Care Bermuda, families of the patients with chronic mental disorders in Iran surrounded by psychosocial problems and needs: a qualitative study.

Background: A mental disorder is characterized by a clinically significant impairment of cognition, emotion regulation, or behavior. As a result of the shift in care from medical centers and hospitals to home care, we now see a change in the treatment of patients with chronic mental disorders. Consequently, families have become the main support system in the progressive care of these patients, leading to psychological and social problems. The current qualitative study investigated the social and psychological health needs and problems of family caregivers of patients with chronic mental disorders in Iran's cultural and social context. Methods: This was a content analysis qualitative study. The study was conducted in three psychiatric hospitals in Farabi, Noor, Modares. Purposive sampling was done and continued until data saturation. Semi-structured, face-to-face, and individual interviews were conducted with 49 participants (15 family caregivers of patients with CMD and 34 members of the mental health care team). Data analysis was done using the conventional content analysis method. Results: Eight hundred seventy-five primary codes were obtained, which were classified into 10 subcategories and 3 main categories of 'health challenges of caregiver', 'confused concept of care' and "the need for a coherent support system. Conclusion: In Iranian society, after the patient is discharged from the hospital or care center, family members will change their role to the most important caregivers of these patients. The psychological and social health of these caregivers is destroyed because of the problems they have in providing care for their patients and their needs, which are not met.

Relationship between professional self-concept and perceived organizational support with family functioning in nurses in Isfahan, Iran.

BACKGROUND: Vocational issues affect nurses' family functioning in long term. So the purpose of this study is to investigate the relationship between professional self-concept and perceived organizational support with nurses' family functioning. MATERIALS AND METHODS: This descriptive correlational study conducted in hospitals affiliated to Isfahan University of Medical Sciences and 250 nurses who met the inclusion criteria participated in this study. The samples were selected conveniently from December 2022 to August 2022. To collect data, Cowin's professional self-concept questionnaire, Eisenberger's perceived organizational support questionnaire, and Epstein's family function measurement were used. Data collection was done in one step and cross-sectional. Descriptive statistics and inferential methods of data analysis consisted of Pearson's correlation coefficient and multiple linear regression were used. Data were analyzed with statistical package for the social sciences (SPSS) version 22. RESULTS: One of the six dimensions of professional self-concept consisted of staff relations significantly predicted the family function of nurses (P = .004). No significant relationship was found between perceived organizational support and nurses' family function (P = .825). CONCLUSION: Promoting the healthcare organizations' human climate may improve nurses' wellbeing and hereby their family functioning which could further improve quality of healthcare services. It may be worthwhile to suggest supporting interpersonal and interprofessional relationships to ensure a healthy professional life for the nurses.

Faculty members as academic knowledge brokers in Iran's health sector: a social network analysis study.

BACKGROUND: Interaction between researchers and policymakers is an essential factor to facilitate the evidence-informed policymaking. One of the effective ways to establish this relationship and promote evidence-informed policymaking is to employ people or organizations that can play the role of knowledge brokers. This study aims to analyze the communication network and interactions between researchers and policymakers in Iran's health sector and identify key people serving as academic knowledge brokers. METHODS: This study was a survey research. Using a census approach, we administered a sociometric survey to faculty members in the health field in top ten Iranian medical universities to construct academic-policymaker network using social network analysis method. Network maps were generated using UCINET and NetDraw software. We used Indegree Centrality, Outdegree Centrality, and Betweenness Centrality indicators to determine knowledge brokers in the network. RESULTS: The drawn network had a total of 188 nodes consisting of 94 university faculty members and 94 policymakers at three national, provincial, and university levels. The network comprised a total of 177 links, with 125 connecting to policymakers and 52 to peers. Of 56 faculty members, we identified four knowledge brokers. Six policymakers were identified as key policymakers in the network, too. CONCLUSIONS: It seems that the flow of knowledge produced by research in the health field in Iran is not accomplished well from the producers of research evidence to the users of knowledge. Therefore, it seems necessary to consider incentive and support mechanisms to strengthen the interaction between researchers and policymakers in Iran's health sector.

Notes to Factor Analysis Techniques for Construct Validity.

This paper introduces and discusses factor analysis techniques for construct validity, including some suggestions for reporting using the evidence to support the construct validity from exploratory and confirmatory factor analysis techniques. Construct validity is a vital part of psychological testing and a prerequisite to every measurement instrument, including aptitude, achievement, and interests. Research, particularly in nursing and the health sciences, depends on reliable and valid measurements. Therefore, a growing emphasis is on assessing validity regarding the structure of test variables commonly estimated by factor analysis techniques. However, it is not always clear how to report the analysis and use it to support the construct validity. Both exploratory and confirmatory factor analysis techniques provide vital evidence to support the construct validity. However, these are not the only available evidence for construct validity, and the researcher should always consider other sources of evidence to develop and support the construct validity of their intended measures. In addition, the collection and presentation of this evidence are not limited to a time, but the validity of constructs is a continuous process that leads to validating the underlying theories from which constructs have emerged.

The Effect of the Web-Based Psychosocial Health Promotion Program on the Burden of Care in Family Caregivers of Patients with Chronic Mental Disorders.

Background: Family members of Chronic Mental Disorders (CMD), who are responsible for patient care, face many physical, psychological, and social problems which make them face the burden of care. This study aimed to investigate the effect of a psychosocial health promotion program on the care burden of family caregivers of patients with CMD. Materials and Methods: This is a quasi-experimental study that was conducted in two intervention and control groups in the form of pretest and posttest. This study was performed on 67 family caregivers of patients with CMD in Farabi and Noor centers in Isfahan, Iran. Participants in this study were randomly divided into two intervention and control groups. Data from the intervention and control groups were collected in two stages, before and after the intervention by demographic information form and Zarit burden questionnaire. The intervention group received a web-based psychosocial health promotion program in eight sessions in 4 weeks. At the end of the intervention, the Zarit questionnaire was completed by the intervention and control groups. Results: The mean score of care burden between the intervention and control groups was not statistically significantly different before the implementation of the program (p = 0.534). But after the intervention, the mean score of care burden was significantly different between the two groups (t65 = 3.43, p = 0.001). Conclusions: This study provides evidence for the benefits of web-based psychosocial health promotion program in reducing the perceived care burden of the caregiver of CMD.

Requirements for promoting help-seeking behaviors in family caregivers of cancer patients: A qualitative study.

BACKGROUND: Caring for a family member with cancer is a challenging issue for families. Family caregivers often need the help of supportive resources to solve problems in their care role. A deep understanding of the requirements of caregivers to seek help is an effective step toward their ability to use supportive resources. This study aimed to identify and describe the requirements for promoting help-seeking behaviors in Iranian family caregivers of cancer patients. MATERIALS AND METHODS: This qualitative study was conducted through in-depth semi-structured interviews with 28 participants selected using purposeful sampling method from 2019 to 2021. An interview guide with general questions about seeking help was used to maintain coherence in data collection. The interviews continued until data saturation. All interviews were recorded, transcribed and analyzed through qualitative content analysis. RESULTS: The requirements of promoting help-seeking behaviors in family caregivers were grouped into four main categories: (1) improving social paths toward seeking help, (2) spiritual-psychological-cognitive empowerment toward seeking help, (3) strengthening the motivations behind seeking help, and (4) modifying the perception of cultural barriers to seeking help. CONCLUSION: According to the results of this study, it is expected that by identifying the requirements of caregivers for seeking help and by health stakeholders designing comprehensive programs to address these needs, caregivers will be empowered to use supportive resources and provide a better care role.

The effect of educational intervention on the quality of life of family caregivers of hemodialysis patients: A randomized controlled trial.

BACKGROUND: Family caregivers of hemodialysis patients experience various physical, psychological, social, economic, and spiritual problems that reduce their quality of life. The present study aimed to determine the effect of a family-centered education program on the quality of life of family caregivers of patients undergoing hemodialysis. MATERIALS AND METHODS: This was a randomized controlled trial that was performed on 70 caregivers of patients undergoing hemodialysis in the medical centers of Hazrate Ali Asghar and Hazrate Zahraye Marzieh in Isfahan. Caregivers were randomly divided into experimental and control groups, and the experimental group received an eight-session family-centered education program. Data were collected using the Quality of Life Scale (QOLS)-short form immediately after and 1 month after the intervention. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) software version 18 and analysis of variance and covariance. RESULTS: The results showed that both experimental and control groups were homogeneous in terms of demographic information and there was no significant difference between them in this regard. Analysis of data on quality of life and its four domains showed that the mean scores of quality of life (P = 0.089) and its four domains including physical health (P = 0.367), mental health (P = 0.429), community relations (P = 0.132), and environmental health (P = 0.232) increased significantly immediately after and 1 month after the intervention (P < 0.001 in all cases). CONCLUSION: Educational programs can improve the quality of life of family caregivers of hemodialysis patients. Therefore, it is recommended that programs be developed and evaluated in various studies in the future.

Promoting Psychosocial Health of Family Caregivers of Patients with Chronic Mental Disorders: A Review of Challenges and Strategies.

The present study aimed to investigate the mental and social health challenges of family caregivers of the patients with chronic mental disorders (CMD) and strategies which can be helpful in this regard. This study is a narrative review conducted in PubMed, Web of Science, Scopus, Elsevier, Google Scholar, Proquest, Magiran, and Sid databases where keywords such as Family caregiver, Chronic Mental disorder, Health Promotion, Program, Psychosocial, Support, Challenge, and Problem were searched in both Persian and English. A total of 5,745 published documents were found and were screened based on inclusion and exclusion criteria. Finally, 64 studies were found which had examined the related challenges, needs and strategies. According to the results, information deficits, needs for support, community participation deficits, and psychological suffering were recognized as challenges of family caregivers of these patients. Moreover, empowerments programs for the enhancement of the knowledge and skills of caregivers and peer-centered support programs were used to improve the level of mental and social health of family caregivers of these patients. Psychosocial problems and challenges that family caregivers of the patients with CMD face affect their health, satisfaction and quality of life. Using a collaborative approach, mental health service providers and government systems can help improve the psychosocial health of caregivers. The related managers and policymakers can reduce the emotional and psychological burden of families and promote their psychosocial health through developing a comprehensive program including practical objectives and strategies and taking into account the challenges that exist for caregivers in caring for patients with CMD.

Facilitating and Inhibiting Factors of Clinical Knowledge Sharing among Medical Specialists in University Hospitals.

Background: Clinical knowledge sharing (CKS) is one of the key points of knowledge management in the field of health and significantly increases the quality of care and patient safety. It also provides the achievement of an efficient system in hospitals and educational and treatment centers involved in clinical processes in order to make the best clinical decisions. The purpose of this research is to identify the factors that facilitate and inhibit CKS among medical specialists in the educational-treatment hospitals in Iran. Methods: This was an applied qualitative study with the conventional content analysis method conducted in 2022. The data collection tool was a semi-structured interview. The participants were 13 medical specialists and sub-specialists working in educational-treatment hospitals of the country, who were selected by purposeful and snowball sampling. The method of data analysis was based on Graneheim and Lundman's five-step method, which was followed by codes, sub-categories, main categories, and classifications. Results: After conducting the interviews and assessing their content, finally, 193 codes were extracted, which were identified in two general classification of facilitating and inhibiting factors with 92 and 101 concepts, respectively. Facilitating factors in the three main categories of "education in the context of culture, society and university", "planning and implementation management", and "behavioral-motivational factors" and inhibiting factors in the four main categories of "infrastructural, policy-making and cultural challenges", "technological and scientific infrastructural challenges", "personality-behavioral challenges", and "financial and non-financial motivations" were classified. Conclusions: The participants of the research pointed out the effective role of CKS in keeping them up-to-date in the use of diagnostic, therapeutic, and even drug prescribing methods. According to their belief, knowledge sharing (KS) in the clinical setting will reduce diagnostic errors and cause the primordial prevention of diseases as well as increase the knowledge and awareness of the society members.

Adherence Barriers to Treatment of Patients with Cardiovascular Diseases: A Qualitative Study.

Background: Adherence to treatment is highly important in the management of Cardiovascular Diseases (CVD). Barriers to effective and long-term adherence to treatment by the patient make achieving care and treatment goals challenging. The aim of this study was to identify the adherence barriers to the treatment plan in patients with CVD. Materials and Methods: A qualitative content analysis study was conducted to explore the experience of patients, family caregivers, and healthcare professionals (n = 35) using qualitative content analysis. The study was carried out between 2019 and 2020 in Isfahan, Iran. Purposive sampling was performed. Data collection was conducted through in-depth interviews and semi-structured until data saturation. Graneheim and Landman content analysis was performed simultaneously with data collection. Results: After data analysis, 3 themes and 6 categories were identified and named. Themes (and categories) include "Patients unreadiness to change" (misunderstanding of conditions and consequences and deterrence cultural practices and beliefs); "gap in healthcare services" (lack of adequate support for patients and discordance between healthcare professionals); and "limited access to healthcare services" (limited physical access and financial burden). Conclusions: The findings of the present study can provide a framework for healthcare professionals to employ preventive strategies, reduce disease complications, decrease unhealthy behaviours, and increase prolonged adherence to treatment recommendations in patients with CVD.

The Effectiveness of Self-Compassion Based Training Program on Resilience of Mothers of Children with Type 1 Diabetes in Isfahan, Iran.

Background: Concerns about the complications of diabetes and the responsibility of constantly managing a child's blood glucose are stressful for parents, especially for mothers, and can reduce their resilience. This study aimed to investigate the effectiveness of a self-compassion-based training program on the resilience of mothers of children with type 1 diabetes. Materials and Methods: This is a randomized clinical trial study. The statistical population of the study consisted of all mothers of children with type 1 diabetes who were being treated at the Isfahan Endocrine and Metabolism Research Centre, Iran. The study samples were recruited conveniently, 64 of whom were randomly divided into two groups (compassion training program = 32; control group = 32). The intervention group participated in eight training sessions. Data were analyzed using t-test, and Analysis of Covariance (ANCOVA) tests for between-group comparisons of dependent variables. Results: There was no significant difference between the mean scores of resilience before intervention (p > 0.05). Mean scores of resilience in the intervention group were significantly higher than the control group immediately (F1,60 = 9.726 p = 0.003) and 1 month after intervention (F1, 60 = 13.146, p = 0.001). Conclusions: It may be worthwhile to suggest compassion-based training program for mothers of children with type 1 diabetes to improve their resilience.

Strategies, facilitators, and barriers to interaction between health researchers and policy makers: Protocol for a systematic review.

This systematic review protocol is developed with the objective to identify the strategies, facilitators, and barriers to interaction between researchers and policy makers to use research evidence in health policy making. It seems that review of interactive methods between researchers and policy makers can help to understand the role of researchers on evidence-informed policy making. Moreover, identifying barriers and facilitators of these interactions can help universities and institutions associated to health policy making in planning to improve the interaction between researchers and policy makers to facilitate evidence-informed policy making.

Identification of the factors related to the clinical knowledge sharing: A protocol for systematic review.

Today, the ability of the organizations to successfully knowledge management and sharing can help them in better performance. Effective knowledge sharing (KS) in the clinical context provides better clinical decisions and improves the quality of care services. This systematic review will be conducted to identify the factors related to the clinical KS (CKS). This systematic literature review will be conducted to search the published documents about the affecting factors on the (clinical) KS. To this end, PubMed, Scopus, Web of Science, ProQuest, Cochrane, Embase, SID, Magiran, IranDoc, and ISC will be thoroughly assessed with considered keywords and search strategy. No time limit will be considered and all relevant documents published will be evaluated until the start date of the search. To the best of our knowledge, no systematic review study has been conducted on the factors related to CKS and our research will try to comprehensively extract the effective factors in this topic. Identifying the factors affecting CKS will lead to transparency in the exchange and interpretation of clinical knowledge in clinical care delivery and making the best clinical decisions as well as improving the quality of clinical care. It will also provide a condition to facilitate the delivery of more effective clinical education for policymakers in the field of clinical education.

The effect of cognitive-behavioral therapy on death anxiety and depression in patients with heart failure: A quasi-experimental study.

PURPOSE: In this study, the effect of cognitive-behavioral therapy (CBT) on death anxiety and depression was investigated in patients with heart failure. DESIGN AND METHODS: In this quasi-experimental study, 66 patients with heart failure were randomly assigned to intervention (n = 33) and control (n = 33) groups. Data collection was done using a demographic questionnaire, Templer death anxiety scale, and Beck depression inventory. FINDINGS: It was found that the overall scores of death anxiety and depression in posttest were significantly lower than those at the follow-up stage in the intervention group. PRACTICE IMPLICATIONS: CBT could significantly reduce death anxiety and depression in patients with heart failure. Therefore, it is recommended to equip nurses with CBT trainings to manage patients with heart failure better.