The effect of mindfulness-based stress reduction (MBSR) training on serum cortisol levels, depression, stress, and anxiety in type 2 diabetic older adults during the COVID-19 outbreak.

Old age is rapidly increasing and is linked to with chronic diseases, especially diabetes. Diabetes is associated with increased anxiety, stress, and depression and, in turn, can increase cortisol secretion. To this end, the present research studied the impact of mindfulness-based stress reduction (MBSR) training on serum cortisol levels, depression, anxiety, and stress in type 2 diabetic (T2DM) older adults during the COVID-19 epidemic. The participants in this interventional work were 56 older adult patients with type 2 diabetes chosen through systematic random sampling and then randomly divided into control and intervention groups containing equal members. In the intervention group, the participants attended eight mindfulness-based stress reduction (MBSR) training sessions. The subjects in the control group received no intervention. Since four patients left the study, only data for 52 patients were collected using the Depression Anxiety Stress Scale (DASS-21) and a demographic and disease information questionnaire. Data were examined with SPSS18 software using the Kolmogorov-Smirnov test, chi-square test, Fisher test, independent samples t-test, and two-way ANOVA; the significance was p<0.05. Statistically significant differences were observed between the mean scores of anxiety, stress, depression, and cortisol levels in the intervention group (p<0.00001) before, directly after, and three months after the intervention. However, no statistically significant difference was observed in the mentioned variables in the control group. The mindfulness-based stress reduction (MBSR) intervention can improve anxiety, depression, stress, and cortisol levels in older adults suffering from T2DM.

Psychometrics of the Persian Version of the Team Assessment Questionnaire in Providing Care for Heart Failure Patients.

BACKGROUND: Teamwork in the health care domain is the preferred mode of care delivery. Few instruments have been developed to assess teamwork in the field of health care, particularly in Iran. This study aimed to validate the Persian version of the Team Assessment Questionnaire (P-TAQ) in care for Congestive Heart Failure (CHF) patients. MATERIALS AND METHODS: In this cross-sectional study, the validity (face, content, and construct validity) and the reliability (internal consistency and stability) of the cross-cultural adaptation of the Persian version of the Team Assessment Questionnaire (P-TAQ) were assessed. RESULTS: The P-TAQ had adequate face and content validity. The confirmatory factor analysis confirmed the seven dimensions of the questionnaire. The internal consistency of the P-TAQ was 0.91, and the Intraclass Correlation Coefficient (ICC) was 0.89. CONCLUSIONS: The P-TAQ is a valid questionnaire in terms of dimensions and items. Assessing teamwork is an essential component of delivering adequate care. By examining the status of teamwork using this questionnaire, it is possible to promote teamwork and to understand its strengths and weaknesses. Future research is necessary to better understand the P-TAQ so that it can be used for the assessment of teamwork outcomes regarding patient safety, cultural barriers, and medical errors.

Growth: A Journey from Experience to Higher Perception Among Iranian Muslim CPR Survivors.

Several studies have been conducted among cardiopulmonary resuscitation (CPR) survivors. Some studies have shown that positive and negative experiences coexist. Emotional distress and psychopathology in CPR survivors are related to the urgent need to make growth. Understanding the meaning of CPR survivors' lived experiences of growth may facilitate their growth. The aim of the study was to illuminate the meaning of CPR survivor's lived experiences of growth in southeast Iran. A qualitative design using a phenomenological hermeneutic approach influenced by Ricoeur was used in 12 CPR survivors. Three main themes emerged including: (1) opening up a new horizon in the meaning of life, (2) opening up a new horizon in the meaning of interpersonal connections and (3) opening up a new horizon in the meaning of God and spirituality. The interpreted comprehensive understanding conveyed a meaning that CPR survivors' experience of growth seems to be like opening the doors of perception to the higher reality. The finding may assist other CPR survivors to learn from participants in this study. Exposure to suitable narratives under health care provider supervision could develop profound learning. Training sessions with an emphasis on meditation education and how to use connecting to God in the adaptation process may approve the quality of life of CPR survivors.

Post-traumatic Stress Disorder and Post-traumatic Growth Among Muslim CPR Survivors.

The present study was conducted to compare post-traumatic growth (PTG) and post-traumatic stress (PTSD) in CPR survivors in Shia and Sunni. In a cross-sectional study, the results showed that the mean score of PTSD in Sunni (n = 74) was more than that of Shia (n = 89). There was no difference between Shia and Sunni in the mean score of PTG. Regarding the useful role of religion on PTG, the use of religious coping strategies in post-traumatic life-threatening situations can be helpful. It is recommended that further studies be conducted on the cultural, social, and psychological factors affecting PTG and PTSD in different societies.

The mediating role of difficulties in emotion regulation on attachment styles of adolescents with conduct disorders.

Adolescence is a period of achieving emotion regulation skills. One of the main responsibilities of adolescents is to learn adaptive emotion regulation and personal autonomy. The purpose of this study was to investigate the mediating role of difficulties in emotion regulation in the attachment styles of adolescents with conduct disorders. This was a cross-sectional and correlational study. The study consisted of 105 adolescent residing in detention centers in the southeast of Iran using multi-stage random sampling. Data were collected using various questionnaires such as the Inventory of Parents and Peer Attachment-Revised (IPPA-R), the Difficulties of Emotion Regulation Scale (DERS), and the Strength and Difficulties Questionnaire (SDQ). Information was analyzed using path analysis. The results show parental attachment and difficulties in emotion regulation significantly contribute to the prediction of conduct problems. A sense of alienation causes conduct disorders through disturbance in emotional regulation, but trust and communication with parents are only indirectly related to conduct disorders by disturbances in emotional regulation. As attachment is closely correlated with emotional regulation and difficulties in emotion regulation also lead to the conduct disorders, it is suggested to train emotion regulation in adolescents and their families with the aim of shaping relationships that will lead to the formation of a secure attachment style in the child.

Correction to: Burst Out of the Dead Land by the Help of Spirituality: A Case Study of Living with Blindness and Cancer.

In the original version of this article, there is a typo in the family name of the author. The co-author family name should be Seyed Bagheri; instead, it has been published as Seyed bagheri.

Post-traumatic stress and growth among CPR survivors in the southeast of Iran.

Background Almost 7.2%-10.6% of patients survive CPR in Iran. Most of them experience post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG). There are limited studies to assessing the correlation between these two psychological outcomes among CPR survivors. Objective This study aimed to examine the correlation between PTSD and PTG among CPR survivors in South-East Iran. Subjects Using Quota sampling, 163 CPR survivors in two provinces in the South-East of Iran were selected to participate in this study. Method A descriptive-correlational study was used to fulfill the aim of the study. The impact of Event Scale-Revised (IES-R) for assessing PTSD and Post-traumatic growth questionnaires were used to assess PTG. Results The mean score of PTSD was 39.89 and according to the cutoff point, 87.1% of participants suffered from PTSD. The mean score of PTG was 78.6. PTSD and PTG had significant negative correlation. The result of multi-variate logistic regression showed that only the PTG score predicted PTSD (Odds ratio = 0.79, CI = 0.72-0.87; and p < 0.001). The result of multi-variate linear regression indicated that PTSD, time passed since CPR, and physical disability caused by CPR predicted PTG score significantly. Conclusion This study provides CPR survivors and health care personnel with some valuable insights about cultural aspects of PTSD and PTG among CPR survivors and that PTG is positively influenced by physical disability and time passed since CPR. CPR survivors may gain positive experience and valuable insight in group meetings and discussions with their counterparts.

Challenges of teacher-based clinical evaluation from nursing students' point of view: Qualitative content analysis.

INTRODUCTION: Clinical evaluation is very important in the educational system of nursing. One of the most common methods of clinical evaluation is evaluation by the teacher, but the challenges that students would face in this evaluation method, have not been mentioned. Thus, this study aimed to explore the experiences and views of nursing students about the challenges of teacher-based clinical evaluation. METHODS: This study was a descriptive qualitative study with a qualitative content analysis approach. Data were gathered through semi-structured focused group sessions with undergraduate nursing students who were passing their 8th semester at Rafsanjan University of Medical Sciences. Date were analyzed using Graneheim and Lundman's proposed method. Data collection and analysis were concurrent. RESULTS: According to the findings, "factitious evaluation" was the main theme of study that consisted of three categories: "Personal preferences," "unfairness" and "shirking responsibility." These categories are explained using quotes derived from the data. CONCLUSION: According to the results of this study, teacher-based clinical evaluation would lead to factitious evaluation. Thus, changing this approach of evaluation toward modern methods of evaluation is suggested. The finding can help nursing instructors to get a better understanding of the nursing students' point of view toward this evaluation approach and as a result could be planning for changing of this approach.

Burst Out of the Dead Land by the Help of Spirituality: A Case Study of Living with Blindness and Cancer.

Blindness is one of the most complex problems related to health throughout the world. The condition is worse when such stress is accompanied with cancer. The aim of this case study was to introduce a patient with both these conditions who could come over her problems well. A phenomenological hermeneutic approach influenced by Ricoeur was used to explore the experience of the patient. Data were collected through unstructured and deep interview and by checking patient medical records. The patient is an Iranian 58-year-old teacher residing in Kerman who became blind at age 32 due to bloodshed inside the eye and was affected by breast cancer at age 52. The patient could come over these divine tests through the help of spirituality so that she believed blindness and cancer was the best events in her life. Spirituality is one of the human aspects that give meaning and purposes to life. Health care providers are suggested to implement spiritual strategies such as instructional workshops for increasing spirituality in settings, such as oncologic wards for patients to pass stages of adaptation to such great stresses easily and rapidly.