The design and psychometric evaluation of the Supportive-Care Needs Scale (ZOKH-SCNS29) in patients living with cancer.

BACKGROUND: Understanding the needs of cancer patients and planning to meet these needs is a major concern of the health system. AIM: The present study aimed to design and conduct a psychometric evaluation of supportive-care needs scale in patients with cancer. METHODS: This study was conducted in both qualitative and quantitative stages. In the qualitative phase, the questionnaire items were generated by analysing the data from 16 interviews, after which, face, content and construct validity were tested. To construct the validity, the questionnaire was completed by 229 cancer patients. The reliability of the questionnaire was assessed by internal consistency. Data were analysed using SPSS (version 18). FINDINGS: In this study, 4 factors were extracted from 29 items through exploratory factor analysis: 'Need to be understood by the spouse and family' (10 items), 'Need to manage existential and psychological challenges' (7 items), 'Need to manage lack of knowledge about the disease' (7 items), 'Need organisational-therapeutic support '(5 items). These factors accounted for 50.1%. of the total variance. Internal consistency was 0.88, and also the Cronbach's alpha coefficient was also 0.89 after construct validity for the scale items'. The Cronbach's alpha was 0.91 after the construct validity. CONCLUSION: The findings of the present study showed that this supportive care needs scale is a valid and reliable scale for identifying the supportive care needs of patients with cancer.

Examining the mother's supportive role caring for a child with cancer.

Background: Childhood cancer is a stressful experience for patients and their families; it has a profound effect on families emotionally, psychologically and financially. The mother's supportive role affects the child's treatment outcomes and the health of all family members. Aims: This study was conducted to describe the experiences of mothers of children with cancer. Methods: A total of 14 mothers of children with cancer were recruited using purposive sampling. In-depth semi-structured interviews were conducted using a qualitative inductive content analysis. Data were analysed using Graneheim et al's (2004) approach. Findings: According to data analysis, the mother's supportive role can be depicted across four subthemes: 'being genuinely present with a sick child'; 'keeping the family together and strengthening its cohesion'; 'providing compassionate collaborative care for peers'; and 'empowering the self and taking charge of one's own life'. The main overarching theme extracted from this study was 'sacrifice'. Conclusion: This study results suggest that the mothers' supportive role is relying on their own personal power, in which they not only give the care to the child, family and counterparts, but also drive personal growth and empowerment of mothers. A deeper understanding of mothers' experiences of their supportive role may enhance the quality of care and promote further paediatric approaches to palliative care.

Investigating the effect of inquiry-based stress reduction on mortality awareness and interpersonal problems among intensive care unit nurses.

INTRODUCTION: Caring for dying patients is one of the job stressors. Nurses in intensive care units are among the medical staff who have a close interaction with dying patients. Studies have shown that psychological interventions are very helpful in improving thinking about death and its problems. Therefore, this study was conducted to investigate the effect of Inquiry-Based Stress Reduction on mortality awareness and interpersonal problems among intensive care unit nurses in southeastern Iran. MATERIALS AND METHODS: This was a Quasi-experimental study with a pretest-posttest design in southeast of Iran in 2021. Nurses were selected using the convenience sampling method and divided into intervention (n = 32) and control (n = 35) groups using the block randomization method. The intervention group received a two-hour Inquiry-Based Stress Reduction counseling session every week for 6 weeks. Data were gathered using Multidimensional Mortality Awareness Measure and Inventory of Interpersonal Problems before, immediately after, and 6 weeks after the intervention. IBM SPSS Statistics software version 25 was used for data analysis. RESULTS: In the intervention group, the mean scores of Mortality Awareness before, immediately after, and 6 weeks after the intervention were 130.41 ± 5.91, 164.47 ± 8.66, and 163.91 ± 9.29, respectively. Therefore, in the intervention group, the increase of Mortality Awareness mean score was statistically significant (P < 0.001). In the control group, the mean scores of Mortality Awareness before, immediately after, and 6 weeks after intervention were 129.63 ± 5.59, 135.26 ± 11.14, and 132.66 ± 5.62, respectively. Difference between the two groups was significant (P < 0.001). The results also showed that in the intervention group the mean scores of Interpersonal Problems immediately after and 6 weeks after the intervention were lower than before the intervention (P < 0.001). In the control group, Interpersonal Problems increased over time (P < 0.001). Accordingly, the difference between the two groups in terms of Interpersonal Problems during the study was statistically significant (P < 0.001). CONCLUSION: The study results suggest that the Inquiry-Based Stress Reduction is an appropriate intervention method to improve mortality awareness and reduce interpersonal problems in intensive care unit nurses.

Sense of Coherence in Parents of Children With Cancer and Its Relationship With Self-Construal in Southeastern Iran.

This study aimed to determine sense of coherence and its relationship with self-construal in parents of children with cancer in southeastern Iran. In this descriptive correlational study, 127 parents of children with cancer were studied using sense of coherence scale (SOC) and self-construal scale (SCS) in Iran. The results of the study showed that total mean score of SOC was 51.4 ± 14.2 and the interdependent self-construal (INT) in parents was higher than independent self-construal (IND). Also, the relationship between SOC and SCS showed that IND had a positive and statistically significant relationship with SOC manageability subscale. The weak SOC in the studied parents can cause more stress and suffering in dealing with their child's disease. It is essential that health care providers provide a comprehensive program to enhance parents' SOC and it should be noted that people who have a more INT felt less able to manage challenging situations.

Power of Religious Beliefs and Coping with Cancer: Opinions of Iranian Parents.

Childhood cancer as a stressful event has many consequences for both the parents and their children. The aim of the study was to assess the coping strategies used by Iranian parents of children with cancer. The present study was conducted through convenience sampling with the participation of 205 parents with at least one child with cancer referred to the oncology ward, in the southeast of Iran. The Coping Health Inventory for Parents was used to measure parental coping strategies. Results showed that the highest and the lowest mean coping score belonged to the dimensions of social support and medical factors, respectively. Briefly, "Belief in God" and "Gratefulness for his Blessings" were the most helpful coping strategies among parents. Based on results of this study, it seems necessary for nurses to be aware of all aspects of human existence, including religion and spirituality as strong sources of power for parents to adapt with the illness of their child. Also, providing interventions to teach effective coping skills to parents may reduce their distress and improve their quality of life.

Near-Death Experience among Iranian Muslim Cardiopulmonary Resuscitation Survivors.

BACKGROUND: Near-Death Experience (NDE) refers to a broad range of subjective experiences associated with forthcoming death. The majority of Cardiopulmonary Resuscitation (CPR) survivors experience NDEs. It seems that near-death events are experienced differently by people with different cultural and religious viewpoints. Thus, this study aimed to explain NDEs in Iranian Muslim CPR survivors. MATERIALS AND METHODS: A qualitative hermeneutic phenomenological approach influenced by Ricoeur was used to understand the meaning of CPR survivors' NDEs. Eight survivors were interviewed in private. The study was conducted in southeast Iran. In-depth, semi-structured interviews were used for data collection, and probing questions were added when necessary. The duration of the interviews was between 40 and 65 min. According to Lindseth and Norberg, in the naive understanding phase, we read the interviews several times for achieving naive understanding. In the structural analysis phase, the whole text is divided into meaningful units. Finally, the researchers formulated a comprehensive understanding of the contextualization of the text. RESULTS: Four main themes emerged including 1) pleasing experiences along with flying and seeing light, 2) the experience of transport to the beyond, 3) out-of-body experience, and 4) reviewing life and memories in a religious context. CONCLUSIONS: Iranian Muslim CPR survivors, reported NDEs, much similar to those reported by survivors in Western countries with different theistic religions. This means that medical professionals dealing with these patients need to be aware of such experiences in Iranian Muslims.

The psychometric properties of the Hypertensive Treatment Adherence Scale.

BACKGROUND: Hypertension (HTN) is a public concern and treatment adherence has a key role in its management. This study was conducted to develop and test the reliability and validity of the Hypertensive Treatment Adherence scale (HTA-scale). METHODS: This was a cross-sectional and methodological study. After item generation using a qualitative study and literature review, the scale was developed. The psychometric properties of the scale were evaluated using face, content, construct, and criterion validity and reliability. RESULTS: Data analysis showed that the HTA-scale had acceptable face and content validity. The scale had excellent stability [Intraclass correlation coefficient (ICC) = 0.74] and good acceptability and internal consistency (Cronbach's a = 0.76). Exploratory factor analysis (EFA) showed that the HTA-scale consisted of 6 meaningful subscales including medication adherence and monitoring, adherence to safe diets, avoiding unsafe diets, self-medication, activity, and smoking. Participants in the controlled blood pressure group had significantly higher HTA-scale scores than the uncontrolled blood pressure group. At the cut-off point of 86, the scale had significant sensitivity and specificity. CONCLUSION: All of the psychometric properties of the HTA-scale achieved the standard level and were sufficient to recommend this scale for patients with HTN.

Parental coping with childhood cancer and its relationship with self-construal: A survey in southeast Iran.

BACKGROUND: Childhood cancer is a major challenge for parapets. Parents are one of the main sources of emotional support for their child, but their ability to provide proper care during their child's illness and treatment depends entirely on the way they manage to cope with diagnosis and its outcomes. Parents' coping pattern seems to be affected by their perception of themselves or their surroundings. AIM: To investigate parents' coping strategies with childhood cancer and its relation with self-construal. METHODS: A total of 127 eligible parents participated in this descriptive correlational study. RESULTS: Medical, social support, and family strategies were respectively helpful for parents. The interdependent self-construal score was higher than the independent self-construal score. A significant relationship was found between interdependent self-construal and social support (P = .01). DISCUSSION: It seems that individualists and collectivists' cultural context influence the usefulness of coping strategies. These differences should be considered in training of coping strategies.

Self-management, self-efficacy and knowledge among patients under haemodialysis: a case in Iran.

BACKGROUND: Promotion of self-management is one of the effective ways to improve the quality of life of patients under haemodialysis. Therefore, a better understanding of the factors that are effective on self-management might help nurses find an appropriate method for the promotion of self-management. AIMS: This study aimed to examine self-management and its correlation with self-efficacy and knowledge of haemodialysis among patients under haemodialysis in Yazd, Iran in 2016. METHODS: This is a cross-sectional study conducted in four haemodialysis centres. All patients who were referred to these centres were selected. Demographic characteristic forms, self-management questionnaires, haemodialysis knowledge questionnaires and chronic diseases self-efficacy scales were used to collect data. RESULTS: The score of self-management was between 32 and 80. The mean scores of self-management, knowledge and self-efficacy were 58.88 ± 10.41 (possible score 20-80), 16.15 ± 2.91 (possible score 0-25), 5.24 ± 1.99 (possible score 0-10), respectively. There was a significant positive correlation among self-management, knowledge and self-efficacy. CONCLUSIONS: The level of self-management was moderate among patients under haemodialysis. Effective interventions including training related to dialysis system, laboratory tests and diet are needed to improve self-management among patients under haemodialysis.

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.

Informational Needs of Patients with Cancer: A Qualitative Content Analysis

One of the most important needs of patients with cancer is informational needs. Getting relevant information about the disease can lead to a proper decision making, better response to treatment, lower levels of anxiety, and higher levels of quality of life. Therefore, the current study aimed to determine the informational needs of patients with cancer in southeast Iran. Materials and Methods: This conventional qualitative content analysis was done using a descriptiveexplorative design. Data collection was done through conducting deep semi-structured interviews from September 2017 to March 2018 in cancer treatment centers of Kerman University of Medical Science, Iran. Data saturation was achieved after interviewing with 13 patients during 15 interviews. The patients were asked to narrate their experience about informational needs of cancer patients. The following concepts were considered: the unit of analysis, meaning unit, condensation, code, sub-category, category, and main category. Results: The results of the present study showed that informational needs of these patients could be categorized under one main category called awareness-oriented needs, including three subcategories. These subcategories included lack of knowledge about the nature of the disease, inappropriate control of the disease due to lack of knowledge, and lack of knowledge about cancer treatment methods. Conclusion: Results showed that patients with cancer tended to know what is the cancer and the ways of cancer treatment and complications. Therefore, it is suggested to perform further studies cultivating the awareness of cancer patients in these areas. Therefore So, It should be noted that designing and implementation of this needs assessment provide a comprehensive way to consult and collaborate with health care professionals, patients, and their families.

Body-Mind Healing Strategies in Patients with Cancer: a Qualitative Content Analysis

Background: Cancer is a major health problem around the world. The use of coping strategies among patients with cancer depends on several issues. This study was conducted to determine coping strategies used by patients with cancer in south-east Iran. Methods: This study is a conventional, qualitative content analysis with a descriptive explorative approach. Data saturation achieved after interviewing 13 participants in 15 interviews. Using an in-depth individual semi-structured approach the participants were asked to narrate their experiences of strategies that they used to cope with cancer. The following were considered: unit of analysis, meaning unit, condensation, code, sub-category, category, and main category. Results: Data analysis led to extraction of two main categories of body-mind healing strategies: being connected to the body and mindfully reconnected to the self. The first category was explained with reference to two sub-categories, being aware of intelligence and body nurturing. The second category was explained with the three sub-categories of using embodying knowledge, living for the moment, and being connected to nature. Conclusion: According to the results of this qualitative study, it is possible to form discussion groups with peers or to have self-reflective practice learning groups to reflect patients' questions and strategies that they use for body-mind healing.

Getting Out or Remaining in the Cage of Inauthentic Self: The Meaning of Existential Challenges in Patients' with Cancer.

CONTEXT: Cancer as a life-threatening disease develops a range of existential challenges in persons. These challenges cause the patients to encounter some existential questions and tensions. This study method focuses on a person's experience about them. AIMS: The aim of this study is to illuminate the meaning of existential challenges in patients with cancer in Iran. SUBJECTS AND METHODS: A hermeneutic phenomenological approach, influenced by the philosophy of Ricoeur, was used to analyze the experiences of 10 Iranian patients with cancer. Data analysis was based on three stages of simple and fast understanding, structural analysis, and comprehensive understanding. RESULTS: The present study showed that existential challenges in patients with cancer can be considered as getting out or remaining in the cage of inauthentic self. This theme consists of two subthemes "Being exposed to the light of awareness that revealed the cage of inauthentic self" and "The tension between getting out of the cage or remaining." First, being exposed to the light of awareness revealed the cage of inauthentic self which subjectively refers to the emergence of existential questions, the past, the fear of future, and the collapse of physical body identity. Second, the tension between getting out of the cage or still staying which is characterized by anger, denial, sense of loneliness, and depression. CONCLUSIONS: According to the results of this qualitative study, it is possible to form discussion groups with peers or have self-reflective practice teaching groups to reflect patients' questions and existential challenges. In this way, participants can express themselves, share their experiences, challenges, learn, and find the answers.

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.

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.

Compassion and care at the end of life: oncology nurses' experiences in South-East Iran.

BACKGROUND: End of life (EOL) care is newly established in the Iranian context. Context, in this case, refers to the internal and external manifestation of the nurse values, norms and experiences that are learnt throughout life. AIM: The aim of this study was to explore nurses' experiences of caring for dying patients in Iran. METHODS: A phenomenological hermeneutic approach, influenced by the philosophy of Ricoeur, was used to analyse 10 oncology nurses' experiences of caring for dying persons. FINDINGS: Three themes emerged from the analysis: 1) seeing the patient as unique person, 2) being present and open to seeing patients as unique persons and 3) personal and professional development as a result of closeness between nurse and patient. Caring for dying persons means assisting them at the end of their lives. CONCLUSION: Caring relationships underlie professional palliative care and are essential in EOL care. Proper palliative education and professionally led supervision should be included in the Iranian nursing curriculum.

Translation and validation of the Persian version of the treatment adherence questionnaire for patients with hypertension.

BACKGROUND: Hypertension is a global public health crisis. Poorly controlled high blood pressure is one of the major factors contributed to this crisis. As lack of treatment adherence is often considered the main reason for this failure, the Treatment Adherence Questionnaire for Patient with Hypertension (TAQPH) was developed. Since this questionnaire should be reliable and strongly valid to be used in clinics and research, this study was performed to test the reliability and validity of the TAQPH. METHODS: A cross-sectional study was conducted to validate the Persian version of TAQPH after using a modified forward/backward translation procedure. A total of 330 hypertensive patients were participated in this study. Construct and criterion validity, Cronbach¢s alpha, and test-retest reliability were used to validate the Persian scale. RESULTS: Data analysis showed that the scale had excellent stability (intraclass correlation = 0.95) and good acceptability of internal consistency (α = 0.80). The exploratory factor analysis (EFA) was meaningful but was not confirmed with confirmatory factor analysis (CFA). The scale score was correlated with Morisky Medication Adherence Scale (MMAS) score (Ρ = 0.27). CONCLUSION: In total, most of the psychometric properties of the 25-item P-TAQHP achieved the standard level and were sufficient to recommend for general use.

Critical care nurses' attitude towards life-sustaining treatments in South East Iran.

BACKGROUND: Life-sustaining treatments (LSTs) may prolong life but greatly decrease the quality of death. One factor influencing decision-making about withholding and withdrawing these treatments is the attitude of nurses. This study aimed to evaluate the attitude of critical care nurses towards life-sustaining treatments in South East Iran. METHODS: In this cross-sectional study, "Ethnicity and Attitudes towards Advance Care Directives Questionnaire" was used to investigate the attitude of 104 critical care nurses towards life-sustaining treatments in three hospitals affiliated to Kerman University of Medical Sciences. RESULTS: The findings of this study indicated that although a majority of critical care nurses (77%) did not have personal desire for use of LSTs including CPR and mechanical ventilation, they had moderately negative to neutral attitude towards general use of LSTs (2.95 of 5). CONCLUSIONS: These findings suggest that nurses' attitude towards LSTs can be changed by inclusion of specific courses about death, palliative care and life-sustaining treatments in undergraduate and postgraduate nursing curricula. Educating Muslim nurses about religious aspects of LSTs may also improve their attitudes.