Barriers to Applying Integrative Oncology from the Perspective of the Care Providers in Iran: A Mixed-Methods Study.

OBJECTIVE: The present study aims to explain and determine the use of integrative oncology from the perspective of the care providers in Iran. DATA SOURCES: This mixed-methods study is a convergent type of study with quantitative and qualitative phases that have been performed simultaneously. The quantitative phase was a descriptive study that was conducted through convenience sampling. With the use of a psychometrically evaluated questionnaire with 10 items, 202 nurses and physicians were included in the study to assess their views on the integration of traditional and complementary medicine (TCM) within supportive cancer care. The qualitative part of the study was conducted through semistructured interviews with 11 care providers. The interviews were analyzed through conventional content analysis and the method proposed by Graneheim and Lundman with the use of MaxQDA software. CONCLUSION: After the quantitative and the qualitative data were combined, we identified four main categories as the important dimensions of using TCM: patients' main expectations of TCM services, reasons for using these services, existing challenges and barriers, and recommendations and strategies to improve the interaction between physicians and patients to facilitate the use of integrative oncology . IMPLICATION FOR NURSING PRACTICE: Although cancer patients use TCM due to a wide range of expectations, there are many barriers to integrative oncology in Iran. Therefore, it is necessary to pay attention to the benefits of conventional medical and TCM treatments, conceptualize integrative oncology, and try to meet the existing challenges.

Validation of post-traumatic growth inventory in mothers with the experience of having the NICU-Hospitalized newborns "validation of post-traumatic growth inventory".

AIMS: Investigating post-traumatic growth (PTG) in mothers with the experience of having a preterm newborn hospitalized in the NICU requires a valid tool. This study aims to determine the validity and reliability of the Farsi version of the post-traumatic growth inventory (PTGI) in mothers with the experience of having their newborns hospitalized in the NICU. DESIGN: This study was methodological research. METHODS: In this study, 250 mothers who had newborns with a history of NICU hospitalization during the last 3 to 12 months and had visited paediatric clinics of the selected hospitals in Tehran with the aim of having their children's condition examined were selected through convenience sampling. The data were collected using a demographic information questionnaire and PTGI. The face validity, the construct validity (confirmatory factor analysis), and the internal consistency reliability of the inventory were measured using SPSS V22 and LISREL V8.8. RESULTS: According to appropriate values for factor analysis fit indices (FI = 0.94, RMSEA = 0.07, IFI = 0.94, NFI = 0.93, RFI = 0.91, NNFI = 0.93, SRMR = 0.07), 21 items and 5 factors were confirmed for this inventory. Furthermore, Cronbach's alpha coefficient of this inventory was measured as α = 0.94. CONCLUSION: According to favourable psychometric properties, the Farsi version of PTGI is a suitable tool for studying PTG in mothers with the experience of having preterm newborns in the NICU. Using PTGI can help nurses in planning family-centered care interventions to reduce the impact of the mental trauma caused by the preterm newborn's hospitalization in parents. PATIENT OR PUBLIC CONTRIBUTION: Mothers who had newborns with a history of NICU hospitalization during the last 3-12 months.

Caregivers' Knowledge of and Attitude towards Palliative Care in Iran.

BACKGROUND: Addressing the palliative care needs requires clinicians to have sufficient knowledge of and positive attitudes toward palliative care. The study aimed to determine nurses' and physicians' knowledge of and attitudes towards palliative care in Iran. METHODS: This descriptive cross-sectional study was conducted in 2021 on 493 physicians and nurses, selected through convenience sampling. Three online questionnaires addressing caregivers' demographic and professional's questionnaire, Health Care Providers' Attitude toward PC Questionnaire, and Health Care Providers' Knowledge of PC Questionnaire were used. The data was analyzed in SPSS using correlational and descriptive statistics and regression analysis. RESULTS: The mean score of attitude towards palliative care was 142.03 ± 11.35 and the mean score of palliative care knowledge, 19.47 ± 2.62. Considering the regression coefficients between these two mean scores (P-value = 0.001, b = 1.304), it can be inferred that knowledge is a good predictor of attitude. In addition, the mean scores of knowledge and attitude have a significant relationship with age, female gender, holding a master's or PhD degree, the need for formal education in the field of palliative care and the need to take a palliative care course. CONCLUSIONS: The present study showed that Iranian nurses and physicians have a moderate level of knowledge and attitude towards palliative care. It is necessary to take measures in order to improve knowledge and attitude by holding retraining courses, theoretical and clinical training sessions and relevant seminars in short term, and also by integrating related topics into nursing and medical curriculums in long term.

Does the Farsi version of attitude toward plagiarism questionnaire have acceptable psychometric properties?

This study aims to assess the psychometric properties of the Persian version of the Attitudes Toward Plagiarism Questionnaire (ATPQ) among Iranian medical sciences postgraduate students and faculty members. In this study, the ATPQ developed by Mavrinac et al. in 2010 was translated into Persian. After assessment of face and content validity, we distributed the ATPQ draft among 286 Iranian medical science postgraduate students and faculty members. Explanatory and confirmatory factor analysis were applied, and Cronbach's alpha was used to measure the reliability of the ATPQ. All the items of our English version of the ATPQ were approved by the developer of the original ATPQ, and two were revised in the cognitive interview. Construct validity assessment showed that three items were not seriously involved in the extracted factors. The Persian version of the ATPQ had 26 items, five factors and a Cronbach's alpha of 0.81%, and the combined value explained 38.24% of the total variance of this scale. Two new factors of "perceived control" and "attitude toward self-plagiarism" were extracted and incorporated into the Persian version. To conclude, the ATPQ is a valid, reliable, and convenient instrument to determine attitudes toward plagiarism among Iranian medical science postgraduate students and faculty members.

Emotional upheaval, the essence of anticipatory grief in mothers of children with life threatening illnesses: a qualitative study.

INTRODUCTION: Life-threatening illnesses in childhood are considered a crisis for the whole family, especially for the mother, which leads to experiencing different degrees of grief and emotional-behavioral problems. OBJECTIVE: The present study is conducted with the aim of explaining the concept of anticipatory grief from the perspective of the mothers of the children with life-threatening illnesses. METHODS: This qualitative study is part of a sequential exploratory research for model development in the field of anticipatory grief, which was conducted using conventional content analysis method. The data were collected through in-depth semi-structured interviews with 19 mothers of the children with life-threatening illnesses living in Shiraz and Tehran, who were selected through purposive sampling with maximum variation. When data saturation were achieved, the data were codified by MAXQDA-10 software and analyzed using Graneheim and Lundman's approach. FINDINGS: Data analysis resulted in the identification of 8 subcategories including shock, irritability, fear of losing, feeling guilty, uncertainty, hopelessness, loneliness and isolation, and mourning without a coffin, all forming the major theme emotional upheaval. DISCUSSION AND CONCLUSION: As the result of being in a situation of imminent and possible loss of her child, the mother experiences different responses of sadness and sorrow and suffers the consequences the core of which is consisted of emotional upheaval. Therefore, by explaining the behaviors related to anticipatory grief, efficient and effective interventions can be designed to improve coping among this group of mothers.

The impact of the evaluations made by Mini-CEX on the clinical competency of nursing students.

INTRODUCTION: Clinical competency is defined as one's capabilities in terms of knowledge, attitude and practice, and is a necessity for nursing practice. Evaluation is the inseparable part of the education process, without which the quality of education could not be measured. Considering the characteristics of clinical education and its impact on the clinical competency of students, as well as the importance of making precise evaluations of them using scientific, modern and efficient approaches, this study aims to investigate the impact of the evaluation made using Mini-Clinical Evaluation Exercise on the clinical competency of the nursing students of the School of Nursing and Midwifery Shahid Behesti University. METHODS: This is a quasi-experimental study with a control group conducted on students who were taking courses "Nursing care for a sick child". The students were classified into the intervention and control groups using complete enumeration. The evaluations were made using Mini-Clinical Evaluation Exercise in the intervention group and the portfolio approach in the control group. The skills regarding patient (mother-child) education, IV therapy and medication were evaluated by checklists. FINDINGS: The results showed that the mean score of clinical competency in the intervention group was significantly higher than that of the control group. CONCLUSION: Considering the improvement of clinical competency in the intervention group, it is recommended to use Mini-Clinical Evaluation Exercise for the evaluation of students.

A comparative study of patient safety in the intensive care units.

AIM: This study aimed to assess patient-safety principles in ICUs. DESIGN: This is a descriptive-comparative study. METHODS: The research environment includes ICUs of hospitals affiliated to the two universities of medical sciences in Tehran. Sampling was done by census using Time and Event Sampling methods. Research instrument was "Patient Safety Principles Checklist". Data analysis was performed using SPSS-20 and descriptive-inferential statistics with a significance level of 0.05. RESULTS: There is no significant difference (p-value = .15) in the level of observance of patient-safety principles in two university-affiliated hospitals A (133.26 ± 9.14) and B (128.16 ± 18.01). Evaluation of the mean scores obtained in each dimension and in each of the ICUs was showed that only in dimension No.3 the difference was significant (F[68,2] = 5.20, p-value = .008) and in the AICUs (16.13 ± 1.8) (p-value = .04), it was significantly lower than other ICUs. Identifying risk factors for the patient's immunity reduces the side effects of patient care.

Psychometric Evaluation of the Caring Ability of Family Caregivers of Patients With Cancer Scale-Mothers' Version for the Mothers of Children With Cancer.

BACKGROUND: The experience of caring for cancer patients has adverse outcomes for family caregivers. The ability to care for a sick child is affected by the mother's health; to empower mothers, it will be necessary to examine their caring ability. OBJECTIVE: The aim of this study was to carry out a psychometric evaluation of the Caring Ability of Family Caregivers of Patients With Cancer Scale-Mothers' Version (CAFCPCS-Mothers' Version). METHODS: The present study is a psychometric evaluation of the CAFCPCS-Mothers' Version. The sample consisted of 196 mothers of children in treatment for cancer selected through convenience sampling. The face, content and construct validity, internal consistency, and stability of the scale were measured. Data were analyzed using the software SPSS 19 and LISREL 8.8. RESULTS: After removing 2 items during confirmatory factor analysis, the values of root-mean-square error of approximation, comparative fit index, and nonnormed fit index were reported to be 0.066, 0.92, and 0.91, respectively. The Cronbach's α was calculated to be 0.71 and the stability correlation coefficient was 0.75. The final tested scale included 29 items in 5 dimensions: effective role play, fatigue and surrender, trust, uncertainty, and caring ignorance for mothers of children with cancer. CONCLUSION: The CAFCPCS-Mothers' Version has satisfactory content, face, and construct validity and adequate reliability in terms of internal consistency and stability in a sample of mothers of children receiving treatment for cancer. IMPLICATION FOR PRACTICE: The CAFCPCS-Mothers' Version can be used to assess the caring ability of Iranian mothers of children with cancer and to determine maternal care needs.

COVID-19 Management in Iran as One of the Most Affected Countries in the World: Advantages and Weaknesses.

COVID-19 management is a hot topic due to its extensive spread across the world and the declaration of pandemic status. How a crisis is managed in each country is influenced by several factors, and various strategies are applied in accordance with these factors in order to manage the crisis. Due to the rapid spread and increasing trend of the crisis and the fact that almost more than half of the countries are engaged in this pandemic, it is impossible to apply trial-and-error based strategies. One of the best strategies is to use the experiences of other countries in dealing with COVID-19. This report explores the advantages and weaknesses of the Islamic Republic of Iran in the management of this crisis in regard with political economic and cultural issues, health service coverage, and the transparency of information that can be used as a model for other countries around the world.

Perspectives of Afghan refugee mothers on the experience of caring for a child with cancer: a qualitative analysis.

BACKGROUND: Cancer in children causes many challenges for the family. When a refugee family experiences it, its impacts may be different and more specific considerations for care may be needed. AIMS: This study aimed to explore the experiences of Afghan mothers living in the Islamic Republic of Iran who had a child with cancer. METHODS: This was a qualitative study, conducted in 2017, of Afghan refugee women with children diagnosed with cancer and referred to a cancer referral hospital in Tehran; they were selected through purposive sampling. Face-to-face, semi-structured and in-depth interviews were conducted for data collection until data saturation was reached. Conventional content analysis was done. MAXQDA 10 was used for organizing the data. RESULTS: Nine Afghan mothers were interviewed. They were aged 24-44 years and the children were aged 2-9 years. A primary theme called "passive acceptor" was found with five subthemes: chronic suffering, health issues, lack of skills, maladaptive coping and enthusiasm. The mothers were struggling to cope with the challenges of caring for a child with cancer both financially, physically and emotionally. CONCLUSION: In spite of many issues in common with similar groups in other countries, Afghan mothers appear to need to greater assistance when it comes to seeking help and understanding for the care for their child with cancer, possibly because of cultural barriers to self-empowerment. Tailored care plans are recommended for Afghan refugee mothers in the Islamic Republic of Iran.

General Family Functioning as a Predictor of Quality of Life in Parents of Children With Cancer.

PURPOSE: The diagnosis of cancer in a child brings about a crisis for the whole family. This study aimed to (1) determine family functioning and parents' quality of life in comparison with groups in relevant studies, (2) assess the correlation between dimensions of family functioning and parents' quality of life domains, and (3) explore the predictive role of general family functioning (GFF) for quality of life domains in a sample of families (mother-father as a dyad) of children with cancer. DESIGN AND METHODS: This is a cross-sectional study which was performed on 62 pairs of parents of children with cancer (n = 124). Data were collected using the Demographic-Clinical Information Questionnaire, validated Persian versions of the McMaster Family Assessment Device (FAD) and the World Health Organization's Quality of Life-BREF (WHOQOL-BRFF). The Canonical Correlation Analysis and the Generalized Estimating Equation (GEE) model were used for data analysis. RESULTS: All dimensions of the FAD were reported as unhealthy dimensions. Also, a poor quality of life was reported in all domains by parents. Most of the family functioning dimensions were correlated with quality of life domains. Consequently, after controlling for several demographic and clinical variables the GFF was the most important predictor of parents' quality of life and its domains. CONCLUSIONS: The GFF should be measured at the first meeting with a family of a child with cancer and during the follow-up meetings to help plan family empowerment interventions.

The Effect of Spiritual Care on Adolescents Coping With Cancer.

People's experiences of living with cancer suggest that spirituality creates purpose and meaning in life for patients. Strengthening spirituality has positive effects on coping, mental health, and symptoms of the disease. This study examines the effect of spiritual care on adolescents coping with cancer. This research is a single-group, quasi-experimental, pre-/poststudy conducted on 32 adolescents. The spiritual care program was presented individually and face to face over six 45-minute sessions held on the admission days. Data were collected using the Ways of Coping Questionnaire by Lazarus and Folkman. A significant difference was observed between the pretest and posttest mean values in all the coping subscales, which suggests the effect of spiritual care on adolescents' coping with cancer, but no significant differences were observed between the posttest and follow-up mean values, which shows the importance of the continuity of spiritual care in adolescent patients. According to the results, spirituality-based care programs offered by nurses can positively affect adolescents' coping with cancer and improve their overall coping.