Meeting death and embracing existential loneliness: A cancer patient's experience of being the sole author of his life.

Facing the truth of death in silence instead of fearing and denying it enables people to regain their freedom. This qualitative case study aimed to illuminate the meaning of a single person's experience of confronting death and living with cancer. The transcripts of unstructured interviews were analyzed using the hermeneutic phenomenological method. Data analysis led to extraction of four themes including "Confronting death, meeting nonbeing and longing for being", "Embracing existential loneliness, responsibility and freedom", "Taking over the mind, living mindfully, a meaningful life", and "Flourishing authentic self-love, moving in the path of caring and healing the self".

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.

The Effect of Massage With and Without Aromatic Oil on Delirium After Open-Heart Surgery: A Randomized Controlled Trial.

OBJECTIVE: The current study aimed to determine the effect of massage with and without aromatic oil on the delirium of patients hospitalized in the cardiac intensive care unit. METHODS: This study was a single-blind, randomized, controlled trial. Using a convenience method, 150 patients were selected and assigned into 3 groups: control, massage with aroma, and massage without aroma using the minimization method. Only routine care was provided for the control group. Brown massage with 4% rose oil in the base of sweet almond oil was given to the massage group with aroma 1 day after the surgery. The same steps and massage techniques with sweet almond oil were performed for the massage group without aroma. The incidence and severity of delirium were evaluated at the end of each day using the Neelon and Champagne Confusion Scale. RESULTS: Delirium scores were not significantly different among the 3 groups on the first, second, and third days (P > .05). Also, the incidence of delirium significantly decreased in all 3 groups from day 1 to day 3. CONCLUSION: The results of this study could not prove the beneficial effects of massage with and without aroma on delirium incidence. Further studies are suggested to determine the best intervention to reduce delirium in patients undergoing coronary artery surgery.

Comparative Effect of Mother's Hug and Massage on Neonatal Pain Behaviors Caused by Blood Sampling: A Randomized Clinical Trial.

BACKGROUND: The early experience of pain can lead to complications such as tachycardia, tachypnea and increased metabolic needs of the body, thereby exacerbation of the behavioral and physiological responses to pain in neonates. The current study aimed to compare the effect of a mother's hug and massage on pain behaviors during and after blood sampling in neonates. METHOD: This study was a randomized clinical trial. A total of 135 healthy full-term neonates were selected by convenience sampling method. Samples were randomly assigned to a mother's hug group, massage group or control group. In all three groups, the behavioral responses of the neonate were measured and recorded before, immediately and 5 min after blood sampling by Neonatal Infant Pain Scale. Heart rate, respiratory rate and blood oxygen saturation were recorded with pulse oximetry, and the crying period was measured from start to silence using a stopwatch. RESULTS: The results showed that after 5 min, the pain and heart rate in the mother's hug group decreased significantly compared to the massage and control groups (p < 0.001). There were no significant changes in the respiratory rate and blood oxygen saturation level in any of the newborns during blood sampling (p > 0.05). The duration of crying in the mother's hug group had more reduction than that of the massage and control groups (p < 0.001). CONCLUSION: The placement of the baby in the mother's hug during painful procedures is recommended due to the reduction of pain, the improvement of physiological symptoms and the promotion of neonatal health.

Experiences of Iranian Teen Mothers with Parenting Stress: A Qualitative Study.

Early motherhood may develop various stresses for the teen mothers and have adverse consequences. Current research aims at exploring experiences of teen mothers with stress and stressors of early motherhood. This qualitative study was conducted using conventional content analysis through in-depth semistructured interview. Eighteen Iranian teen mothers, who experienced parenting stress, with maximum variation in the age of first pregnancy, child's age, place of residence, and financial condition took part in this research. Data collection continued until saturation and were analyzed using MAXQDA10 software. Data analysis led to extraction of five categories including "storm of anxiety," "wander identity," "an unaccompanied way," "unarmed combat," and "a tired body." Teen mothers experienced tensions such as fear and worry, isolation and loneliness, regret, shame, depression, and doubt. These tensions originated from identity conflicts, inadequate social support, role inefficiencies, physical problems, and responsibilities. Teen mothers are influenced by various physical, psychological, social, and economic stressors which are in relation with the teenage, motherhood role, and the environment. Nurses are the major source of support for the teen mothers. Nurses should identify stress and stressors in teen mothers and strengthen well-being feeling in the teen mothers and their children through care, educational, consultative, and coordination interventions.

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.

The relationship between Iranian patients' perception of holistic care and satisfaction with nursing care.

BACKGROUND: Holistic care is comprehensive care that emphasizes the interaction of human existential dimensions and has a significant role in accelerating the recovery process. Since nurses interact and communicate with patients more than other health care providers, the current study aimed to determine the Iranian patients' perceptions of holistic care and overall satisfaction with nursing care. METHODS: It is a descriptive-correlational study done on patients admitted to the oncology wards of hospitals in southeastern Iran. The holistic caring inventory and patient satisfaction instrument were used to measure the patients' perceptions of holistic care and their satisfaction, respectively. SPSS 19 was used to analyze the data. RESULTS: The results showed that there is a significant positive correlation between patients' perception of holistic care and overall satisfaction with nursing care (P < 0.01, r = 032), which means that the higher the patients' perception of holistic care, the greater their overall satisfaction. Based on the regression model, type of hospital, Patient's perception of holistic care, education, previous experience of hospitalization, age and marriage are respectively predictors of overall satisfaction with nursing care (P < 0.05). CONCLUSION: The present study showed that patients' overall satisfaction with nursing care depends on holistic nursing care, meaning that nurses should pay attention to patients' physical, mental, emotional aspects and increase the quality of care.

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.

"Tender Care": Iranian Women's Needs to Cope with Hysterectomy and Oophorectomy- A Qualitative Content Analysis Study.

BACKGROUND: Gynecological surgeries associated with loss of feminine organs evoke more personal, interpersonal and psychological distress that may diminish women's quality of life. Women need and seek support to cope with various distresses which may change over the course of diagnosis to treatment. This study aimed to explore Iranian women's needs to cope with hysterectomy and oophorectomy. METHODS: This qualitative study was conducted in Kerman and Tehran, Iran from 2015 to 2017. Thirty interviews were conducted with 28 eligible participants including 24 main participants including one gynecologist, one midwife and one nursing faculty member, one gynecologist and one midwife and 2 husbands. They were recruited through purposeful sampling. Data were collected through semi-structured and in-depth interviews and analyzed with Graneheim and Lundman's method of conventional content analysis. The trial version of the MAX QDA 10 Software was used to manage the coding process. RESULTS: "Tender care" emerged as the main theme. It was comprised of three categories: "to be well-informed, "to be treated with compassion in healthcare setting", and "to be welcomed in the society". CONCLUSION: Women after hysterectomy/oophorectomy were preoccupied with many physical and emotional concerns. They need a whole package of care which consists of proper information to know what to do, a well-prepared/trained healthcare setting to meet their needs, and visibility in the society as a whole person. A multidisciplinary approach must be activated to meet their coping requirements and it is necessary to address these needs in each level of healthcare services.

Exploring the experiences of Iranian adolescent mothers about the maternal role: a qualitative study.

BACKGROUND: Early motherhood is one of the most important issues in developing countries. Adolescent mothers are not sufficiently prepared to accept the maternal role. How to achieve success in the maternal role should be studied. OBJECTIVE: To explore the experiences of Iranian adolescent mothers about the maternal role. METHODS: This qualitative study was conducted through a conventional content analysis approach from March to December 2016. Face to face in-depth semi-structured interviews were conducted with 18 Iranian teenage mothers in Kerman province, Iran. Participants were selected purposefully and with maximum variation of the age of the first birth, child's age, place of residence and financial status. Data collection continued until data saturation and MAXQDA software was utilized to analyze the collected data. RESULTS: Data analysis resulted in the extraction of the two main categories including optimizing the process of the maternal experience (use of maximum individual capabilities, planning and management of conditions, efforts to acquire maternal competency, and reliance on spirituality) and supporters for the acceptance of the maternal role (social support, professional services of health care providers, time lapse, care history). CONCLUSION: Early motherhood is not merely an unpleasant experience; if appropriate strategies and facilitators are used, it can have positive consequences. Health care providers should provide satisfactory services in care, education and support with adequate knowledge of adolescent characteristics. Opportunities in the community should also be directed to support this vulnerable group.

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.

Feeling an Invisible Wall: The Experience of Iranian Women's Marital Relationship After Surgical Menopause: A Qualitative Content Analysis Study.

Sexual relationships after surgical menopause matter when talking about sex is taboo and marriage is the only justified way to meet sexual needs. In this qualitative research study, 22 surgical menopausal women shared their experiences of sexual/marital relationship after surgery through in-depth, face-to-face, semi-structured interviews. Qualitative content analysis technique was used for data analysis. An overarching theme entitled "feeling an invisible wall" reflected this experience. It comprised three categories: (1) declined marital intimacy, (2) disarming, and (3) transformation of societal norms into concerns. This study proposed new contextual information about the marital relationship of Iranian women after surgical menopause that was not openly articulated before and which may be applicable for others in such contexts. Women's main concern was the emotional separation because of the sexual consequences of the surgery. Healthcare providers should be aware of women's concerns, which may alter their marital relationship. They must provide individualized care, education, and support for couples to make thoughtful decisions about rebuilding their sexual relationship. Results may also have implications for psychiatrists, sex/marital therapists, and probably clergy who have the authority to openly address this important issue to the public.

Theory analysis for Pender's health promotion model (HPM) by Barnum's criteria: a critical perspective.

Background Analysis of nursing theoretical works and its role in knowledge development is presented as an essential process of critical reflection. Health promotion model (HPM) focuses on helping people achieve higher levels of well-being and identifies background factors that influence health behaviors. Objectives This paper aims to evaluate, and critique HPM by Barnum's criteria. Methods The present study reviewed books and articles derived from Proquest, PubMed, Blackwell Databases. The method of evaluation for this model is based on Barnum's criteria for analysis, application and evaluation of nursing theories. The criteria selected by Barnum embrace both internal and external criticism. Internal criticism deals with how theory components fit with each other (internal construction of theory) and external criticism deals with the way in which theory relates to the extended world (which considers theory in its relationships to human beings, nursing, and health). Results The electronic database search yielded over 27,717 titles and abstracts. Following removal of duplicates, 18,963 titles and abstracts were screened using the inclusion criteria and 1278 manuscripts were retrieved. Of these, 80 were specific to HPM and 23 to analysis of any theory in nursing relating to the aim of this article. After final selection using the inclusion criteria for this review, 28 manuscripts were identified as examining the factors contributing to theory analysis. Evaluation of health promotion theory showed that the philosophical claims and their content are consistent and clear. HPM has a logical structure and was applied to diverse age groups from differing cultures with varying health concerns. Conclusion In conclusion, among the strategies for theory critique, the Barnum approach is structured and accurate, considers theory in its relationship to human beings, community psychiatric nursing, and health. While according to Pender, nursing assessment, diagnosis and interventions are utilized to operationalize the HPM through practical application and research.

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.

Iranian mothers' experiences of the outcomes of early motherhood: A qualitative study.

Early motherhood is a major health challenge in most developing countries. The aim of this study was to explore Iranian mothers' experiences of the outcomes of early motherhood. This qualitative study was done using the conventional inductive content analysis approach. A purposive sample of 18 Iranian mothers, with the experience of early motherhood, was recruited with maximum variation in terms of their age at their first pregnancy, their children's age, place of residence, and financial status. Data collection was done via in-depth semistructured interviews and continued up to data saturation. The MAXQDA software (v. 10.0) was employed for handling the data. Iranian mothers' experiences of the outcomes of early motherhood came into two main categories that were named "realization of the childhood dream of adulthood" and "heavy burden of adulthood on the small shoulders of childhood," The four subcategories of the first category were the acceleration of intellectual and mental maturation, strengthening of family relationships, developing a strong identity, and closer companionship with the child. The second main category also included four subcategories, namely, experiencing numerous difficulties, threats to mothers' physical and mental health, threats to children's health, and missing opportunities. Early motherhood is not merely a negative experience; rather it is also associated with different positive outcomes. Healthcare providers need to provide high-quality prenatal, perinatal, and postnatal care services to adolescent mothers and use available opportunities to strongly support them and their children.

Exploring the Challenges of Adolescent Mothers From Their Life Experiences in the Transition to Motherhood: A Qualitative Study.

Objective: Early motherhood and its impact on mothers, children, families and communities is a prevalent health challenge in developing countries that needs to be urgently explored. The aim of this study was exploring the challenges encountered by Iranian adolescent mothers during the transition to motherhood. Materials and methods: Inductive conventional content analysis approach was used in this qualitative study. Face to face in-depth semi-structured interviews were conducted with 16 Iranian teenage mothers in the Kerman province of Iran from March to December2016. Data collection continued until the point of data saturation and MAXQDA software was utilized in the analysis of the data. Results: Six main categories increasing burden of responsibility, experiencing physical problems, receiving insufficient support, inefficiency in maternal role, emotional and mental distress; and role conflict and 18 sub-categories were extracted from the data analysis. Conclusion: The findings of this study showed that adolescent mothers experience many physical, psychological, mental and social challenges. Therefore, it is expedient that special attention and care support is made available to them by health care providers. A comprehensive understanding of the challenges encountered by adolescent mothers, will aid the development of culturally appropriate health promotion guidelines and strategie.

The effect of empowerment program on empowerment level and self-care self-efficacy of patients on hemodialysis treatment.

BACKGROUND: Patients with end-stage renal disease (ESRD) who receive dialysis confront the burdens of long-term illness and numerous physical problems. MATERIALS AND METHODS: This was a quasi-experimental study. The selected patients from Gorgan Dialysis Centre were randomly assigned into an empowerment group (n = 40) and a control group (n = 40). Instruments comprised scales of Empowerment and the Strategies Used by People to Promote Health (SUPPH). Data were collected at baseline and at 6 weeks following the intervention. The data were analyzed by descriptive and inferential statistics through SPSS (version 17). RESULTS: The results indicate that scores of the empowerment (P ≤ 0.001) and self-care self-efficacy (P = 0.003) in the empowerment group showed a significantly greater improvement than the control group. CONCLUSIONS: The study supports the effectiveness of the empowerment program to promote empowerment level and self-care self-efficacy of hemodialysis patients.