P < .001), marital status (B = -7.37, P = .04), working shift (B = 7.80, P < .001), and employment status (B = -2.87, P = .02). Using structural equation modeling, it was found that the effect of missed care on burnout was significant. Considering the effect of missed care on burnout among nurses working in intensive care units, it seems that creating better working conditions, providing sufficient resources for nurses, supporting them, and changing the factors affecting missed care in order to improve the conditions can reduce the possibility of missing nursing care and, finally, burnout.

The Association between Occupational Burnout and Spiritual Well-being in Emergency Nurses: A Cross-Sectional Study.

Objective: This study evaluated the occupational burnout (OB) and spiritual well-being (SWB) of emergency nurses as well as the associations between these variables. Method: This cross-sectional study was conducted in six hospitals and emergency medical centers affiliated with Ardebil University of Medical Sciences (Ardebil, Iran), in 2020. Data were collected via socio-demographic, Spiritual Well-Being Scale (SWBS), and Maslach Burnout Inventory (MBI) questionnaires. Results: This study included 239 emergency department nurses. The mean age of the participants was 34.4±6.4 years. The mean of existential well-being and religious well-being was 40.3±8.7 and 41.0±9.2, respectively. The results indicated that moderate (P=0.007) and severe (P<0.001) personal accomplishment was a positive and significant predictor of the SWB in emergency department nurses. Conclusion: Proper planning and provision of suitable educational programs in the dimension of the SWB of nurses prevent the creation and continuation of OB and increase the self-efficacy and job satisfaction of emergency medical staff, resulting in better patient care.

The effect of melatonin on sleep quality and cognitive function of individuals undergoing hemodialysis.

BACKGROUND: and purpose: This study aimed to investigate the effect of melatonin on sleep quality and cognitive function of individuals undergoing hemodialysis. MATERIALS AND METHODS: In this randomized controlled clinical trial, 102 eligible individuals were assigned to two equal intervention and control groups. The intervention group received melatonin 3 mg tablets half an hour before going to bed for six weeks, while the control group was given a placebo with similar conditions. RESULTS: This study had 102 participants who were divided into intervention and control groups. The mean age of the participants was 58.30 (SD = 12.10). Among the participants, 54.90% were female. Moreover, 33.33% of the individuals received dialysis for four years or longer. After the intervention, the mean and standard deviation of the Pittsburgh Sleep Quality Index (PSQI) was 12.66 (SD = 3.09) in the intervention group and 18.86 (SD = 3.8) in the control group (P < 0.001). Moreover, the mean sleep quality index in the intervention group showed a statistically significant difference before and after the intervention (P < 0.001); the PSQI score declined from 20.21 to 12.66. Likewise, there was a statistically significant difference between the two groups after intervention in the mean Montreal Cognitive Assessment (MoCA) index (P = 0.002); it was 24.27 (SD = 3.42) in the intervention group and 22.15 (SD = 2.3) in the control group. The mean MoCA score in the intervention group showed a significant difference before and after the intervention (P < 0.001), increasing from 21.19 to 24.27. CONCLUSION: According to the study's findings, melatonin can improve individuals undergoing hemodialysis' cognitive function and sleep quality.

Effects of acupressure on intestinal function in patients with coronary artery bypass graft surgery: a randomized clinical trial.

Aim: This study aimed to determine the effects of acupressure on the intestinal function of patients undergoing Coronary Artery Bypass Graft (CABG) surgery. Background: Studies indicated that cardiovascular patients are prone to constipation. Acupressure is one of the therapeutic and palliative approaches that can be used by doctors, nurses, and even patients themselves. Methods: The present three-group randomized clinical trial study was conducted on 90 patients undergoing CABG surgery. In the intervention group, 48 hours after surgery the patients received acupressure points LI4 and ST25 twice a day (10 am and 6 pm) for three sequential days. In the sham group, the patients received acupressure at a 1.5 cm distance from the LI4-ST25 points, and the patients in the control group received only the usual care. This research used a demographic and medical information questionnaire, Rome IV scale, Bristol stool scale, symptom registration checklist, and daily excretion assessment checklist. The intestinal function indices were completed 24 hours after surgery (before intervention), 48, 72, 96, and 120 hours after surgery. Results: All three intervention, sham, and control groups were without defecation in 24 hours (before intervention) and 48 hours after surgery. There was a significant difference between the three intervention, sham, and control groups in the number of stools after 72 hours, 96 hours, and 120 hours after the intervention (p<0.001). Also, a significant difference was observed among the three groups in terms of stool consistency 96 hours after the start of the intervention (p=0.032) and 120 hours after the start of the intervention (p<0.001). Conclusion: The results showed that patients had a significant improvement in the number of bowel movements and stool consistency in the intervention group. In acute conditions, acupressure on LI4-ST25 points can positively affect intestinal function when patients are hospitalized in the intensive care unit.

Comparison of the effects of Benson relaxation technique and nature sounds on pain, anxiety, and body image in burn-injured patients admitted to the burn ICU: A single-blind randomized clinical trial.

BACKGROUND: Burn patients feel a lot of physiological and mental stress during treatment and rehabilitation which often cause anxiety and body image dissatisfaction. This study aimed to compare the effects of the Benson relaxation technique and nature sounds on pain anxiety and body image in burn-injured patients admitted to a burn intensive care unit (BICU). METHODS: This single-blind randomized clinical trial studied 60 burn patients allocated into three groups (Benson relaxation, nature sounds, and control) from September 2021 to February 2022. The patients received the intervention for seven consecutive days in person. Burn Specific Pain Anxiety Scale (BSPAS), was completed on the 1st, 4th, and 7th days. The intervention continued for four weeks measuring body image using the Satisfaction with Appearance Scale (SWAP) at the end of the 1st, 3rd, and 5th weeks. Finally, the data were statistically analyzed using the Shapiro-Wilk test, chi-square test, Fisher's exact test, Bonferroni post hoc test, repeated measures ANOVA, Kruskal Wallis test, and Generalize Estimating Equations (GEE). RESULTS: The mean pain anxiety and dissatisfaction with the appearance were high in the three groups in the pretest. On the 7th day after the intervention, the ANOVA showed that the mean pain anxiety decreased significantly in Benson's relaxation and nature sounds groups in three stages (before intervention (S1), after intervention (S2) and immediately after dressing change (S3) (P < 0.001). Correspondingly, the Kruskal Wallis test revealed that the body image dissatisfaction decreased significantly in the three groups at the end of the 3rd and 5th weeks (P < 0.001). The mean scores of pain anxiety showed that the nature sounds group proved more effective than the Benson relaxation technique. Also, the means scores of body image satisfaction showed that the Benson relaxation technique proved more effective than nature sounds. CONCLUSION: The study findings suggested that the Benson relaxation technique and nature sounds effectively reduces pain, anxiety, and improves body image satisfaction in patients with burn injuries.

A systematic review of self-esteem and related factors among burns patients.

Introduction: The present systematic review was conducted to examine self-esteem and related factors in burns patients. Methods: A comprehensive search was conducted from the first to the April 1, 2022 at the international electronic databases such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Burns", "Self-confidence", "Self-perception", "Self-esteem", and "Self-concept". Results: A total of 762 burn patients were included in this review from ten cross-sectional studies. The mean score of self-esteem in burn patients based on Rosenberg Self-Esteem Scale, State Self-Esteem Scale, Cooper Smith's self-esteem questionnaire, and Rifai's self-esteem scale were 17.77 (SD = 5.55) out of 30, 65.91 (SD = 5.49) out of 100, 56.68 (SD = 5.49) out of 100, and 109.77 (SD = 9.55) out of 145, respectively. Factors associated with self-esteem in burns patients were gender, occupation, the location of the burn, type of burn, site of burn, burn scar, and quality of life had a significant relationship with burn patients' self-esteem. Factors such as social support, family support, friends support, and supporting others, had a significant positive relationship with self-esteem of burns patient. However, self-esteem in patients with burn had a significant negative relationship with grade of burn injury, percentage of burn, depth of burn, facial burn, post-traumatic stress disorder, psychiatric morbidity, major depressive, and suicidality factors. Conclusion: Overall, patients with burns had moderate levels of self-esteem. Therefore, it is recommended that health professionals use interdisciplinary approaches to better manage burn patients.

Effect of a forensic nursing virtual education course on knowledge and clinical decision-making of master's nursing students in Iran: a non-equivalent control group pre- and post-test study

PURPOSE: Forensic nursing is a specialty in the nursing profession based on legal procedures. This study aimed to assess the effect of a forensic nursing virtual education course on knowledge and clinical decision-making among master's nursing students. METHODS: In a quasi-experimental study with a pre- and post-test, 106 master's nursing students at Guilan (n=65) and Mazandaran (n=41) Universities of Medical Sciences, Iran were enrolled. Data were collected using census sampling from March to April 2021. Participants in the intervention group received a forensic nursing virtual education course in three 90-minute sessions for 2 days. RESULTS: A total of 88 out of 106 master's nursing students were enrolled in this study. The mean post-education score for knowledge in the intervention group was significantly higher than in the control group (12.52 vs. 7.67, P<0.001). The mean post-education score for clinical decision-making in the intervention group was significantly higher than in the control group (16.96 vs. 13.64, P<0.001). CONCLUSION: The level of knowledge and clinical decision-making of master's nursing students regarding forensic evidence improved after the forensic nursing virtual education course in the intervention group compared to the control group. Nursing managers and policymakers can develop appropriate strategies to improve the knowledge and clinical decision-making of nursing students by using forensic nursing education courses in the curricula of nursing programs, especially in postgraduate education as an elective or mandatory course.

Investigation of antibacterial, antifungal, antibiofilm, antioxidant and anticancer properties of methanol extracts of Salvia marashica Ilçim, Celep & Dogan and Salvia caespitosa Montbret & Aucher ex Benth plants with medicinal importance.

In this study, Antimicrobial, Antifungal and Antibiofilm activity tests on 16 bacteria and 2 fungi of Salvia marashica Ilçim, Celep & Dogan and Salvia caespitosa Montbret & Aucher ex Benth species were performed by Agar Well Diffusion and Microdilution methods. Salvia species showed sensitivity with a zone diameter of 12-16 mm. Concentrations of 0.5 mg/ml to 16 mg/ml by the dilution method were used to determine the Minimum inhibited concentration (MIC) and Minimum bactericidal concentration (MBK). The MIC values of the plants are mostly 0.5 mg/ml - 4 mg/ml and MBC values are between 0.5 mg/ml - 8 mg/ml. Antifungal activity findings are remarkable on the species and it has been observed to have very high effects especially on Candida parapsilosis. When the antioxidant research findings are examined; It was observed that Salvia marashica and Salvia caespitosa plants have approximately 75% antioxidant activity at 1 mg/ml, and findings mostly directly proportional between concentrations and antioxidant activity capacity were recorded. MCF-7 and HUVEC cell lines were used to investigate anticancer activity properties. In line with the findings, while the IC50 value of Salvia marashica on the MCF-7 Cell line was 0.125 mg/ml, it was 1.65 mg/ml in the HUVEC cell line, while the IC50 value of Salvia caespitosa on the MCF-7 Cell line was 0.115 mg/ml in the HUVEC Cell line. It was found to be 9.87 mg/ml. It has been proven that both Salvia species have a cytotoxic effect on the MCF-7 Cell line.

The effect of an empowerment program on the moral sensitivity and caring behaviors of emergency nurses in Iran.

AIM: The present study aimed to evaluate the effect of an empowerment program on the moral sensitivity and caring behaviors of nurses in emergency departments in Iran. BACKGROUND: Emergency department is often a high stress environment. Nurses who worked in the emergency departments are expected to work under pressure to many standards, guidelines and protocols related to patient care. It will expose emergency department nurses to psychological pressures and moral conflicts. A nurse's sensitivity to ethical issues is necessary to provide humane care; it is considered to be a professional competence for nurses. METHODS: This study had a controlled quasi-experimental design. Data were collected before, immediately after, and 1 month after the intervention using a moral sensitivity questionnaire and a caring behavior questionnaire. A total of 131 emergency department nurses from 4 teaching hospitals were divided into an intervention group and a control group. The intervention group received six 60-minute training sessions; the control group did not receive the training. RESULTS: The mean moral sensitivity and caring behavior scores for both groups increased significantly immediately and 1 month after the intervention. However, the significance was higher in the intervention group than in the control group. A comparison of the mean moral sensitivity and caring behavior scores between the groups immediately and 1 month after the intervention did not show a statistically significant difference. CONCLUSIONS: Implementing a training program on ethical issues could thus have a significant impact on the clinical performance of nurses, which could be maintained through follow-up.

Comparing the effects of teach-back method, multimedia and blended training on self-care and social support in patients with heart failure: A randomized clinical trial.

BACKGROUND: The knowledge level of caregivers and their support for patients can affect the self-care of patients with heart failure (HF). The present study was conducted to compare the effects of teach-back, multimedia, and blended training methods on self-care and social support in patients with HF and on knowledge in their caregivers. MATERIALS AND METHODS: In a randomized clinical trial, a total of 150 HF patient-caregiver dyads were randomly allocated into three equally sized training groups, using a simple number table (n = 50). The study was conducted between May to October 2018 in Sari, northern Iran. In the teach-back, multimedia and blended training groups, patient-caregiver dyads participated in 20-30-min training sessions held face-to-face, using digital video disc (DVD) and combination of teach-back and DVD on 4 consecutive days at the bedside of hospitalized patients in coronary care unit, respectively. Data were collected using the European Heart Failure Self-Care Behaviour Scale and the multidimensional scale of perceived social support for patients. Caregivers' level of knowledge was measured using the HF Knowledge Scale. Data were measured on the first day of hospitalization, 1 day before discharge and 4 and 8 weeks after patients' discharge. Data were analyzed using SPSS version 18 (SPSS Inc., Chicago, IL, USA). RESULTS: All three educational methods improved self-care behaviors in patients. The comparison of self-care behavior scores in patients with HF among the three groups at different time points showed no statistically significant differences (P > 0.05), except 1 day before discharge (P = 0.04). There were no statistically-significant differences between the teach-back, multimedia and the blended training group in terms of perceived social support at any of the four-time points (P > 0.05). All three training methods improved the level of knowledge of caregivers. However, the score in the blended training groups was higher than the other groups (P < 0.001). CONCLUSION: According to the results of the present study, it seems that all three educational interventions can improve self-care behaviors in HF patients and increase knowledge in their caregivers. However, using the blended training method was associated with better outcomes.

Depression in the Iranian Elderly: A Systematic Review and Meta-Analysis.

Depression can lead to increased medical costs, impaired individual and social functioning, nonadherence to therapeutic proceeding, and even suicide and ultimately affect quality of life. It is important to know the extent of its prevalence for successful planning in this regard. This study was conducted to determine the prevalence of depression in the Iranian elderly. This systematic review and meta-analysis study was done through Medline via PubMed, SCOPUS, Web of Science, ProQuest, SID, Embase, and Magiran with determined keywords. Screening was done on the basis of relevance to the purpose of the study, titles, abstracts, full text, and inclusion and exclusion criteria. The quality of the articles was assessed using the Newcastle-Ottawa standard scale. After primary and secondary screening, 30 articles were finally included in the study. According to the 30 articles reviewed, the prevalence of depression in the Iranian elderly was 52 percent based on the random-effects model (CI 95%: 46-58). According to the results of the present study, depression in the Iranian elderly was moderate to high. Therefore, more exact assessment in terms of depression screening in elderly people seems necessary. Coherent and systematic programs, including psychosocial empowerment counselling for the elderly and workshops for their families, are also needed. Researchers can also use the results of this study for future research.

Investigating the effect of seeing patients' pre-burn face photo on the quality of care and level of empathy of nurses with patients admitted to BICU.

BACKGROUND: One of the results of burn injuries is the appearance of scars and deformities in various organs of the body, which can cause many physical and psychological challenges to burn patients. Lack of proper communication between nurse and patient leads to inaccurate identification of psychological and social needs of these patients and thus affects the quality of care. AIM: This study aimed to investigate the effect of seeing the patient's pre-burn face photo on the quality of care and empathy of nurses with patients admitted to the burn intensive care unit. METHODS: The present study is a quasi-experimental interventional study conducted on 26 Burn Intensive Care Unit (BICU) nurses who were selected by census sampling method in 2018. Data were collected through QUALPAC Nursing Care Quality Questionnaire, Lumonica Empathy Questionnaire and Demographic Questionnaire, which were completed by nurses before and after the intervention. Pre-burn photos of patients with facial burns were displayed at the nursing station for one month and the data were compared before and after the intervention. Descriptive statistics and paired t-test and independent t-test, Mann-Whitney and Pearson correlation tests were used to analyze the data. FINDINGS: The results of present study showed that there was a statistically significant difference between the quality of nursing care (p = 0.001) and its psychological dimension (p < 0.001) before and after the intervention in the group of nurses. However, no significant relationship was found between nurses' empathy with patients before (p = 0.901) and after intervention (p = 0.001). CONCLUSION: Seeing the photo of the patient's pre-burn face and establishing a relationship between the nurse and the patient had an effect on the quality of nursing care and especially its psychological dimension. However, in order to generalize the results and implement this low-cost, convenient and low-complication intervention for all patients admitted to the intensive care unit, more studies are needed in this field.

Perception of futile care and caring behaviors of nurses in intensive care units.

OBJECTIVES:: Futile medical care is considered as the care or treatment that does not benefit the patient. Staff of intensive care units experience moral distress when they perceive the futility of care. Therefore, this study aimed to determine the relationship between perceptions of nurses regarding futile medical care and their caring behaviors toward patients in the final stages of life admitted to intensive care units. METHOD:: This correlation, analytical study was conducted with 181 nursing staff of the intensive care units of health centers affiliated to Mazandaran University of Medical Sciences, Mazandaran, Iran. The data collection tool included a three-part questionnaire containing demographic characteristics form, perception of futile care questionnaire, and caring behaviors inventory. To analyze the data, statistical tests and central indices of tendency and dispersion were investigated using SPSS, version 19. Pearson's correlation coefficient, partial correlation, t-test, and analysis of variance tests were performed to assess the relationship between the variables. ETHICAL CONSIDERATIONS:: The study was reviewed by the ethics committee of the Mazandaran University of Medical Sciences. Informed consent was obtained from participants. RESULTS:: Our findings illustrated that the majority of nurses (65.7%) had a moderate perception of futile care, and most of them (98.9%) had desirable caring behaviors in taking care of patients in the final stages of life. The nurses believed that psychosocial aspects of care were of utmost importance. There was a significant negative relationship between perception of futile care and caring behavior. CONCLUSION:: Given the moderate perception of nurses concerning futile care, and its negative impact on caring behaviors toward patients, implementing suitable interventions for minimizing the frequency of futile care and its resulting tension seems to be mandatory. It is imperative to train nurses on adjustment mechanisms and raise their awareness as to situations resulting in futile care.

Relationship of Hemodialysis Shift With Sleep Quality and Depression in Hemodialysis Patients.

This descriptive correlational study was aimed at determining the relationship of hemodialysis shift with sleep quality and depression in 310 hemodialysis patients. Demographic and Clinical Questionnaires, the Pittsburgh sleep quality index, and Beck's Depression Inventory were used to ascertain the aforementioned relationship. Among the patients, 59.6% reported poor sleep quality and 44.8% reported experiencing depression. Results show that these conditions were significantly related to many factors. Although dialysis shift was not significantly related to sleep quality and depression, sleep quality was found significantly associated with age, female gender, illiteracy, unemployment, residence in rural areas, diabetes, addiction to sedatives, and phosphorus levels. A significant relationship was also found between depression and phosphorus levels. Logistic regression predicted age, gender, illiteracy, unemployment, residence in rural areas, and addiction to sedatives as factors for poor sleep quality. A body mass index (BMI) above 30, decreased urea, and increased phosphorus were predicted as factors for increased depression.

Persian version of thirst distress scale (TDS) in patients on hemodialysis: Factor structure and psychometric properties
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BACKGROUND: Patients on hemodialysis can experience thirst distress. However, there is no valid and reliable Persian instrument to measure this condition in such patients. The present study aims to determine the psychometric properties of the Persian version of the thirst distress scale (TDS) for patients on hemodialysis. MATERIALS AND METHODS: Our sample consisted of 142 hemodialysis patients completed the TDS Persian version. The face, content, and construct validity of the scale were ascertained. Reliability was also assessed using internal consistency, construct reliability, and intra-class correlation coefficient (ICC). RESULTS: Construct validity determined one factor with an eigenvalue greater than 0.7. The model revealed good fitness (χ2 (121, N = 142) = 269.32, p < 0.001; χ2df = 2.225, goodness of fit index (GFI) = 0.912, normed fit index (NFI) = 0.866, comparative fit index (CFI) = 0.926, incremental fit index (IFI) = 0.961, and root mean square error of approximation (RMSEA) = 0.089 (90% confidence interval = 0.069 - 0.109)). The internal consistency, construct reliability, and ICC were greater than 0.70. The scale's convergent validity was demonstrated. CONCLUSION: This study confirmed the acceptable psychometric properties and the factor structure of the TDS in Iranian patients on hemodialysis.
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The Effect of Relaxation Technique on Fatigue Levels after Stem Cell Transplant.

BACKGROUND: Many patients undergoing hematopoietic stem cell transplant (HSCT) experience fatigue due to their disease process and its long period of treatment. Using nonpharmacological methods to help reduce their fatigue is a reasonable endeavor. The present study was conducted to investigate the effect of Benson's relaxation technique on fatigue levels in patients after HSCT. MATERIALS AND METHODS: Thirty-seven patients were randomly selected to the intervention (n = 19) and control group (n = 18). In the intervention group, the participants performed Benson's relaxation exercises for 20 min twice per day over a period of 15 days. The data collection tools used included a demographic and medical information form and the Brief Fatigue Inventory, completed by both groups on three different occasions (upon admission and days 8 and 14 after the HSCT). The data obtained were analyzed in Statistical Package for the Social Sciences version-20 using statistical tests. RESULTS: The results of the independent t-test showed no significant preintervention differences in fatigue levels between the two groups. On days 8 (t = 11.21, p < 0.001) and 14 after the transplant (t = 15.62, p < 0.001), a significant difference was observed in the mean level of fatigue between the two groups. CONCLUSIONS: These findings indicate that Benson's relaxation technique would improve fatigue in HSCT patients.

Determining the Effectiveness of Acceptance and Commitment Therapy (ACT) on Life Expectancy and Anxiety Among Bereaved Patients.

INTRODUCTION: Acceptance and commitment therapy tries to increase one's psychological acceptance regarding subjective experiences (thoughts, feelings, etc.,) and in turn, decrease ineffective control actions. AIM: The current study was conducted with the aim to investigate the effect of acceptance and commitment therapy (ACT) on the amount of life expectancy and anxiety among bereaved patients. MATERIAL AND METHODS: This research was a quasi-experimental study with pretest-post-test control group design. The statistical population included all bereaved patients aged between 20-40 who referred to counseling and treatment centers and psychiatric clinics in Tehran in 2015. Bereaved patients were identified through convenient random sampling method amongst patients and based on clinical diagnosis of psychiatrist treating patients. Thirty four persons were chosen and were randomly assigned in two 17- persons experimental and control groups. Both groups were evaluated at two stages of pre-test and post-test through anxiety scale (Spielberger STAI-y 1970) and life expectancy (Schneider, 1991). FINDINGS: Conducted investigation shows that the average life expectancy in the experimental group has increased from 12.40 to 23.30 after acceptance and commitment therapy. Moreover, the average of anxiety scores in the experimental group has decreased in post-test from 121.20 to 79.10 after acceptance and commitment therapy. Results of covariance analysis revealed that the experimental group subjects experienced a significant lower level of anxiety than those in control group (p<0.001). Furthermore, the life expectancy has significantly increased in the experimental group (p<0.001). CONCLUSION: Inefficient beliefs (illogical), intellectual faults and cognitive distortions have reduced, and these in turn cause a reduction in anxiety. In this way bereaved patients' life expectancy has increased. CONCLUSION: The acceptance and commitment therapy has led to the anxiety reduction and caused an increase in bereaved patients' life expectancy.

Effects of nonpharmacological interventions on reducing fatigue after hematopoietic stem cell transplantation.

Fatigue is one of the main complaints of patients undergoing allogeneic and autologous hematopoietic stem cell transplantation (HSCT). Since nonpharmacological interventions are cost-effective and causes fewer complications, this study aimed to review the studies performed on the effects of nonpharmacological interventions on fatigue in patients undergoing HSCT during September 2016. MEDLINE, CINAHL, Scientific Information Database, IranMedex, PubMed, ScienceDirect, Scopus, Magiran, and IRANDOC databases were searched using Persian and English keywords. A total of 1217 articles were retrieved, 21 of which were used in this study. Exercise is known as an effective intervention in alleviating physical and mental problems of patients undergoing stem cell transplant. This review-based study showed that nonpharmacological methods such as exercise might be effective in decreasing fatigue in patients undergoing stem cell transplant. There is a multitude of studies on some of the complementary and alternative therapy methods, such as music therapy, yoga, relaxation, and therapeutic massage. These studies demonstrated the positive effects of the aforementioned therapies on reduction of fatigue in patients undergoing stem cell transplantation. All the investigated methods in this study were nonaggressive, safe, and cost-effective and could be used along with common treatments or even as an alternative for pharmacological treatments for the reduction, or elimination of fatigue in patients undergoing stem cell transplantation. Given the advantages of complementary and alternative medicine, conducting further studies on this issue is recommended to reduce fatigue in patients after stem cell transplantation.