The Effect of Spiritual Care on Hope in Patients with Multiple Sclerosis Referred to the MS Association of Hamadan in Iran.

The negative impact of hopelessness on mental health makes multiple sclerosis (MS) disease unmanageable. This study aimed to determine the effect of spiritual care on hope in MS patients. In the present randomized controlled trial study, 70 MS patients were selected from the MS Association of Hamadan, Iran, and randomly allocated to intervention and control groups (35 patients per group). A demographic characteristic form and Snyder's Adult Hope Scale were completed before and after the intervention. Spiritual care was provided in weekly group sessions held for four weeks (45-60 min each). The data were analyzed using SPSS-16. Before the intervention, there were no significant between-group difference (P = 0.323). After the intervention, a significant between-group difference was observed (p < 0.001). There was also a significant increase in the mean of hope scores in the intervention group from baseline to follow-up (within-group difference) (p < 0.001), while there was no significant difference between baseline and follow-up in the control group (p = 0.38), confirming the effectiveness of spiritual care in improving hope. Given the impact of spiritual care on increasing patients' hope and improving their psychological state, nurses are advised to devote adequate time to their patients' spiritual needs.

Comparison of the effect of licorice and chlorhexidine mouthwash on the oral health of intubated patients in the intensive care unit.

BACKGROUND: Chlorhexidine mouthwash is a common oral hygiene product used in intensive care units, but it may have some adverse effects. Licorice, a natural herb, could be a potential alternative to chlorhexidine. However, the effect of licorice mouthwash on the oral health of intubated patients has not been studied yet. Therefore, this study aimed to compare the effects of licorice and chlorhexidine mouthwash on the oral health of intubated patients. METHODS: This was a triple-blind clinical trial. The sample included 130 intubated patients admitted to an intensive care unit in Iran. The samples were selected by convenience sampling and randomly assigned to two groups: A and B. In group A, the main researcher applied 15 ml of 0.2% chlorhexidine mouthwash after each brushing (twice a day for 5.5 days) and suctioned it after 30 s. In group B, 20% licorice mouthwash was used instead of chlorhexidine. The demographic information questionnaire and the Beck Oral Assessment Scale (BOAS) were completed by one of the nurses before and on the sixth day of the study. RESULTS: Finally, 60 patients in each group completed the study. There was no significant difference between the groups in terms of demographic variables or oral health before the intervention (P > 0.05). The oral health of patients in both the chlorhexidine and liquorice mouthwash groups improved significantly after the intervention (P < 0.05). However, there was no significant difference in oral health between the two groups at postintervention (P = 0.06). CONCLUSION: The results demonstrated that both mouthwashes exerted a comparable effect on dental and oral health. However, the chlorhexidine mouthwash showed a greater impact on the reduction of dental plaque and the thinning of saliva compared to licorice mouthwash. In essential cases, licorice mouthwash can be employed as an alternative to chlorhexidine.

Perceptions of professional challenges by emergency medical services providers: a qualitative content analysis study.

INTRODUCTION: Emergency medical services (EMS) providers encounter a variety of challenges due to the unpredictable, uncontrollable, and dynamic conditions in the pre-hospital field. This study explored the perceived professional challenges among EMS providers. MATERIALS AND METHODS: This study was conducted using a qualitative research approach and the method of content analysis. Eighteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. The collected data were then analyzed based on the Granheim and Lundman's method. RESULTS: Based on data analysis, five categories and one theme were identified. The extracted theme was professional challenges. The five categories were as follows: Ineffective policies; multicultural and multidisciplinary factors; ambulance dispatch route problems; legal issues; and abuse against the emergency medical services CONCLUSION: In general, it has been found that EMS providers encounter numerous and complex professional challenges during their work. EMS managers can utilize the findings of the present study to develop strategies for reducing the professional challenges faced by EMS providers. By doing so, they can improve the quality of care in the prehospital field.

Impact of a spiritual care program on the sleep quality and spiritual health of Muslim stroke patients: A randomized controlled trial.

OBJECTIVES: Stroke patients often experience poor sleep quality and spiritual health due to complications and limitations. In this situation, implementing spiritual care may reduce these problems. Therefore, this study aimed to examine the effect of a spiritual care program on sleep quality and spiritual health of Muslim stroke patients. METHODS: This was a two-group randomized clinical trial conducted in Hamadan, Iran, in 2021, with 117 stroke patients. The samples were selected by convenience sampling and assigned to experimental (N = 59) and control (N = 58) groups based on random permutation blocks. The data were collected using the demographic information form, the Pittsburgh Sleep Quality Index, the Paloutzian and Ellison Spiritual Well-Being Scale, and the Modified Rankin Scale before and one month after the intervention. The experimental group received five daily sessions of spiritual care for 45-60 min based on standard and local methods, including patient orientation and identification of spiritual needs, religious care, supportive spiritual care, and beneficial evaluations. Data were analyzed by chi-square test, Fisher's exact test, independent t-test, and paired t-test at 0.05 significance level in SPSS 21. RESULTS: The socio-demographic characteristics were similar between the groups (p > 0.05). At baseline, there was no significant difference in sleep quality and spiritual health between the experimental and control groups (p > 0.05). However, after the intervention, the sleep quality and spiritual health of patients in the experimental group improved significantly compared with the control group (p < 0.05). CONCLUSION: The spiritual care program improved sleep quality and spiritual health of stroke patients; therefore, nurses should consider these aspects to provide holistic care.

Effect of education based on the Common-Sense Model of Self-Regulation on blood pressure and self-management of hypertensive patients: A clinical trial study.

Objective: This study aimed to determine the impact of training based on the Common-Sense Model of Self-Regulation (CSM) on blood pressure and self-management of patients with hypertension. Methods: This randomized controlled trial study was conducted. Seventy-two hypertensive patients were referred to the Farshchian Hospital clinic in Hamadan from April 2021 to March 2022. Samples were selected and randomly assigned to the intervention group (n = 36) and control group (n = 36). The intervention group participated in a training program based on the CSM in five sessions of 30-45 min for one month. Phone follow-up was also done once every three days. The control group only received routine clinic education. The clinic's nurse measured the patients' blood pressure, and the participants completed the self-management questionnaire before and three months after the start of the study. Results: A total of 68 participants completed the study. Results showed that before the intervention, there was no statistically significant difference in the mean scores of self-management and its dimensions, systolic, diastolic, and mean arterial pressure between intervention and control groups (P > 0.05). However, after the intervention, the mean of systolic blood pressure (116.21 ± 14.52 vs. 128.62 ± 16.88) mmHg, mean arterial pressure (88.03 ± 8.47 vs. 98.11 ± 11.69) mmHg and the scores of self-management and its dimensions among patients in the intervention group were decreased comparison with control group (P < 0.05). Conclusions: Education based on the CSM improved self-management and blood pressure reduction in hypertensive patients, so nurses should use it as an effective educational model.

Ethical challenges as perceived by nurses in pediatric oncology units.

BACKGROUND: Providing care to children with cancer is one of the most challenging areas of ethical care for nurses. Few studies have addressed nurses' perception of the barriers to giving ethical care in oncology departments. Thus, it is essential that the ethical challenges in caregiving as perceived by oncology nurses be investigated. OBJECTIVE: The present study was conducted to investigate the ethical challenges as perceived by nurses in pediatric oncology units in the south of Iran. RESEARCH DESIGN: The present study is a qualitative work of research with a conventional content analysis design. Data were collected via individual semi-structured interviews. The collected data were analyzed using the qualitative content analysis method. PARTICIPANTS AND RESEARCH CONTEXT: The participants were 21 nurses from pediatric oncology units in state hospitals who were selected by purposeful sampling. Sampling continued until the data were saturated. The study lasted from April to October 2022. FINDINGS: Three main themes, promoting psychological safety in the children, respect for the dignity of the children, and expansion of support for families, and nine subthemes were extracted from the data. ETHICAL CONSIDERATIONS: The study's protocol was approved by the Research Ethics Committee of the University of Medical Sciences and ethical principles were followed throughout the study. DISCUSSION AND CONCLUSION: From the nurses' perspective, the major ethical challenges in providing ethical care in pediatric oncology units were reducing tension toward promoting the patients' psychological safety, showing respect for the identity and dignity of the children with cancer, and expanding support of the patients' families. By creating the right cultural and professional context and establishing proper protocols, healthcare policymakers and administrators can take effective steps toward eliminating the barriers to providing ethical care.

Comparing the effect of the Model of Therapeutic Engagement in cardiac rehabilitation on the sense of coherence and adherence to treatment: a randomized clinical trial.

PURPOSE: The study aimed to compare the effectiveness of a traditional cardiac rehabilitation (CR) program with an enhanced program incorporating the model of therapeutic engagement (MTE) and extended remote support for patients undergoing coronary artery bypass graft (CABG) patients. MATERIALS AND METHODS: In a randomized controlled trial, 88 CABG patients were assigned to experimental and control groups. The experimental group received integrated MTE cardiac rehabilitation, and assessments were conducted at three time points: pre-CR, one month later, and three months post-CR. The study measured medication adherence (MARS-5) and sense of coherence (SoC-13) scales. RESULTS: The study found no significant differences in demographic factors between the experimental and control groups. However, significant differences were observed in MARS and individuals' SoC scores over time in the experimental group, with notable improvements (p < 0.001). The control group showed significant changes only up to one month. Group effects were evident, with consistent increases in the experimental group's outcomes at each assessment point. CONCLUSION: Integrating the MTE into CR programs offers benefits in terms of medication adherence and individuals' sense of coherence, which warrants further investigation and clinical implementation.

Cardiac rehabilitation (CR) is recognized as one of the most effective interventions for secondary prevention, but its accessibility is limited in middle-income countries (MICs).This study represents one of the first theoretically-informed CR trials in a MIC that incorporates the model of therapeutic engagement (MTE) combined with extended remote support services into CR program.The MTE model, as a theoretical framework, was highly suitable for CR settings and demonstrated favorable outcomes.This approach has the potential to greatly benefit cardiac patients, particularly those who may initially show hesitance or reluctance towards engaging in CR.

Young transgender individuals' lived experiences of facing life's challenges: a qualitative study in Iran.

Introduction: In recent years, several studies have addressed the challenges and psychological issues that transgender individuals face. However, only a few studies have explored the experiences of this population in Iran. Life experiences are heavily influenced by the dominant religious and cultural conditions and common beliefs in a society. The present study aimed to investigate transgender individuals' lived experiences of facing life's challenges in Iran. Methods: This is a qualitative study with a descriptive and phenomenological design conducted from February to April 2022. Data were collected using semi-structured, in-depth interviews with 23 transgender individuals (13 AFAB and 10 AMAB). The collected data were analyzed using Colaizzi's method. Results: Analysis of the qualitative data resulted in the emergence of three themes and 11 subthemes. The three main themes included mental health disparities (fear of having one's secret revealed, depression and despair, suicidal thoughts, and secrecy in the family), gender dysphoria (contradictory gender identity and contradictory behaviors), and stigma and insecurity (sexual abuse, social discrimination, disrupted occupational performance, a lack of support, disrepute, and disgrace). Conclusions: The findings of the study indicated that transgender people in Iran are exposed to considerable mental health disparities. In addition to disrepute, infamy, and stigma, transgender people face sexual abuse, social discrimination, and a lack of family social support. The results of the present study can help mental health experts and the healthcare system as a whole to adjust their mental and physical health programs according to the needs and experiences of transgender people and their families. It is recommended that future research address the problems and psychological challenges that transgender people's families have to confront.

Treatment adherence and associated factors in older people with type 2 diabetes: A qualitative study.

PATIENT CONTRIBUTION: Older people with T2D participated in this study to achieve the objective of the study. AIM: Treatment adherence is an important indicator for evaluating successful diabetes control and overall disease management. It is necessary to identify the hidden themes of the concept of treatment adherence and related factors based on the experiences of older people with T2D. Therefore, the present study was conducted to identify the concept of treatment adherence and its associated factors in older people with type 2 diabetes (T2D). DESIGN: The study was conducted as a qualitative study using a content analysis approach. METHODS: Semi-structured interviews were conducted with 20 older people with T2D, between May and September 2021. Data were organized using MAXQDA-10 software and analysed using the Elo and Kyngas qualitative content analysis method. We followed the COREQ Checklist to ensure rigour in our study. RESULTS: Three themes emerged from the analysis of the data, including: 'Health literacy', 'Support umbrella' and 'responsibility'.

Examining the Health-Related Needs of Females during Menopause: A Systematic Review Study.

Menopause is one the most crucial stages in a female's life. Identifying the education gaps regarding menopause is important, thus this study aims to explain the health-related needs of females during menopause. Scopus, PubMed, Scientific Information Database, and Web of Science databases were searched for the available observational (cohort, case-control, and cross-sectional), systematic review, meta-analysis, and clinical trial studies (2007-2021) using keywords, such as 'Educational Needs Assessment,' 'Assessment of Healthcare Needs,' 'menopause,' 'climacteric,' 'premenopause,' and 'postmenopause.' A total of 180 out of 5,705 papers were evaluated after considering the inclusion and exclusion criteria. The educational needs of females during menopause in the reviewed studies include osteoporosis, oral and dental problems, metabolic disorders, cardiovascular diseases, hypertension, lung diseases, infectious diseases, musculoskeletal problems, urinary problems, breast cancer, defecation problems, genital disorders, special diseases such as eye diseases and hypothyroidism and hormone therapy, mental disorders, cognitive function, sleep disorders, sexual disorders, physical activity, supplement consumption, public health issues, health education, fall, and nutrition. The study results reveal that females during postmenopause require training, counseling, and support in all aspects to get through this challenging time, and providing these services, infrastructure, appropriate policy, and the use and support of the medical team's capacity are all required.

Psychiatric nurses' perception of dignity in patients who attempted suicide.

BACKGROUND: Maintaining the dignity of patients who attempted suicide is one of the caregivers' main ethical duties. Yet, in many cases, these patients are not treated with dignity. The concept of dignity is abstract, and there is no research on the dignity of suicidal patients. So, the present study is done to investigate psychiatric nurses' perception of dignity in patients who attempted suicide. OBJECTIVE: The present study explores the concept of dignity in patients who attempted suicide from the perspective of psychiatric nurses. RESEARCH DESIGN: The present study is a qualitative, descriptive work of research. PARTICIPANTS AND RESEARCH CONTEXT: A total of 20 psychiatric nurses from 2 hospitals affiliated with a university of medical sciences in the southeast of Iran were selected via purposeful sampling. ETHICAL CONSIDERATIONS: The Research Ethics Committee of the Hamadan University of Medical Sciences approved the study's protocol, and ethical principles were followed in general. FINDINGS: From the findings of the study, three main themes, namely " respect for personal; identity," "management of psychological tension," and "compassion-focused therapy," with 12 sub-themes were extracted. DISCUSSION AND CONCLUSION: In the perspective of caregivers, patients who attempted suicide need to be cared for in supportive environments with compassionate and respectful behaviors to control their psychological tensions. These conditions would maintain such patients' dignity and result in appropriate behavioral outcomes. Policy-makers and administrators can use the present study's findings to create an appropriate clinical environment in which the dignity of patients who attempted suicide is properly maintained.

Child exposure to domestic violence, substance dependence and suicide resilience in child laborers.

BACKGROUND: Child laborers are often defined as work that deprives children of their childhood, their potential and their dignity, and that is harmful to physical and mental development. Child laborers are one of the most vulnerable groups in domestic violence. Domestic violence severely affects the physical and mental health, and consequently affects substance dependence and resilience to suicide of these children. Accordingly, it is essential to examine domestic violence, substance dependence, and suicidal ideation in working children. OBJECTIVES: the present study aimed to investigate the relationship between exposure to domestic violence and substance dependence and suicide resilience on the other among child laborers in Iran. METHODS: This study employed cross-sectional research. 600 child laborers were selected via convenience and snow ball sampling from one rehabilitation and welfare center and three charity organization societies in the west of Iran, from January to August 2022. They completed questionnaires. Data were analyzed by SPSS software version 22 and with using descriptive statistics (frequency, percentage, mean and standard deviation) and ANOVA, independent t-test and the multiple linear regression model with a backward strategy. RESULTS: Findings showed that exposure to domestic violence has a strong and direct correlation with substance dependence (r = 0.94, p < 0.001) and strong and indirect correlation with suicide resilience (r =- 0.91, p < 0.001). Also substance dependence has a strong and direct correlation with suicide resilience (r = -0.87, p < 0.001) in child laborers. Variables of substance dependence, suicide resilience, gender, guardian's disease status, living status and age can predict 76.51% of the variance in domestic violence in these children. CONCLUSION: Child laborers experience a lot of domestic violence, which severely affects their suicide resilience and substance dependence in them. Therefore, there is an urgent need for systematic support programs with content (teaching self-care behaviors, stress management, avoiding tense and violent environments) in order to support of these children and reduce domestic violence against them and subsequently reduce substance improve abuse resilience to suicide in these children.

Death anxiety, resilience, and family cohesion in parents of children and adolescents in the end stages of life.

Purpose: Adolescents in the end stages of life impose a lot of psychological stress on other family members, which may affect their resilience and quality of life. So, the aim of the present study was to investigate death anxiety, family adaptability and cohesion, and resilience in the parents of children and adolescents who were at the end stages of life. Methods: This is a cross-sectional study. Two hundred and ten parents were selected by convenience sampling and completed the questionnaires such as demographics survey, the death anxiety scale, Connor-Davidson resilience scale, family adaptability, and cohesion scale. Data were analyzed by descriptive statistics (frequency, percentage, mean, and standard deviation), independent t-test, ANOVA, and multiple linear regressions. The significance level was set at p < 0.05. Result: The findings showed that death anxiety in parents of children and adolescents in the end stages of life has a significant inverse correlation with family adaptability and cohesion (p < 0.001, r = -0.92) and resilience (p < 0.001, r = -0.90). The variables of family adaptability and cohesion, resilience, number of children, the children's illness duration, and marital status can predict 61.34% of the death anxiety variance in these parents. Conclusion: The parents of children and adolescents in end stages of life reported high death anxiety and moderate family adaptability and cohesion, but low resilience. Accordingly, pediatric nurses and healthcare policymakers should develop comprehensive support plans for these parents to facilitate their adaptation and increase their family adaptability and cohesion.

Barriers to Treatment Adherence Among Older Adults With Type 2 Diabetes: A Qualitative Study.

The current qualitative study aimed to determine the barriers to treatment adherence among older adults with type 2 diabetes (T2D). This study was performed using a content analysis approach. Semi-structured interviews were conducted with 25 older adults with T2D between May and September 2021. Data were organized using MAXQDA-10 software and analyzed using the Elo and Kyngäs qualitative content analysis method. Three themes emerged from the analysis: Patient-Specific Barriers, Health Care Provider- and Heath Care System-Specific Barriers, and Social-Specific Barriers. Results of this study can be used to develop targeted interventions to promote and facilitate treatment adherence among older adults with T2D. [Journal of Gerontological Nursing, 49(1), 42-49.].

Caregivers' perception of teenagers' dignity in end of life stages: A phenomenological study.

Introduction: Maintaining patient dignity in a caregiving environment is one of the most important moral responsibilities for caregivers. Nonetheless, there are vulnerable groups, specifically teenagers, who in their final stages of life are prone to their dignity being threatened. Moreover, dignity is an abstract concept and there is no studies done on teenagers' dignity in the final stages of life available in Iran.Purpose: The purpose of this study is to describe the caregivers' experiences regarding teenagers' dignity in the final stages of life.Research design: This study is a descriptive phenomenological qualitative research project. The data was collected using deep individual and semi-structured interviews as well as taking notes. The Colaizzi analysis method was used to analyze the data.Participants and research context: 22 caregivers working with teenagers in the final stages of life in a public health centers in Iran who had the criteria to enter the study were selected using a purposeful sampling method and invited to join the study from August 2018 to June 2019. The sampling continued until data saturation.Findings: The findings of the present study were presented in the form of three main themes including "private," "respecting individual identity," and "attention to teenagers' needs" and an additional eight categories.Ethical Considerations: The study's protocol was approved by the Research Ethics Committee of the Shiraz University of Medical Sciences and all ethical principles were followed throughout the study.Discussion and conclusion: Based on the present study from the caregivers' point of view, teenagers in their final stages of life required to be cared for and taught in an environment that their privacy was maintained and their individual identity was respected as well as getting attention from the caregivers and companions. In such situations, the teenagers felt calm and their dignity was maintained; therefore, providing a cultural, professional, and organizational setting where all the components of maintaining dignity in teenagers are supported and prioritized is necessary.

Suicide resilience, identity crisis and quality of life in burned adolescents.

AIM: The aim of this study was to investigate the relationship between identity crisis and suicide resilience and quality of life in adolescents with burns in Iranian society. DESIGN: A cross-sectional study. METHODS: Four hundred thirty adolescents with burn in three hospitals were selected via convenience sampling. They completed questionnaires online. Data were analysed by SPSS software version 22. RESULTS: Findings showed a strong and inverse correlation between identity crisis with suicide resilience (r = -.92, p < .001) and quality of life (r = -.87, p < .001). Variables of suicide resilience, being a child of a divorced family, cause of burns, extent of burn, financial situation, gender and age can predict 68.74% of the variance in identity crisis in these patients. PATIENT OR PUBLIC CONTRIBUTION: Adolescents with burns suffer from an identity crisis, and although they report high resilience to suicide, they have a mediocre quality of life. Therefore, it is suggested that basic planning and extensive support be taken to improve physical and mental health, promote the quality of life and consequently reduce the identity crisis in these adolescents.

Survival to Discharge Rate and Favorable Neurological Outcome Related to Gender, Duration of Resuscitation and First Document of Patients In-Hospital Cardiac Arrest: A Systematic Meta-Analysis.

Objective: To investigate the relationship between outcomes and demographic-clinical variables in in-hospital cardiac arrest (IHCA). Methods: The Medline database was searched along with Google Scholar, Scopus, Web of Science, and Persian language database without time limitation until January 6th, 2020. The inclusion criteria included papers published in journals or presented in English and Persian congress that reported the IHCA outcomes based on the Utstein criterion. All the descriptive, cross-sectional, and cohort studies on CPR were covered based on inclusion and exclusion criteria. Primary checks covered titles and abstracts followed by a full-text check of the remaining papers from the first screening stage. Data analysis was done using comprehensive meta-analysis (CMA) software version 2.0. The finding's heterogeneity was checked using Q and Cochran tests with heterogeneity >50% and the random-effects model was used to estimate survival and favorable neurological outcome (FNO) in the analysis. To detect the publication bias of studies, the subgroup test, meta-regression test, sensitivity analysis test, funnel plot, and Eagger's regression test were used. Results: Survival to discharge was 19.1% (95% CI=16.8-21.7) and FNO in the survived to discharge cases was 68.1% (95% CI=55.8-78.3). Survival to discharge and FNO were notably higher in men, CPR duration <15min, and shockable dysrhythmias. Conclusion: IHCA outcomes are poor in developing countries. The outcomes of IHCA in terms of gender were inconsistent with the result reported by other meta-analyses.

Adaptation status and related factors in patients living with implantable cardioverter defibrillators.

Introduction: An implantable cardioverter-defibrillator (ICD) is the only approach to treat patients with life-threatening ventricular arrhythmias. Adaptation and acceptance of ICD play an important role in the optimal treatment of the patients. The aim of this study was to determine adaptation status and related factors in patients living with ICDs. Methods and Materials: In this descriptive-analytical study, 148 patients referred to Kowsar Hospital in Shiraz and Farshchian Hospital in Hamedan city between July 2020 and September 2021 were included in the study. Patients' adjustment status was measured based on the mode of the Roy nursing model and using the Baecke physical activity questionnaire, Pittsburgh sleep quality, mini nutritional assessment (MNA) nutrition questionnaire, constipation scoring questionnaire, self-concept scale, and multidimensional scale of perceived social support (MSPSS). Results: Patients had low physical activity and poor sleep quality. Negative self-concept in relation to the disease and adherence to physicians' recommendations was observed among patients. In addition, patients did not have optimal interpersonal communication. Multivariate regression findings showed that the number of years of device implantation and the number of shock discharges are effective factors in the incidence of insomnia and the negative self-concept of patients. Conclusion: Patients living with ICD did not adjust to the new conditions after placement of the device. Low level of physical activity and sleep disturbance and also negative self-concept about the disease and adherence to treatment was observed among the patients. Shock discharges and duration of the device implantation were associated with impaired self-concept and insomnia in the patients.

Impact of Hope on Stroke Patients Receiving a Spiritual Care Program in Iran: A Randomized Controlled Trial.

This study sought to examine the effect of a spiritual program on the hope of stroke patients in Iran. The present study was a randomized controlled trial that included 108 stroke patients referred to Besat Hospital, Hamadan, Iran, in 2021. Participants were randomized to either the intervention group (n = 54) or control group (n = 54). The data were collected before the intervention by using the demographic information form, Snyder's Adult Hope Scale (AHS), the Modified Rankin Scale (MRS), and after the intervention, the  Snyder's Adult Hope Scale (AHS). The intervention group received four sessions of 45-60 min (one session per week) that included a spiritual needs assessment, religious care, spiritual supportive care, and evaluation of benefits. After the intervention, a significant between-group difference was observed (p < 0.001). There was also a significant increase in the mean of hope scores in the intervention group from baseline to follow-up (within-group difference) (p < 0.001), while there was no significant difference between baseline and follow-up in the control group (p = 0.553). (IRCT 20160110025929N36 and date: 2021/09/27).