Resilience and spirituality mediate anxiety and life satisfaction in chronically Ill older adults.

BACKGROUND: Spirituality and psychological resilience can be considered as a protective factor for coping with anxiety in geriatric populations. The aim of the study was to investigate the structural model related to the mediating role of spirituality and psychological resilience in predicting the relationship between anxiety and life satisfaction in older adults with chronic illness. METHODS: In a cross-sectional study, one hundred patients over sixty years of age from one university hospital were selected by convenience sampling. Data were collected using the Spiritual Health Scale, the Anxiety Module of the Hospital Anxiety and Depression Scale, the Connor-Davidson Resilience Scale, the Life Satisfaction Scale, and a sociodemographic questionnaire. Data analysis was performed using Partial Least Squares (PLS) structure modeling. RESULTS: There was a positive and significant relationship between resilience, spirituality and life satisfaction of the samples. The structural model showed that spirituality, and psychological resilience mediated in the relationship between anxiety and life satisfaction directly and in indirectly in the older people with chronic disease, explaining approximately 34% of the variance in life satisfaction. CONCLUSIONS: The findings suggest that spirituality and psychological resilience can help older adults with chronic illness to negate the impact of anxiety on satisfaction, with the effect of spirituality being stronger than resilience in this relationship.

Developing a Culture of Civility in Nursing Students.

ABSTRACT: Incivility is a significant problem in nursing education. The purpose of the study was to determine the impact of culture management on incivility in nursing students. Nursing faculty and students participated in a quasi-experimental study. The program included the formation of a committee, development of codes of conduct, giving positive scores for civil behaviors, and setting a vision. Behavioral changes were assessed before and after the intervention. There were significant differences between the two groups for perceived level and occurrence rate of incivility ( p < .05).

The mediating role of moral reasoning in spiritual intelligence and caring behaviors in Iranian emergency nurses.

Moral reasoning is necessary to the nursing profession. Therefore, this study aimed to investigate the mediating role of moral reasoning in spiritual intelligence and caring behaviors among Iranian emergency nurses. In this descriptive-analytical study structural equation modeling (SEM) is employed for the data analysis. the minimum required sample size determined by the number of parameters of the model was 18. Considering that 5 to 15 samples were required for each of the parameters; the required sample size was 272. Nurses working in the emergency department of all hospitals in Qom, Iran, were selected by convenience sampling. Demographic characteristics inventory, King's Spiritual Intelligence Self-Report Inventory, Crisham's Nursing Dilemma Test, and Wolf's Caring Behaviors Inventory used for data collection. SPSS (V20) and Mplus were used to analyze the data. The results showed that a significant direct relationship was observed between moral reasoning and caring behaviors. According to SEM results, direct and indirect effects were observed of spiritual intelligence on caring behavior It is therefore recommended managers and hospital officials pay meticulous attention to spiritual intelligence and the power of decision-making in nurses to improve their caring behaviors.

Psychometric evaluation of the perceived nursing student's Incivility questionnaire.

AIM: Student's uncivil behaviour is one of the most common problems in the educational setting, including nursing schools. It is essential to develop tools for measuring the uncivil behaviour of nursing students to solve this problem. Therefore, this study aimed to evaluate psychometric properties of perceived nursing student's incivility questionnaire among the Iranian community. DESIGN: In this methodological study, perceived nursing student's incivility questionnaire was completed by 360 nursing students and 121 nursing faculty members. METHODS: Sampling was done from October 2019-November 2019. Content and construct validity of the questionnaire were evaluated. Reliability was estimated using Cronbach's alpha and McDonald's omega coefficients and composite reliability. The construct validity of nursing student's perceived incivility was investigated by exploratory and confirmatory factor analyses. RESULTS: Content validity index 0.88 for the whole instrument. The three factors of violent behaviours, irresponsible behaviours and unsound behaviours explained more than 51.485% of the variance. Factor structure extracted using model fit indices (PCFI = 0.763, PNFI = 0.732, CMIN/DF = 2.501, RMSEA = 0.056, GFI = 0.941, AGFI = 0.918, CFI = 0.935) and convergent validity were also confirmed. Internal consistency and composite reliability were estimated to be more than 0.7. The results showed that Iranian perceived nursing student's incivility questionnaire is a three-dimensional construct with good validity and reliability.

Developing a charter of spiritual care for patients.

BACKGROUND: Spirituality is recognized as an important issue in health care, and every individual has spiritual needs. Despite increased knowledge about spiritual care and its necessity, there is no unique agreed-upon framework for spiritual care among the practitioners. This study aimed to explore the concept from the viewpoint of both health-care providers and patients within the Iranian social, cultural and overall contexts and present a charter for providing spiritual care. METHODS: The first phase of the study was a systematic literature review. The next phase consisted of two qualitative studies on the components of spiritual care from the perspective of healthcare providers and its dimensions as perceived by patients. The findings were then integrated to make up a charter draft that was accredited through expert opinion. RESULTS: The review of literatures led to the identification of two main themes and 10 themes. Perspectives of health-care providers were categorized into four main themes and 10 themes, and patients' opinions were classified into three main themes and 11 themes. The themes and their subthemes were integrated to build the concepts and form the proposed charter with 30 statements. CONCLUSION: The charter of spiritual care for patients is intended to present an agreed-upon framework for spiritual care delivery and resolve some of the problems in this path. This can improve health-care delivery system.

Experiences of Fathers with Inpatient Premature Neonates: Phenomenological Interpretative Analysis.

BACKGROUND: Birth and hospitalization of premature neonates create enormous challenges for the family with serious impacts on parents' mental and emotional health. The present study was designed to explore the experiences of fathers with premature neonates hospitalized in a neonatal intensive care unit (NICU). MATERIALS AND METHODS: In this interpretative phenomenological study, data were collected using in-depth interviews guided with a semi-structured questionnaire and analyzed by interpretative phenomenological analysis. Totally seven interviews were conducted with six participants. RESULTS: The mean age of the fathers was 32 (23-42) years, and all of the fathers lived with their wives. Experiences of the fathers were categorized into 13 subordinate and three superordinate themes: "abandonment and helplessness" (lack of financial support, lack of informational support, and indignation and distrust toward the hospital staffs); "anxiety and confusion" (family disruption, shock due to the premature birth of the neonate, uncertainty, the loss of wishes, feeling of guilt and blame, and occupational disruption); and "development and self-actualization" (emotional development, spiritual development, independence and self-efficacy, and responsibility). CONCLUSIONS: The present study showed that the fathers with premature neonates hospitalized in NICU encounter both positive (development and self-actualization) and negative experiences (lack of financial and informational supports, distrusting toward the hospital staffs, family disruption, and occupational disruption). Planning to manage adverse experiences can help fathers to cope with this situation.

Gastrointestinal Complications of Ferrous Sulfate in Pregnant Women: A Randomized Double-Blind Placebo-Controlled Trial.

BACKGROUND: Some pregnant women discontinue iron supplements consumption due to Gastrointestinal (GI) complications, whereas pregnancy induces the same complications physiologically. OBJECTIVES: The aim of the present study was to assess GI complications of ferrous sulfate in pregnant women. PATIENTS AND METHODS: This randomized, double-blind, placebo-controlled clinical trial was performed on 176 pregnant women referred to prenatal care clinic of Maryam Hospital from April 2011 to February 2012. Pregnant women with Hb ≥ 13.2 gr/dL at 13(th) - 18(th) weeks of gestation were selected based on the inclusion criteria and were randomly assigned to the ferrous sulfate and placebo groups. The ferrous sulfate group (n = 90) received a 50-mg ferrous sulfate tablet daily from the 20(th) week to the end of pregnancy and the placebo group (n = 89) received one placebo tablet in the same way. All participants were visited twice at 24(th) - 28(th) and 32(nd) - 36(th) weeks to assess the GI complications as well as Hb level to determine the Hb changes in two groups. Chi-square test, t-test and Kolmogorov-Smirnov test were used to analyze the data. P value of < 0.05 and confidence level of 95% were considered as statistically significant. RESULTS: None of the GI complications were significantly different between the ferrous sulfate and placebo groups at 24(th) - 28(th) and 32(nd) - 36(th) weeks. Hemoglobin drop lower than 10.5 gr/dL at 24(th) - 28(th) weeks or lower than 11 g/dL at 32(nd) - 36(th) weeks was not observed in any cases. CONCLUSIONS: It can be concluded that GI complications in pregnant women using ferrous sulfate are mostly caused by physiologic changes of pregnancy rather than ferrous sulfate; therefore, it is not reasonable to stop using ferrous sulfate due to GI complications.

Social Capital as a Determinant of Self-Rated Health in Women of Reproductive Age: A Population-Based Study.

INTRODUCTION: Recognition of the factors related to women's health is necessary. Evidence is available that the social structure including social capital plays an important role in the shaping people's health. The aim of the current study was to investigate the association between self-rated health and social capital in women of reproductive age. METHODS: This study is a population-based cross-sectional survey on 770 women of reproductive age, residing in any one of the 22 municipality areas across Tehran (capital of Iran) with the multi stage sampling technique. Self-rated health (Dependent variable), social capital (Independent variable) and covariates were studied. Analysis of data was done by one-way ANOVA test and multiple linear regressions. RESULTS: Depending on logistic regression analyses, the significant associations were found between self-rated health and age, educational level, crowding index, sufficiency of income for expenses and social cohesion. Data show that women with higher score in social cohesion as an outcome dimension of social capital have better self-rated health (PV = 0.001). CONCLUSION: Given the findings of this study, the dimensions of social capital manifestations (groups and networks, trust and solidarity, collective action and cooperation) can potentially lead to the dimensions of social capital outcomes (social cohesion and inclusion, and empowerment and political action). Following that, social cohesion as a dimension of social capital outcomes has positively relationship with self- rated health after controlling covariates. Therefore, it is required to focus on the social capital role on health promotion and health policies.

Validity and Reliability of Persian Version of HIV/AIDS Related Stigma Scale for People Living With HIV/AIDS in Iran.

OBJECTIVE: To assess the perceived HIV/AIDS related stigma a comprehensive and well developed stigma instrument is necessary. This study aimed to assess validity and reliability of the Persian version of HIV/AIDS related stigma scale which was developed by Kang et al for people living with HIV/AIDS in Iran. MATERIALS AND METHODS: Thescale was forward translatedby two bilingual academic members then both translations were discussed by expert team. Back-translation was done by two other bilingual translators then we carried out discussion with both of them. To evaluate understandability the scale was administered to 10 Persons Living with HIV/AIDS (PLWHA). Final Persian version was administered to 80 PLWHA in Qom, Iran in 2014. Test-retest reliability was assessed in a sample of 20 PLWHA after a week by intra-class correlation coefficient (ICC). RESULTS: Cronbach's alpha coefficient for overall scale was 0.85. Also Cronbach's alpha coefficients for the five subscales were as follows: social rejection (9 items, α = 0.84), negative self-worth (4 items, α = 0.70), perceived interpersonal insecurity (2 items, α = 0.57), financial insecurity (3 items, α = 0.70), discretionary disclosure (2 items, α = 0.83). Test-retest reliability was also approved with ICC = 0.78. Correlation between items and their hypothesized subscale is greater than 0.5. Correlation between an item and its own subscale was significantly higher than its correlation with other subscales. CONCLUSION: This study demonstrate that the Persian version of HIV/AIDS related stigma scale is valid and reliable to assess HIV/AIDS related stigma perceived by people living whit HIV/AIDS in Iran.

Emotional experiences in surrogate mothers: A qualitative study.

BACKGROUND: Surrogacy is one of the new techniques of assisted reproduction technology in which a woman carries and bears a child for another woman. In Iran, many Shia clerics and jurists considered it permissible so there is no religious prohibition for it. In addition to the risk of physical complications for complete surrogate mothers, the possibility of psychological complications resulted from emotional attachment to a living creature in the surrogate mother as another injury requires counseling and assessment prior to acceptance by infertile couples and complete surrogate mothers. OBJECTIVE: The purpose of this study was to assess the emotional experiences of surrogate mothers. MATERIALS AND METHODS: This was a qualitative, phenomenological study. We selected eight complete surrogate mothers in Isfahan. We used convenient sampling method and in-depth interview to collect the information. The data analysis was fulfilled via Colaizzi's seven-stage method. Reliability and validity study of the roots in the four-axis was done. RESULTS: The findings of these interviews were classified into two main themes and four sub themes: acquired experiences in pregnancy (feelings toward pregnancy, relationship with family, relatives and commissioning couple) and consequences of surrogacy (complications of pregnancy, religious and financial problems of surrogacy). CONCLUSION: Surrogacy pregnancy should be considered as high-risk emotional experience because many of surrogate mothers may face negative experiences. Therefore, it is recommended that surrogates should receive professional counseling prior to, during and following pregnancy.

Effects of music on physiological and behavioral responses of premature infants: a randomized controlled trial.

INTRODUCTION: Despite persuasive theories about the beneficial effects of music and singing in developmental care for premature infants, few small studies are available in this regard. We conducted this study to investigate the physiological and behavioral responses of premature infants to recorded lullaby music and silence. METHODS: In a randomized controlled trial, 90 premature infants in the neonatal care unit of a hospital in Qom (Iran) were randomly allocated to intervention (lullaby and silence) or control groups. Lullaby music was played via headphones at a volume of 50-60 dB. In the silence group, headphones were placed on the infants' ears while no music was played. The three groups were surveyed for physiological responses including oxygen saturation, respiratory and heart rates, and behavioral states every five minutes before, during, and after the intervention. RESULTS: The three groups were not significantly different in terms of mean values of respiratory and heart rates, oxygen saturation, and behavioral states of infants. Similarly, no significant within group differences in respiratory and heart rates, oxygen saturation, and behavioral states were observed at different times. CONCLUSION: Our findings did not support the beneficial effects of music for premature infants. However, music is a noninvasive, non-pharmaceutical, and relatively low-cost intervention that can be implemented at infants' bedside. Thus further research is warranted to determine whether the effects noted in previous studies can be consistently replicated in diverse settings and with diverse groups of preterm infants.