Breast cancer screening patterns and associated factors in Iranian women over 40 years.

Screening is a key component of breast cancer early detection programs that can considerably reduce relevant mortality rates. The purpose of this study was to determine the breast cancer screening behavioral patterns and associated factors in women over 40 years of age. In this descriptive­analytical cross­sectional study, 372 over 40 years of age women visiting health centers in Tabriz, Iran, in 2023 were enrolled using cluster sampling. The data were collected using the sociodemographic characteristics questionnaire, breast cancer perception scale, health literacy for Iranian adults scale, and the Breast Cancer Screening Behavior Checklist. The obtained data were analyzed in SPSS version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (univariate and multivariate logistic regression analyses). In total, 68.3% of all participants performed breast self­examination (BSE) (9.9% regularly, once per month), 60.2% underwent clinical breast examination (CBE) (8.9% regularly, twice per year), 51.3% underwent mammography (12.3% regularly, once per year), and 36.2% underwent sonography (3.8% regularly, twice per year). The findings also showed that women with benign breast diseases were more likely to undergo CBE (OR = 8.49; 95% CI 2.55 to 28.21; P < 0.001), mammography (OR = 8.84; 95% CI 2.98 to 10; P < 0.001), and sonography (OR = 18.84; 95% CI 6.40 to 53.33; P < 0.001) than others. Participants with low and moderate breast cancer perception scores were more likely to perform BSE than women with high breast cancer perception scores (OR = 2.20; 95% CI 1.21 to 4.00; P = 0.009) and women who had a history of benign breast disease were more likely to perform screening behaviors than others (OR = 2.47; 95% CI 1.27 to 4.80; P = 0.008). Women between the ages of 50 and 59 were more likely to undergo mammography (OR = 2.33; 95% CI 1.29 to 4.77; P = 0.008) and CBE (OR = 2.40; 95% CI 1.347 to 4.20; P = 0.003) than those ≥ 60 years. Given the low participation of women in regular breast cancer screening, it is suggested that health care providers highlight the need for screening at the specified intervals in their training programs. In addition, health authorities are recommended to use reminder systems to remind women, especially those over 40 years of age, of the best time for breast screening. Moreover, health care providers must seek to improve breast cancer knowledge, attitudes, and perceptions of women who visit health centers, which are the first level of contact with the healthcare system for the general population.

Measurement properties of the Iranian version of the breast cancer perception scale (BCPS) according to the COSMIN checklist.

BACKGROUND: Breast cancer is a prevalent cancer characterized by its aggressive nature and potential to cause mortality among women. The rising mortality rates and women's inadequate perception of the disease's severity in developing countries highlight the importance of screening using conventional methods and reliable scales. Since the validity and reliability of the breast cancer perception scale (BCPS) have not been established in the Iranian context. Therefore, this study aimed to determine the measurement properties of the BCPS in women residing in Tabriz, Iran. METHODS: The present study comprised a cross-sectional design, encompassing a sample of 372 Iranian women. The participants were selected through a multi-stage cluster random sampling technique conducted over a period spanning from November 2022 to February 2023. The measurement properties of the Iranian version of BCPS were assessed following the guidelines outlined in the COSMIN checklist. This involved conducting various steps, including the translation process, reliability testing (internal consistency, test-retest reliability, and measurement error), and methodological tests for validity (content validity, face validity, construct validity, and hypothesis testing). The study also investigated the factors of responsiveness and interpretability. The presence of floor and ceiling effects was assessed. RESULTS: The internal consistency of the scale was assessed using Cronbach's alpha, yielding a satisfactory value of 0.68. Additionally, McDonald's omega (95% CI) was computed, resulting in a value of 0.70 (0.66 to 0.74). Furthermore, the test-retest reliability was evaluated, revealing a high intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94 to 0.99). The CVI, CVR, and impact scores of the BCPS were determined to be 0.98, 0.95, and 3.70, respectively, indicating favorable levels of content and face validity. To assess construct validity, an examination of the Exploratory Factor Analysis (EFA) was conducted on a set of 24 items. This analysis revealed the presence of six distinct factors, which collectively accounted for 52% of the cumulative variance. The fit indices of the validity model (CFI = 0.91, NFI = 0.96, RFI = 0.94, TLI = 0.90, χ2/df = 2.03, RMSEA = 0.055 and SRMR = 0.055) were confirmed during the confirmatory factor analysis (CFA). The overall score of BCPS exhibited a ceiling effect of 0.3%. The floor effect observed in the overall score (BCPS) was found to be 0.5%. Concerning the validation of the hypothesis, Spearman's correlation coefficient of 0.55 was obtained between the BCPS and the QLICP-BR V2.0. This correlation value signifies a statistically significant association. Furthermore, it is worth noting that the minimum important change (MIC) of 3.92 exhibited a higher value compared to the smallest detectable change (SDC) of 3.70, thus suggesting a satisfactory level of response. CONCLUSIONS: The obtained findings suggest that the Iranian version of the BCPS demonstrates satisfactory psychometric properties for assessing the perception of breast cancer among Iranian women. Furthermore, it exhibits favorable responsiveness to clinical variations. Consequently, it can serve as a screening instrument for healthcare professionals to comprehend breast cancer and as a reliable tool in research endeavors.

The effectiveness of couple-based interventions on the marital outcomes of women with genital and breast cancer and their partners: a systematic review and meta-analysis.

BACKGROUND: Breast cancer and genital cancer are known as cancers that affect people's relationships with their partners. Women with such cancers are emotionally vulnerable and need more support from their partners. The present systematic review and meta-analysis evaluated the effectiveness of couple-based interventions on the marital outcomes of patients with these cancers and their intimate partners. METHODS: To perform this systematic review, Google Scholar and databases such as PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database), and Magiran were searched systematically. The reviewed studies included randomized controlled trials and quasiexperimental studies in which the intervention group, couple-based interventions, and the control group received routine care, general education or no intervention for cancer treatment. In this study, the included participants were patients with breast cancer or genital cancer and their intimate partners. The primary outcomes considered in this study included patients' marital adjustment, patients' marital satisfaction, patients' marital intimacy, and patients' marital relationships. The secondary outcomes were partners' marital adjustment, partners' marital satisfaction, partners' marital intimacy, and partners' marital relationships. A meta-analysis was performed with Review Manager v. 5.3 software (The Nordic Cochrane Centre, Cochrane Collaboration, 2014; Copenhagen, Denmark). The intervention impacts on continuous outcomes were measured using standardized mean differences (SMDs) with 95% confidence interval because of the use of various scales to evaluate the outcomes. The quality of evidence presented in the included studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In the subgroup analysis, the studied outcomes were divided into two parts (theory-based and non-theory-based) in terms of the theoretical context of couple-based interventions. RESULTS: From a total of 138 retrieved studies, 14 trials were eligible for inclusion in the study. The results of the meta-analysis showed that the patient's marital satisfaction increased significantly with couple-based interventions (SMD 0.46, 95% confidence interval 0.07 to 0.85; 7 trials, 341 patients, very low certainty) compared to the control group, but the evidence was uncertain. However, there were no significant differences between the groups in the partner's marital satisfaction, the patient's and partner's marital adjustment, and the patient's and partner's marital intimacy. Additionally, the results of the subgroup analysis showed that the couple-based interventions significantly increased the patient's marital adjustment (SMD 1.96, 95% CI 0.87 to 3.06; 4 trials, 355 patients, very low certainty), the partner's marital adjustment (SMD 0.53, 95% CI 0.20 to 0.86; 4 trials, 347 partners, very low certainty), the patient's marital satisfaction (SMD 0.89, 95% CI 0.35 to 1.43; 2 trials, 123 patients, very low certainty), and the partner's marital satisfaction (SMD 0.57, 95% CI 0.20 to 0.94; 2 trials, 123 partners, very low certainty) compared to the control group in theory-based studies. In. However, in non-theory-based studies, the results of the meta-analysis revealed no significant differences between the intervention and control groups. CONCLUSIONS: The results of this study demonstrated the impact of couple-based interventions on the marital outcomes of patients with breast and genital cancers. Because of the very low confidence in the evidence, high-quality randomized trials with a sufficient sample size should be conducted considering the proper theoretical context.

Developing the questionnaire of general population knowledge, attitudes and practices towards the COVID-19 outbreak.

AIM: To develop the general population knowledge, attitudes and practices (KAP) questionnaire towards the COVID-19 outbreak. DESIGN: A methodological study. METHODS: The general population KAP questionnaire items were designed using a literature review. A panel of experts was used to calculate content validity ratio (CVR) and content validity index (CVI). Construct validity was examined using exploratory factor analysis (EFA) and hypothesis testing. Internal consistency of the questionnaire was measured using Cronbach's α coefficient. Eight hundred forty-seven patients referred to health centres in Tabriz, Iran completed the questionnaire in 2021. RESULTS: The developed questionnaire consisted of three parts, including knowledge, attitudes and practices. EFA identified three dimensions for the knowledge (ways of transmission and prevention, high-risk groups, and symptoms and treatment), three dimensions for the attitudes (hope, fear and view of the vaccine) and three for the practices (adherence to personal and public hygiene, limiting their presence in society and protecting yourself in the community). The Kaiser-Meyer-Olkin index for knowledge, attitudes and practices was 0.733, 0.725 and 0.886, respectively, with a significant Bartlett's test of sphericity (p < 0.01). The hypotheses of knowledge and attitudes that are the related factors of practices were confirmed. Cronbach's α was 0.63, 0.74, 0.77, 0.1 and 0.85 for knowledge; fear, hope and view of the vaccine subscales of attitudes; and practices, respectively. PATIENT OR PUBLIC CONTRIBUTION: The developed 47-item questionnaire had acceptable validity and reliability. Thus, nurses can use it to assess the clients' KAP during the COVID-19 outbreak. Also, nursing researchers can use this questionnaire in their descriptive and interventional studies.

Emotional intelligence and stress and their relationship with breastfeeding self-efficacy in mothers of premature infants.

BACKGROUND: Premature infants need to be hospitalized in the neonatal intensive care unit (NICU) for long periods of time, which can increase anxiety and stress in their mothers. Additionally, the breastfeeding rate is lower among preterm infants. This study aimed to determine stress levels and emotional intelligence in mothers of preterm infants and their relationship with breastfeeding self-efficacy. METHODS: This descriptive-correlational study was performed with a convenience sampling of 210 mothers of premature infants admitted to the neonatal intensive care unit in Tabriz, Iran in 2021. Data collection tools included socio-demographic checklist, perceived stress scale (PSS14), Dennis' breastfeeding self-efficacy scale, and the Schering emotional intelligence questionnaire. Data were analyzed using SPSS software version 16 via descriptive and inferential statistics (Pearson correlation and one-way ANOVA and modified general linear model). RESULTS: Study findings demonstrated that most of the mothers had low stress (75.2%) and high breastfeeding self-efficacy (61.9%). The mean (SD) of emotional intelligence of the participants was 88.18 (16.60), ranging from 33 to 165. The results of the general linear model by modifying the demographic characteristics showed that the variables of emotional intelligence (B = 0.23, P = 0.03), stress (B=-0.56, P = 0.01), gestational age (B = 2.81, P < 0.001) and number of deliveries (B = 9.41, P < 0.001) were predictors of breastfeeding self-efficacy. CONCLUSION: The findings showed that mothers of preterm infants had low emotional intelligence, and the majority of them had low perceived stress and high breastfeeding self-efficacy. Findings highlight the importance of addressing maternal stress and enhancing emotional intelligence to promote successful breastfeeding in mothers of preterm infants. Healthcare providers and managers are encouraged to offer support and educational programs to mothers of preterm infants, aiming to enhance their emotional intelligence. Further research and interventions focusing on these factors are warranted to improve the overall well-being of both mothers and infants in the neonatal intensive care unit.

Breastfeeding challenges and the impact of social support in Iranian Muslim mothers: A cross-sectional study.

Breast milk is the perfect food during infancy. Adequate support from family and health systems can be helpful to continue breastfeeding. This study aimed to determine the status of breastfeeding challenges and its relationship with social support and socio-demographic factors. In this correlational-descriptive study, 348 breastfeeding mothers were recruited using cluster random sampling from health care centers in Tabriz, Iran in 2022. Socio-demographic, breastfeeding challenges and social support questionnaires were used for data collection. Data were analyzed for descriptive and inferential statistics (Pearson correlation tests, independent t-test, one-way ANOVA and general linear model) using SPSS version 16. Difficulty in completing household tasks and breastfeeding at the same time (32.5 percent) was the most common challenge reported by mothers. There was an inverse and significant correlation between perceived social support and experiencing challenges (r = -0.199؛ p = .001). Based on the adjusted general linear model, with increasing social support, the score of breastfeeding challenges decreased (B = -0.165; 95 percent CI: -0.07-0.25, p < .001). Considering the relationship between perceived social support and the challenges experienced during breastfeeding, it can be concluded that adequate support from family along with training and guidance from health care providers can lead women to have better breastfeeding experiences and overcome breastfeeding problems.

Health anxiety and its association with perceived subjective workload in psychiatric nurses during the COVID-19 outbreak: a correlational study.

Background: Health care professionals, especially nurses, experience added workload, and psychological impact during the COVID-19 outbreak. This study aimed to investigate health anxiety and its association with perceived subjective workload in nurses working in psychiatric hospital wards. Methods: This descriptive correlational study was conducted on 206 nurses working in the psychiatric wards of Razi Psychiatry Hospital in Tabriz, Iran, in 2020-2021. Census sampling was applied and data were collected using the National Aeronautics and Space Administration Task Load Index, and the Health Anxiety Inventory. Data were analyzed using descriptive statistics, t-tests, and Pearson correlation in SPSS software version 16. Results: The mean (SD) of health anxiety and workload of nurses was 23/22(6/86) score range of 0-54 and 71.46 (12.37) score range of 0-100, respectively. The correlation between the mean of health anxiety and workload was significant only in the temporary dimension. Conclusions: Given the high workload and moderate level of health anxiety and the significant correlation between health anxiety and the temporary dimension of workload and the important role of appropriate workload in the health of nurses and the quality of nursing care, organizations and nursing managers should provide some strategies, like stuff shortage management in psychiatric wards and creating a suitable organizational culture.

Examining psychometric properties of the Iranian version of exclusive breastfeeding social support scale (EBFSS).

BACKGROUND: The exclusive breastfeeding (EBF) is undeniably proven significant in mothers' health and infants' growth and survival. Its persistence has many familial, social, and economical benefits. Social support is known to be an effective factor in EBF's success and sustainability. However, Exclusive breastfeeding social support (EBFSS) scale validity and reliability is not evaluated in Iran. This study aimed to determine the psychometric properties of EBFSS during postpartum period in Tabriz city, Iran. METHODS: It is a cross-sectional study with descriptive survey method performed between March 2021 and August 2022. Psychometric properties were determined for the Persian version of EBFSS in six stages: translation process, evaluating content validity, face validity, construct validity, discriminant validity, and reliability. A group of experts (n = 10), followed by a group of women with EBF (n = 10), evaluated the instrument's items based on content and face validities, respectively. A cross-sectional study using the multi-stage cluster random sampling method on 348 women with EBF in the first four months after delivery was conducted to determine the construct validity. The internal consistency and repeatability (test-retest on 30 women, 2 weeks apart) were used to find out the reliability. RESULTS: Content validity ratio (CVR), content validity index (CVI), and impact score were 0.98, 0.98, and 3.54 for EBFSS, respectively. This indicates a good content and face validity. Exploratory factor analysis (EFA) was performed on 16 items to examine the construct validity identified emotional, instrumental, and informational factors. These factors explained 59.26% of the cumulative variance. The fit indices (CFI = 0.98، TLI = 0.95، χ2/df = 4.20، RMSEA = 0.07 and SRMSEA = 0.05) confirmed the validity of the model in a confirmatory factor analysis (CFA). The internal consistency was examined through Cronbach's alpha and McDonald's omega coefficients that were 0.90 and 0.92, respectively. Finally, Repeatability and reproducibility were found 0.97 (95% CI: 0.92 to 0.99) using Intra-class correlation. This shows an appropriate reliability of the instrument. CONCLUSIONS: The research findings indicate that the Persian version of the EBFSS has appropriate psychometric properties for evaluating the social support in Iranian women with EBF. This means healthcare providers can use it for screening social support in EBF. Researchers also can use it as a valid instrument.

Complicated grief and related factors among nursing staff during the Covid-19 pandemic: a cross-sectional study.

BACKGROUND: The challenging working conditions during the Covid-19 pandemic created a perfect storm that can seriously impact nurses' physical and psychological well-being. Our study aimed to investigate complicated grief and its related factors among nursing staff during the Covid-19 pandemic. METHODS: This is a cross-sectional study. The participants comprised 375 nurses selected by the convenience sampling method from designated wards for patients with Covid-19 in 3 hospitals in Tabriz, Iran. Participants completed a survey containing demographic and clinical questions, the Inventory of Complicated Grief, and the Multidimensional Scale of Perceived Social Support. Multiple regression analysis was used to identify the associates of nurses' grief. The STROBE guidelines were followed in reporting the study's findings. RESULTS: A significant proportion of participants (57.6%) were found to be suffering from complicated grief. Gender, educational background, type of ward, type of nursing role, type of working shift, years of nursing work experience, and experience working in the Covid-19 settings remained the significant associates of nurses' grief in the regression analysis. CONCLUSION: Due to frequent exposure to patients' deaths, healthcare providers are at increased risk of suffering from complicated grief during the Covid-19 and post-pandemic. If it remains unresolved, complicated grief can result in significant health problems and the experience of burnout among nurses. Governments, health authorities, and nursing managers should support nurses who work in Covid-19 settings to reduce the adverse impact of the pandemic on nurses' health and well-being.

Donor Breast Milk Banking: Knowledge and Attitudes of Iranian Mothers.

INTRODUCTION: Milk donation is allowed in Islam and considered a virtue, though according to Islam Sharia, feeding donated milk of other mothers leads to kinship between infants, complicating milk donation programs in Islamic countries. This study aimed to determine the knowledge and attitude of Iranian Muslim mothers regarding milk donation and milk banks. METHODS: In this cross-sectional descriptive-analytic study, 634 mothers of infants below 1 year of age were recruited using cluster random sampling from health care centers in Tabriz, Iran. Data were collected by questionnaire. RESULTS: The findings revealed a low level of knowledge but relatively positive attitudes. Knowledge predictors were education level, income, type of birth, breastfeeding experience, encouragement to donate milk, and hearing about milk donation (p ≤ .02). Predictors of attitude were knowledge score and encouragement to donate milk (p ≤ .001). DISCUSSION: Comprehensive, culturally congruent education of mothers during pregnancy and post-pregnancy related to milk banks is recommended.

It's all not negative: a cross-section study on the impacts of Covid-19 pandemic on Iranian population.

BACKGROUND: Covid-19 has had significant effects on the quality of life of individuals around the world. Research highlights many negative impacts related to Covid-19; however, there are also potential positive impacts. The current study aimed to identify both the perceived negative and positive effects of Covid-19 among the residents of Tabriz, Iran. MATERIALS & METHODS: The descriptive cross-sectional study was conducted in 10 health centers in Tabriz city in 2021. Cluster random sampling was used to select the 861 study participants. A questionnaire was developed to collect demographic and Covid-19 impacts. Data were analyzed with descriptive and inferential statistics using SPSS 16 software. RESULTS: The mean (SD) of negative and positive impacts of Covid-19 was 37.7 (5.10) and 36.35 (5.31), respectively. Significant negative impacts included restriction in participation in cultural (90.4%) and religious (88.9%) activities. Positive impacts were increased attention to personal hygiene (88.7%) and attention to elders (87.6%). Gender (p = 0.006), work status (p = 0.004) and age (p = 0. 01) had significant association with the mean of negative impacts and work status (p = 0.01), age (p < 0.001), history of Covid-19 (p = 0.01) and family history of Covid-19 (p < 0.001) had the significant association with the mean of positive impacts of Covid-19. CONCLUSION: The findings revealed that the general population experienced many negative impacts of Covid-19. This may be related to the priority of religious gatherings in Iranian culture. Despite the unfavorable effects of Covid-19, its positive effects and post-traumatic growth should not be ignored. Covid-19 may be used as an opportunity to develop personal growth and a positive outlook on life. Healthcare workers should reinforce the positive impacts of Covid-19 while taking into consideration the importance of spirituality among Iranian individuals during times of community lockdowns.

Knowledge and Attitudes Regarding Donated Milk and their Socio-demographic Predictors in Healthcare Providers in Tabriz, 2021: A Cross-sectional Study.

Background: Donated milk is the best choice for infants who cannot receive breast milk from their mothers. Researchers in this study evaluated the knowledge and attitude of healthcare providers regarding milk-donation and examined their socio-demographic predictors in Tabriz-Iran, 2021. Methods: In this cross-sectional analytic study, the total sample size consisted of 535 healthcare providers including 272 nurses and midwives working at maternal hospitals and 263 healthcare providers working at healthcare-centers. Census-sampling method was used during October 2020 to February 2021, and data collection tools included socio-demographic, knowledge and attitude questionnaires. Pearson-correlation test, independent t-test, one-way analysis of variance, and adjusted general linear model were used to analyze the data using SPSS version 16. Results: The mean (SD) of the knowledge score was 12.04±4.30 (score range of 0-22) and that of the attitude score was 134.27±20.23 (score range of 42-210). Results of general linear model was adjusted for socio-demographic characteristics and showed that predictors of knowledge variable were associated with having prior experience of breastfeeding another infant (P=0.006) and encouraging others to breastfeed (P=0.008); also, the predictor of attitude variable was aligned with encouraging others to breastfeed (P<0.001). Conclusions: The findings of this study affirm that knowledge and attitude of healthcare providers were moderately influential for breast milk donation. Since they could play a responsible role in providing education, positive atmosphere for specialized training for the general public, the efforts to improve their knowledge and attitudes can contribute to acceptability of a milk-bank in the community and reduction of the rate of neonatal mortality in Iran.

Clinical competency and psychological empowerment among ICU nurses caring for COVID-19 patients: A cross-sectional survey study.

AIM: This study aimed to determine clinical competency and psychological empowerment among ICU nurses caring for COVID-19 patients. BACKGROUND: Nurses need clinical competency (skills pertaining to knowledge, reasoning, emotions and communication) and psychological empowerment (regard for one's organisational role and efforts) to deliver quality care. METHODS: This cross-sectional study was conducted with 207 nurses working in ICUs in Iran. A clinical competency survey instrument consisting of basic demographic questions and the Spreitzer psychological empowerment questionnaire was completed online. Descriptive and inferential statistics were used to analyse the data in SPSS software version 13 to address the primary research question. RESULTS: There was a significant positive relationship between clinical competency and psychological empowerment (r = .55, p < .001). Clinical competency had a significant positive relationship with work experiences (r = .17, p = .01). CONCLUSION: Clinical competency has been tied to nurse health and quality of care. Given the significant positive relationship between clinical competency and psychological empowerment, attention must be given to ways to psychologically empower nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers can consider the promotion of psychological empowerment related to its significant positive relationship to clinical competency. Psychological empowerment can be bolstered through the promotion of servant leadership, organisational justice and empowering leadership practices.

Ability of older adults to recognize cognitive changes and its relationship with mental health: a cross-sectional study.

INTRODUCTION: With rising age, the incidence of physical and mental problems increases. Physiological and social changes occur across the lifespan that can affect an individual's health and ability. The present study was aimed to determine older adult's ability to recognize cognitive changes and its relation with mental health status. MATERIALS AND METHODS: A descriptive correlational design was used to recruit 423 older adults who were referred to health centers in Tabriz, Iran in 2019 to receive primary health care. A systematic random sampling method was used for selecting participants. Data collection tools included a demographic-social questionnaire, General Health Questionnaire for assessing mental health (with 4 subscales) and a questionnaire of ability to recognize cognitive changes (with 8 sub-scales). Data were analyzed using descriptive statistics and inferential statistics. RESULTS: The mean score of mental health of the older adults was 56.35 (8.40) which shows moderately impaired mental health. The most impaired aspect of mental health detected was the social function dimension 13.20 (2.67). The average of the total ability score was 41.19 (4.78) and the physical strength dimension had the highest average of 9.08 (1.80) and the empowerment obligation dimension had the lowest average of 3.06 (1.08). There was significant relationship between dimensions of depression (r = 0.21, p < 0.001), anxiety (r = 0.1, p = 0.04) and social functioning (r = 0.17), p < 0.001) with the ability to recognize cognitive changes of the older adults. CONCLUSION: Negative mood states and social functioning were associated with the ability to recognize cognitive changes in this population of older adults. This sample exhibited moderately impaired mental health status and relatively large burdens of untreated affective symptoms. Although causality cannot be determined with this cross-sectional design, use of social programs to keep older adults mentally active, as well as cognitive rehabilitation programs could be tested with longitudinal designs for their impact on cognitive change recognition.

Evaluation of a self-care education program for older adults in Iran using a lifestyle improvement model.

BACKGROUND: Older adults and their caregivers often believe it is either too late or too difficult to make health-focused lifestyle changes. However, this is inaccurate, as older adults can make health promotion focused lifestyle changes thereby improving their health. This study developed and evaluated a self-care education program using Pender's Health Promotion Model and its influence on health-focused behaviour changes among older Iranians. METHOD: This was a quasi-experimental study with a convenience sample of 136 community-living older adults from Tabriz, Iran. The participants were randomly assigned to either an intervention (n = 69) or control (n = 67) group. Chi-square test, independent t tests and Analysis of covariance (ANCOVA) statistical methods were used to compare pre- and post-intervention data, control and intervention groups and changes over time. The intervention was an eight-week educational program with pre- and post-intervention data collected using the Health Promoting Lifestyle Profile II (HPLP II) questionnaire. RESULTS: The mean difference and confidence limits of the older adults' health behaviours pre- and post-intervention scores were 2.228 (-5.450 - 9.916) and - 35.820 (-32.051 - 39.588). The covariance analysis adjusting for the baseline values showed significant differences post-intervention (p<0.0001) in the areas of interpersonal communication, physical activity, nutrition, stress management and spiritual growth. CONCLUSION: The health promotion education intervention illustrated that older Iranians could improve their health outcomes in several areas. Thus, culturally tailored intervention programs can be successful in challenging the opinion that older adults cannot make behaviour changes supporting their health.

Home healthcare in Iran: A hybrid concept analysis.

BACKGROUND: Healthcare is changing from a focus on acute care health issues to one of managing chronic conditions. This change has resulted in the development of home health-care systems as a way of managing chronic conditions outside the hospital. The aim of this study was to analyze the concept of home healthcare using a hybrid model. MATERIALS AND METHODS: This hybrid concept analysis consisted of three phases: theoretical, fieldwork, and analytical. Science Direct, PubMed, ProQuest, and Scopus were searched with related terms in the theoretical phase. In the fieldwork phase, six professionals with experience in home healthcare were interviewed and after each interview, qualitative content analysis was conducted. During the final phase, descriptions and themes from the first two phases were combined. RESULTS: In the theoretical phase, the definition of home healthcare included descriptions answering the Who, What, When, Where, and Why questions. In the fieldwork phase, the results were divided into three areas: 1-comprehensive care; 2-extent of services; and 3-outcomes. The final analysis phase of this study indicated that the home health-care concept is a comprehensive, professional, and holistic care system accompanied by medical services and professionals whose goals are to support an individual's health and provide care in their home. Healthcare provided in one's home was found to preserve a patient's dignity and reduce health-care costs. CONCLUSIONS: The definition of the home healthcare concept establishes a foundation for developing a comprehensive home health-care system. This concept analysis for home healthcare could be a guide for future studies.

Internet gaming disorder and its relationship with behavioral disorder and mother's parenting styles in primary school students according to gender in Iran.

BACKGROUND: The problem of students' gaming addiction has been related to the individual student's characteristics and the influence of family environment. Researchers aimed to investigate if and how internet gaming disorder (IGD) of the elementary school boys and girls is related to behavioral disorder and their mother's parenting style in Iran. METHODS: This is a descriptive correlational study, involving 657 fifth and sixth-grade elementary school students in 2019. Researchers used a multistage stratified random sampling of students, their parents and their teachers. Data were collected using internet gaming disorder questionnaire (IGD 20), Rutter teacher behavioral disorder questionnaire and Baumrind Parenting Styles questionnaire (PSI). Obtained data were analyzed using SPSS version16 for descriptive statistics and Pearson correlation coefficient test. RESULTS: Findings showed that IGD prevalence was 5.9% among primary school students with significant relationship between IGD and behavioral disorder among all participants (r = 0.23, p = 0.04); although it was insignificant among boys (r = 0.13, p = 0.11). Also the relationship between IGD and mother's parenting style was significant in the total sample (r = 0.12, p = 0.03), in particular for girls and their mothers (r = 0.2, p = 0.001). CONCLUSIONS: The results of this study indicate the importance of family and parental involvement in prevention and management of IGD chiefly among girls. Healthcare professionals will benefit from knowing the problematic consequences of online gaming among school-age children and try to promote safe and healthy online behavior supported by a supervised family environment.

Internet Dependency and Its Relation to Sexual Desire and Satisfaction in Married Clients Referred to Healthcare Centers in Tabriz, Iran.

BACKGROUND: Internet dependency has become one of the 21st century dilemmas affecting different aspects of married life such as sexual relationships. Considering the importance of family in the Iranian society, this study aimed to determine how internet dependency is related to sexual desires and satisfaction among married clients of healthcare centers. MATERIALS AND METHODS: This cross-sectional study was conducted on 326 married clients referred to healthcare centers in Tabriz City, Iran, between February and August 2019. Proportionate stratified random sampling was used based on the health complexes and the healthcare centers covered by them. One of the healthcare centers covered by each complex was selected randomly. The data collection tools included a demographic characteristics checklist, the Internet Addiction Test (IAT), the Index of Sexual Satisfaction (ISS), and the Hurlbert Index of Sexual Desire (HISD). The collected data were analyzed using the Pearson correlation coefficient test and multiple linear regression model. RESULTS: The mean (SD) was 37.33 (15.37) for of internet dependency, 59.20 (17.27) for sexual desire, and 104.45 (22.81) for sexual satisfaction. There was a negative correlation between internet dependency and sexual satisfaction (r = -0.47, p < 0.001). This correlation remained significant (B = -0.41, df = 9, p < 0.001,) even when occupation (B = 3.66, p = 0.01), satisfaction with married life (B = 15.34, p < 0.001), and sexual desire (B = 0.60, p < 0.001) were adjusted as potential confounding factors. CONCLUSIONS: Internet dependency can cause a reduction in sexual desire and sexual satisfaction. Designing educational interventions in healthcare centers is recommended to manage the use of internet and to inform clients about the effects that internet dependency may have.

Happiness and its Relationship with Job Burnout in Nurses of Educational Hospitals in Tabriz, Iran.

BACKGROUND: Happiness is a positive feeling that is vital and significant to maintain health. Nurses are working in difficult conditions which may heavily affect their level of happiness and ability to provide care. Job burnout is a mental reaction against some persistent source of workplace stress. The purpose of this study was to identify happiness and its relationship with job burnout in nurses working at Tabriz's educational hospitals. METHODS: This descriptive-correlational study was conducted on 344 nurses working at Tabriz's hospitals in 2018. The subjects were selected by means of proportionate stratified random sampling. Data were collected using three questionnaires (demographic information, job burnout with 22 items and three subscales and Oxford happiness with 29 items) and analyzed in SPSS version16 using descriptive statistics. Statistical tests such as Pearson correlation coefficient, independent t-test, one-way ANOVA, and multiple linear regression analysis were used to analyze the data. RESULTS: The age range of the participants was 23-57 years with a mean of 35.9±7.5. The mean score of happiness was 64.2±11.5, (score range 35 to 116), which suggests an average level of happiness among the nurses. There was a negative correlation between happiness and total job burnout (r=-0.29, P<0.001). This negative correlation remained significant (B=-0.15, P<0.001) even when nurses' perception of own health status (B=-5.24, P=0.01), history of illness (B=-4.47, P=0.04), job position (B=-6.61, P=0.001), and type of employment (B=3.56, P=0.03) as potential confounding factors were adjusted. CONCLUSION: Considering the reverse relationship between job burnout and happiness, it is suggested that managers try to improve the workplace by managing condition which could lead to job burnout, and therefore use the results to increase the happiness of nurses.

Coping strategies of family caregivers of patients with schizophrenia in Iran: A cross-sectional survey.

OBJECTIVES: This study aimed to identify coping strategies used by family caregivers of patients with schizophrenia and their determinants. METHODS: This was a descriptive correlational study. Participants were 225 family caregivers of patients with schizophrenia who were referred to the psychiatric clinic at one large teaching referral hospital in Iran. They were selected through purposive sampling method. Data collection tools were demographic and clinical data form, the Zarit Burden Interview (ZBI) and the Family Coping Questionnaire (FCQ). RESULTS: The score of caregiver burden was 65.14 ±â€¯9.17. Of 225 family caregivers, 23.11% used an avoiding coping strategy. There was a significant relationship between caregiver burden and coping strategies (P < 0.001). The regression model showed that adaptive coping strategies were significantly associated with some demographic characteristics including age, education level, gender, employment status, losing the job because of caregiving responsibilities, perceived income adequacy, duration of illness, duration of caregiving and caregiver burden (P < 0.05). CONCLUSION: Family caregivers of patients with schizophrenia experience a high level of burden, which can put them at risk of using maladaptive coping strategies. Mental health professionals should plan programs that support both family caregivers and patients in clinical and community settings.