Experiences of family members when accompanying patients in intensive care units: A qualitative study.

BACKGROUND: Family members of Intensive Care Unit (ICU) patients encounter numerous challenges while providing companionship to their hospitalized loved ones. AIMS AND OBJECTIVES: This study aims to explore the experiences of family members with loved ones hospitalized in ICUs. DESIGN: Qualitative research was conducted using a content analysis approach. PARTICIPANTS: Ten family members of ICU patients were recruited using purposive sampling. METHODS: Data were collected through semi-structured, in-depth interviews and analysed following Graneheim and Lundman's suggested steps. FINDINGS: Analysis of interviews with ten family members of ICU patients revealed a theme of "challenging companionship on an obscure path," encompassing four categories (1-4) and nine subcategories (a, b and c). These included (1) the interplay between the patient and the family: a. family affected by the patient's condition; b. patient affected by the family's condition; (2) mixed emotions of apprehension and anticipation regarding ICU admission: a. fear of ICU hospitalization; b. hope for ICU hospitalization; (3) unaddressed needs and concerns: a. pressure from the ICU's visiting limitations; b. lack of a resting room to settle; c. vague information about the patient's condition; (4) two-way care suffering for families a. direct suffering associated with companionship; b. indirect suffering while observing the patients' suffering. CONCLUSIONS: Families of ICU patients encounter various challenges, revealing the complex interplay of emotions, needs and challenges within the ICU. This highlights the intricate dynamics in this critical health care environment. RELEVANCE TO CLINICAL PRACTICE: A holistic and empathetic approach in clinical practice is crucial in ICU care, particularly during the challenging journey patients and their families undergo in this critical setting. Health care systems and providers should adapt ICU rules to address evolving needs, alleviate concerns and enhance the overall family experience during their loved one's hospitalization in the ICU.

Prevalence of COVID-19 anxiety, geriatric anxiety, and related factors among the elderly in Quchan, Iran during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Anxiety is a prevalent mental disorder among the elderly, leading to discomfort, disability, increased expenses, reduced quality of life, and dysfunction. Consequently, this study was conducted to determine the prevalence of COVID-19 anxiety and geriatric anxiety, along with the factors influencing anxiety, in the elderly population served by urban healthcare centres in Quchan. METHODS: This cross-sectional study involved 650 elderly individuals aged 60-95 years. The participants were selected using a two-stage cluster sampling method. Data were collected through three questionnaires: the Geriatric Anxiety Inventory (GAI), the Corona Disease Anxiety Scale (CDAS), and a questionnaire on factors contributing to anxiety. Data analysis was performed using simple and multiple regression with IBM SPSS 24. RESULTS: The prevalence of geriatric anxiety among the elderly was 40.3%, while the prevalence of COVID-19 anxiety (moderate and severe) was 22.8%. Significant relationships were observed between geriatric anxiety and substance abuse, stressful life events, comorbidities, COVID-19 anxiety, financial support, loneliness, walking habits, and sleep patterns (P < 0.05). CONCLUSION: COVID-19 anxiety and geriatric anxiety are prevalent concerns among the elderly. Factors like substance abuse, stressful life events, COVID-19-related anxiety, comorbidity, living alone, lack of financial support, and poor walking and sleeping habits, which affect anxiety in the elderly, it is essential to address these factors in life planning and provide services through relevant organisations, healthcare teams, and initiatives by the elderly themselves.

Iranian Pharmacist's Experiences of COVID-19 Pandemic: A qualitative study.

BACKGROUND: Since the 2019 COVID-19 pandemic is not the first and will not be the last, pharmacists' experiences during this period can be used to establish a more efficient healthcare system to face future pandemics. OBJECTIVE: This study aims to explore Iranian pharmacists' experiences in pharmacies using the content analysis method. METHODS: In this qualitative study, a conventional content analysis approach was applied. Ten male and female pharmacists working in community pharmacies in Birjand, Iran participated using a purposeful sampling method. Semi-structured interviews were carried out for data collection. The data were analyzed using Graneheim and Lundman's method. RESULTS: Four categories and ten subcategories were extracted as follows: Multifaceted concerns of pharmacists (familial, economical, professional, and personal concerns), Non-compliance with protocols from occurrence to cause (facing non-compliance with protocols by clients, obstacles to complying with protocols in the pharmacy), Prevention from COVID-19 (protective equipment usage, designing protection rules), and Double reactions to COVID-19 (emotional and; practical reactions). CONCLUSIONS: Pharmacists dealt with different concerns and challenges during the COVID-19 pandemic. They are one of the main primary care providers and need to be supported by the authorities to maintain their standard level of services.

Nurses' Caring Experiences for Dying Patients: A Meta-Synthesis Review.

Nurses play an important role in caring for dying patients. The ability to face a dying patient is a vital necessity and skill for nurses. Nurses' experiences in dealing with dying patients help to identify the factors affecting nursing care. Therefore, this meta-synthesis explains nurses caring experiences for dying patients. In this meta-synthesis review, English qualitative articles related to nurses' caring experiences with dying patients that were published in Google Scholar, PubMed, Web of Science, Scopus, and CINAHL databases were selected. The results presented in 4 themes and 4 sub-themes, including (i) dual parallel nursing care (patient care and family care), (ii) conflict between nurses' beliefs and care duties, (iii) care reflections on the nurse (positive and negative care reflection, and (iv) coping strategies of nurses. This study shows that nurses provide diverse care to dying patients and their families, which has had positive and negative reflections on their personal and professional lives. Nurses sometimes had a conflict with their beliefs and treatment protocols, which hesitate to perform the treatment. Although nurses use various coping strategies when caring for dying patients and their families, they need more strategies to cope with multi-faceted physical, mental, spiritual, educational, and management issues.

Nursing care based on the Support-Based Spiritual Care Model increases hope among women with breast cancer in Iran.

PURPOSE: Taking care of cancer patients and treating them are among major challenges in the field of health. Several studies have shown that promotion of hope is an efficient strategy for effectively treating this group of patients, reducing their symptoms, and improving the quality of their life. It seems that spiritual care can boost hope in these patients. This study aims to determine the effects of nursing care based on the Support-Based Spiritual Care Model on boosting hope among women with breast cancer. METHODS: In this controlled clinical trial, 72 patients with breast cancer were selected through consecutive sampling and randomly assigned to two control and intervention groups (n = 36 in each group) based on four randomized blocks. The intervention was carried out based on the Support-Based Spiritual Care Model for the patients and their main caregivers in six sessions. Besides, the Snyder's hope scale was completed before and 1 month after the intervention by the participants in the intervention and control groups. RESULTS: The results of the independent samples t-test showed no significant difference in the mean scores of hope between the intervention and control groups before the intervention (P > 0.05). However, after the intervention, the mean scores of hope for the intervention and control groups were 46.71 ± 4.61 and 40.40 ± 5.42, respectively, showing a significant intergroup difference as verified by the independent samples t-test (P < 0.05). CONCLUSION: According to the results of this study, providing nursing care based on the Support-Based Spiritual Care Model can raise hope in patients with breast cancer. CLINICAL IMPLICATIONS: Healthcare professionals can boost hope in cancer patients through proper planning and adequate support in providing nursing care based on the proposed model.

The Effect of Self-Management Education by the Teach-Back Method on Uncertainty of Patients with Breast Cancer: a Quasi-Experimental Study.

The present study aimed to determine the effect of self-management education by the teach-back method on uncertainty of patients with breast cancer. This quasi-experimental study (before and after) investigated 50 patients with breast cancer who referred to Surgery Clinic in Kerman from December 2015 to March 2016. The convenient sampling method was used for participants' selection. Participants were randomly divided into intervention and control groups. The questionnaire was completed before and after training by the teach-back method in both groups. Data were analyzed by SPSS software version 20. The results of the study showed that teach-back training in the intervention group improved self-management compared to the control group and the total score decreased from 106 to 73 (p = 0.01). Even after controlling confounders, such as place of residence and history of cancer education, the differences between the above groups remained statistically significant. Self-management education program by the teach-back method can help reduce uncertainty in patients with breast cancer. Therefore, it is recommended to use this educational method to improve self-management and reduce uncertainty in these patients.

Bipolar Coping Strategies of Nurses in Facing the COVID-19 Pandemic: A Meta-synthesis Review.

Nurses on the front line of facing the COVID-19 pandemic have applied many coping strategies to adapt to their experienced physical and psychosocial challenges. This review aimed to identify coping strategies of nurses in the face of Covid-19. In this meta-synthesis review, qualitative articles related to the coping strategies published in English in the Google Scholar, PubMed, Web of Science, ScienceDirect, and CINAHL databases were selected and analyzed. The review of selected articles showed nurses have used various coping strategies that can be categorized into one main theme, two themes, and ten sub-themes. The theme of efficient coping strategies includes the sub-themes of spiritual-religious coping, protective coping (protection of family members and colleagues), supportive coping by obtaining support from family, friends, colleagues, society, and government organizations, committed coping, positive mind coping, emotional coping, operational coping, and fun coping. The theme of inefficient coping strategies includes the sub-themes of avoidance and risky behaviors. The strategies lead to the synthesis of bipolar coping strategies of nurses during the COVID-19 pandemic. Therefore, healthcare policymakers should emphasize using efficient strategies and avoiding inefficient ones.

Iranian cancer patients' perception of spirituality: a qualitative content analysis study.

BACKGROUND: Spirituality is a subjective and multi-dimensional concept. The ambiguity in its meaning can create barriers in its application in both education and medicine. The present study aimed to explore the Iranian cancer patients' perception of spirituality. METHODS: A qualitative study, using the content analysis approach, was conducted. Semi-structured interviews were held with 11 cancer patients and six members of their families in one of Tehran's hospitals and a charity institute. The data generated were transcribed verbatim and content analysis approach was used for data reduction, naming data, obtaining analytical code and determining categories and themes. RESULTS: Three themes (and seven sub-themes) emerged from the data analysis: 1) God as the spiritual truth (relationship with God and trust in God), 2) Moralities as a spiritual sign (considering personal and social moral codes) and 3) Spiritual resources as the source of hope (religious, personal and social resources). CONCLUSIONS: Overall, in the view of cancer patients, spirituality can be defined in a religious context. However, some of them believe in morality beside religiosity, so health care staff must pay due attention to these aspects, to provide them with the opportunity to use spiritual resources.

Living Experiences with Maintenance Hemodialysis: A Qualitative Content Analysis.

Assessing and providing interventions to improve the comfort status of the patients' needs to be a priority of nursing practice and further research. We did this study to explore the living experiences with maintenance HD among these patients. This qualitative study was conducted using a conventional content analysis approach on 12 HD patients from February 10, 2019 to July 30, 2019. The data were collected through in-depth and semi-structured interviews and were analyzed using Grenham and Landman approach. The main theme was "dialysis therapies with dual face." Three main categories were included: "Dual mood by dialysis," "Dual feelings with dialysis, " and "Relying on the family and health care workers." The results showed that patients' dependence on HD was accompanied by both good and bad moods and created dual emotions both positive and negative. Influenced by these feelings, these patients had shown a variety of reactions such as trying to adjust to life on HD, relying on supports and beliefs. In this study, a dual face was seen in HD in the eyes of these patients. Therefore, "dual face HD therapy" was identified as the essence of the experiences of HD patients. Health-care providers should try to eliminate the bad and unpleasant face of HD.

The Effect of Family-Centered Education on the Care Burden of Family Caregivers of the Elderly with Cancer: A Quasi-experimental Study.

INTRODUCTION: Given the role of the family in decisions related to the patient's health, their role in educating the patient should be considered in the health care program. Therefore, the present study was conducted to determine the effect of family-centered education on the care burden of family caregivers of the elderly with cancer. METHODS: In this quasi-experimental study, 30 elderly caregivers with cancer were selected and randomly divided into two groups of 15 intervention and 15 control from 1 March 2020 to 1 July 2021. Data collection tools were demographic characteristics questionnaire and care burden questionnaire. The intervention was performed as individual training to caregivers in two one-hour sessions. 6 weeks after the intervention, care burden was measured in both groups. Data were collected and analyzed using PSSS software version 23. RESULTS: According to the independent t-test, before the intervention, there was no significant difference between the mean score of care burden in the intervention and control groups, but after the intervention, the mean score of care burden in the intervention group decreased from 56.93 ±11.08 to 42.93 ± 9.78 and in the control group It changed from 54.27 ± 11.38 to 56.80 ± 11.43 and there was a statistically significant difference in the mean scores of the two groups (P <0.001). CONCLUSION: Based on the findings of the present study, family-centered education intervention can be effective in reducing the care burden of caregivers of the elderly with cancer in a sample of Iranian society. Therefore, it is predicted that providing such educational services in the health care delivery system is absolutely necessary and effective, and the use of this type of training in nursing activities is recommended.

Experiences of Spouses of Women with Breast Cancer: A Content Analysis.

INTRODUCTION: In addition to the affected person, diagnosis and treatment of breast cancer also severely affects her husband. Therefore, it is worth paying attention to the needs of husbands of women with breast cancer. Therefore, the aim of the present study was to explain the experiences of spouses of women with breast cancer. METHOD: The present study was a qualitative study with conventional content analysis approach. Purposive sampling was carried out by selecting 6 spouses of women with breast cancer. Data were collected through semi-structured interview. The recorded interviews were transcribed verbatim. Content analysis was used to reduce and name the data, obtain analytical codes, and finally recognize the theme. RESULTS: Data analysis resulted in the extraction of 4 categories of couples' mental challenges, multifaceted romantic meditation, multifaceted traumas caused by the disease, dual energies (inductions) of relatives, and 12 subcategories. CONCLUSION: In spite of suffering from all the challenges and traumas, husbands of women with breast cancer have not left their wives alone and have done their best to improve their lives; so, we can raise ""Scarifying your life to save your wife's life"" as an extract from the experience of spouses of women with breast cancer. Knowing and understanding this point by clinical staffs and policy makers can provide pave the way for planning to provide comprehensive support to these men.

Experience of Nurses in Hemodialysis Care: A Phenomenological Study.

This study aimed to describe the experiences of nurses in hemodialysis care. In this phenomenological study, purposive sampling began and continued until data saturation. The research environment was the Hemodialysis unit. Data was collected through semi-structured interviews. Finally, two main classes and four sub-classes were identified, including factors effective on care (inhibitors and facilitators) and care outcomes (the negative effects of care on the nurse and the positive effects of care on the patient), and "challenging care" as the main theme. As the results show, nurses suffer from several physical and mental harm, and this harm even extends to their family environment, and their families are indirectly affected by the negative effects of this care. Therefore, strengthening management approaches to eliminate the inhibitor factors is essential in order to prevent nurses' burnout or quitting while improving the quality of care provided by them.

From Love and Fidelity to Infidelity- Individual Experiences of Women with Breast Cancer Regarding Relationships with Their Spouses

Background and Objective: Breast cancer and its treatment processes not only involve the patients but also their spouses and can impact on mutual relationships. Spouses of women with breast cancer may experience devastating consequences of the disease in their marital and sexual relationships. Therefore, in the present study we aimed to investigate individual experiences of women with breast cancer in their relationships with their spouses. Materials and Methods: This was a qualitative study with a conventional approach to content analysis. A purposive sampling method was used to select 12 patients with breast cancer visiting the Chemotherapy Clinic in Zabol in 2016. Semi-structured interviews were employed for data collection. Data trustworthiness was checked and data were analyzed based on the steps proposed by Graneheim and Lundman. Ethical issues were considered. Results: Three main categories and ten sub-categories were extracted. The three main categories were surrounded by misery, from emotional to practical companionship and influencebeing imposed upon someone else. Conclusion: The findings showed paradoxical experiences of the women under study ranging from love and fidelity to infidelity. This indicates that some spouses do not adequately support for their sick wives. Therefore, health professionals should provide support, guidance and training for couples, including sex therapy and counseling services, so that spouses can better support their wives.

The Relationship between Anxiety and Coping Strategies in Family Caregivers of Patients with Trauma.

INTRODUCTION: Traumatic events are of high incidence and affect not only the patient but also their family members, causing psychological problems such as stress and anxiety for caregivers of these patients. Therefore, the application of appropriate coping strategies by them seems necessary in order to promote mental health. AIM: To study the relationship of anxiety with coping strategies in family caregivers of trauma patients. MATERIALS AND METHODS: The present research was a descriptive-correlational study which was carried out on 127 family caregivers of patients with trauma in intensive care unit, surgery ward and emergency unit of Amir al-Mu'minin Hospital of Zabol, Sistan and Baluchestan Province. The respondents were selected based on the convenience sampling method. Demographics questionnaire, DASS-21, and Coping Strategies questionnaire were used for data collection. The obtained data were statistically analysed using descriptive statistics, Analysis of Variance (ANOVA), t-test, and Pearson correlation coefficient in statistical package for the Social Sciences (SPSS) version 21.0. RESULTS: Based on the results, 89.9% of family caregivers suffer from mild to severe anxiety. The most common type of coping strategy used by the respondents was emotion-focused. The results showed no relationship between anxiety and emotion-centrism, but an inverse relationship was found between problem-centrism and anxiety. CONCLUSION: The majority of family caregivers had anxiety. Given, the inverse relationship between the level of anxiety and the use of problem-based coping strategy, in addition to identifying and reducing the causes of anxiety in caregivers. It is recommended that appropriate coping strategies should be trained to them.

Effectiveness of Teach-Back Self-Management Training Program on Happiness of Breast Cancer Patients

Self-management training is one of the ways to empower patients to cope with disease. The aim of this before-and-after quasi-experimental study was to determine effects of a teach-back self-management training method on breast cancer patient happiness. Fifty breast cancer patients who visited the Park-e Neshat Limited Surgery Clinic in Kerman, Iran were randomly divided into intervention and control groups after convenience sampling and checking for inclusion eligibility. Data were collected using a demographic questionnaire and the Oxford Happiness Inventory before and after teach-back training and analyzed using SPSS 23. Findings showed no significant difference between mean happiness scores in the two groups before the intervention. However, after the intervention, the mean happiness score in the intervention group increased from 37.2 to 62.9, while it decreased from 41.4 to 29.8 in the control group. These changes were statistically significant (p<0.001). Even after controlling for the effect of confounding factors such as residence location and history of cancer education, the observed differences between the groups were statistically significant (p<0.001). A teach-back self-management training program can increase happiness levels in breast cancer patients. Therefore, the use of this method is recommended to improve self-management and increase happiness.

The Effects of Spiritual Self-Care Training on Caregiving Strain in Mothers of Mentally Retarded Children.

INTRODUCTION: Care for a mentally retarded child induces a lot of problems for the mother and leads her to care giving strain and ignorning her self-care. Spiritual health will co-ordinate all aspects of human life and is necessary for coping with diseases in mother of mentally retarded children. AIM: To evaluate the effects of spiritual self-care training on care giving strain in mothers of mentally retarded children. MATERIALS AND METHODS: The present study, is a before and after type quasi-experimental research based on which 60 mothers of mentally retarded children who were hospitalized in Elahi Rehabilitation Center in Quchan City, were selected using convenience sampling and were randomly assigned to intervention and control groups. Data was collected by demographic characteristic questionnaire and care giving strain questionnaire that were filled by groups before, immediately and two weeks after spiritual self-care training. Data was analysed using SPSS version 20. RESULTS: According to the results, there was no significant difference between the mean score of care giving strain in intervention and control groups before and immediately after the intervention. However, among the members of the intervention group the score of mother care giving strain decreased an average of 87.21% within two weeks after the intervention, which was statistically significant over time (p=0.001). The score of mothers in the control group increased an average of 5% over time which was not statistically significant (p=0.4). The observed differences between these groups were also statistically significant even after controlling the effects of such intervening factors as marital status, children age and the years of caring for children (p=0.001). CONCLUSION: Spiritual self-care training can decrease care giving strain in mothers of mentally retarded children. Therefore, strengthening their spiritual beliefs and backgrounds, mothers can greatly reduce the strain caused by care giving problems of mentally retarded children.

Knowledge, attitude and use of complementary and integrative health strategies: a preliminary survey of Iranian nurses.

BACKGROUND: Disagreement exists regarding the need for knowledge about complementary and integrative health (CIH) strategies, as well as for the need to consider such strategies in clinical nursing practice. OBJECTIVE: This study was conducted to assess the knowledge, attitude and use of CIH strategies among nurses in Iran. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: A cross-sectional study of nurses working in two hospitals of Zabol University of Medical Sciences, in southeast Iran, was conducted from October 2014 to April 2015. The questionnaire, developed specifically for this research, was used to assess the knowledge, attitude and use of CIH by nurses. Descriptive and inferential statistics were used to interpret the survey responses. RESULTS: Most nurses (n=95, 60.5%) have average knowledge about CIH strategies with most holding a positive attitude about use (n=81, 51.6%). The majority (n=90, 57.3%) of nurses, however, never applied CIH methods. Where CIH was used, massage was most often clinically applied (n=129, 82.2%) and a large percentage believed it useful for treating illness (n=136, 87.9%). Other CIH methods commonly used included prayer and herbal medicine. CONCLUSION: Nurses have positive attitudes about CIH though knowledge was typically weak. Educational programs should carefully consider how knowledge about CIH methods could be strengthened within curricula.

Religion as an Alleviating Factor in Iranian Cancer Patients: a Qualitative Study.

After diagnosis of cancer, many patients show more inclination towards religion and religious activities. This qualitative study using semi-structured interviews explored the perspectives and experiences of 17 Iranian cancer patients and their families regarding the role of religion in their adaptation to cancer in one of the hospitals in Tehran and a charity institute. The content analysis identified two themes: "religious beliefs "(illness as God's will, being cured by God's will, belief in God's supportiveness, having faith in God as a relieving factor, and hope in divine healing) and "relationship with God during the illness." In general, relationship with God and religious beliefs had a positive effect on the patients adapting to their condition, without negative consequences such as stopping their treatment process and just waiting to be cured by God. Thus a strengthening of such beliefs, as a coping factor, could be recommended through religious counseling.