The effect of spiritual support on life satisfaction in Iranian patients with gastrointestinal cancer.

Background: The diagnosis and treatment of gastrointestinal cancer not only impose significant physical challenges but also deeply affect patients emotionally and psychologically, significantly influencing their overall quality of life. Among the various factors that can positively impact life satisfaction in individuals facing gastrointestinal cancer, spirituality emerges as a crucial aspect. This study aimed to determine the effect of a spiritual intervention on life satisfaction in patients with gastrointestinal cancer. Methods: This quasi-experimental study was conducted with two groups of 85 gastrointestinal cancer patients from two major hospitals in Tehran. The intervention group received spiritual support through social media for six sessions over three weeks to learn how to effectively improve their spiritual state. The control group received routine medical visits and care. The Satisfaction with Life Scale (SWLS) was used before and after the spiritual support in both the intervention and control groups. The research was approved by the institutional ethics committee. Results: In the pre-test stage, there was no significant difference in average life satisfaction between the intervention and control groups (t = 1.887, d = 0.30, p > 0.05). However, positive changes occurred in the post-test stage. Notably, the disparity in average life satisfaction between the intervention and control groups was significant in the post-test stage (t = 13.118, d = 0.95, p < 0.01). Furthermore, the result showed that the changes in life satisfaction in the intervention group were statistically significant (t = 11.854, d = 0.84, p < 0.001). Changes in life satisfaction in the control group were not statistically significant in the pre-test stage compared to the post-test stage (t = 1.113, d = 0.10, p > 0.05). Conclusion: The results can guide health care providers in dealing with the problems of cancer patients. Assessing patients' spiritual needs and empowering them to promote their spiritual recovery and find meaning in their suffering can lead to improved quality of life and satisfaction with holistic care.

Barriers to Family Caregivers' Coping With Patients With Severe Mental Illness in Iran.

The broad spectrum of problems caused by caring for a patient with mental illness imposes a high burden on family caregivers. This can affect how they cope with their mentally ill family members. Identifying caregivers' experiences of barriers to coping is necessary to develop a program to help them overcome these challenges. This qualitative content analysis study explored barriers impeding family caregivers' ability to cope with their relatives diagnosed with severe mental illness (defined here as schizophrenia, schizoaffective disorders, and bipolar affective disorders). Sixteen family caregivers were recruited using purposive sampling and interviewed using a semi-structured in-depth interview method. Data were analyzed by a conventional content analytic approach. Findings consisted of four major categories: the patient's isolation from everyday life, incomplete recovery, lack of support by the mental health care system, and stigmatization. Findings highlight the necessity of providing support for caregivers by the mental health care delivery service system.

Trapped like a butterfly in a spider's web: Experiences of female spousal caregivers in the care of husbands with severe mental illness.

AIMS AND OBJECTIVES: To explore the experiences of female spousal caregivers in the care of husbands with severe mental illness. BACKGROUND: Family involvement in the care of patients with chronic illness is essential to provide a backbone of support for them. However, little is known about how female spousal caregivers are confronted with challenges while taking care of their husbands with severe mental illness. DESIGN: An exploratory qualitative study. METHODS: Fourteen female spousal caregivers of people with severe mental illness (defined here as schizophrenia, schizoaffective disorders and bipolar affective disorders) were recruited using purposive sampling and were interviewed using a semistructured in-depth interview method. Data were analysed by conventional content analysis until data saturation was achieved. RESULTS: Care of a husband with severe mental illness had a disruptive influence on the emotional relationships of the family and resulted in emotional detachment over time. Despite the caregivers' struggle to protect their families, the lack of supportive resources caused emotional exhaustion. Caregiving tasks interfering with their many other responsibilities, along with being a reference for family matters, led to loss of self. Consequently, they experienced psychological distress because of the transition to a caregiver role without any supportive resources. CONCLUSION: Constant caring, without supportive resources, forced them to do various roles and manage other issues within the family. Being unprepared for a caregiving role led to the psychological distress of female spousal caregivers. Therefore, adequate information, education and supportive resources must be provided for spouses to facilitate their transition to caregiving roles. RELEVANCE TO CLINICAL PRACTICE: It is necessary to pay close attention to the spousal caregivers' own mental health problems while they care for their mentally ill husbands. Mental health professionals should adopt a new approach to the prioritisation and planning of policies that support both family caregivers and patients.

Body-Image Disturbance: A Comparative Study among Haemodialysis and Kidney Transplant Patients.

INTRODUCTION: As a chronic disease, End Stage Renal Disease (ESRD) changes the patients' body and affects their body image negatively. Although the changes in body image are expected in all types of renal replacement therapies, different renal replacement therapy methods could represent different levels of impact on body image. AIM: Present study was conducted to examine and compare the level of body-image disturbance between haemodialysis and kidney transplant patients. MATERIALS AND METHODS: This descriptive study was conducted in two teaching hospitals in Tehran, Iran. Using convenient sampling, 84 patients (42 patients under haemodialysis and 42 patients with transplant) were invited to participate in the study. A self-designed questionnaire was developed to examine the level of body-image disturbance. RESULTS: Out of 42 haemodialysis patients, 64.3%, 19% and 16.7% of patients reported low, moderate and high level of body-image disturbance respectively. The mean score of body-image disturbance was 21.1±18.3(rang=1-71) in haemodialysis patients. Of 42 transplant patients, 69%, 26.2% and 4.8% reported low, moderate and high level of body-image disturbance respectively. The mean score of body-image disturbance was 17.1±13.3 (rang=1-48). According to the results of independent t-test, difference between mean score of body-image disturbance in two groups was statistically significant (p < 0.05). CONCLUSION: The findings of the present study showed that both haemodialysis and renal transplant patients experienced some levels of body-image disturbance. This problem was more prevalent among haemodialysis patients as compared to kidney transplant ones. We recommend more studies may be conducted in this regard.

Contextual factors affecting autonomy for patients in Iranian hospitals: A qualitative study.

BACKGROUND: Consideration of patient autonomy is an essential element in individualized, patient-centered, ethical care. Internal and external factors associated with patient autonomy are related to culture and it is not clear what they are in Iran. The aim of this study was to explore contextual factors affecting the autonomy of patients in Iranian hospitals. MATERIALS AND METHODS: This was a qualitative study using conventional content analysis methods. Thirty-four participants (23 patients, 9 nurses, and 2 doctors) from three Iranian teaching hospitals, selected using purposive sampling, participated in semi-structured interviews. Unstructured observation and filed notes were other methods for data collection. The data were subjected to qualitative content analysis and analyzed using the MAXQDA-10 software. RESULTS: Five categories and sixteen subcategories were identified. The five main categories related to patient autonomy were: Intrapersonal factors, physical health status, supportive family and friends, communication style, and organizational constraints. CONCLUSIONS: In summary, this study uncovered contextual factors that the care team, managers, and planners in the health field should target in order to improve patient autonomy in Iranian hospitals.

Iranian clinical nurses' coping strategies for job stress.

OBJECTIVES: Since the existence of work-related stressors is inevitable in nurses' workplace, nurses usually use a variety of coping strategies which can be called cognitive, affective, and behavioral techniques. In this study, we aimed to explore the coping strategies employed by the Iranian clinical nurses in depth. METHODS: This work was a qualitative study using Straus and Corbin's grounded theory approach focusing on the process of coping with job stress used by Iranian clinical nurses. RESULTS: The results of the present qualitative study indicate that the core category was "on the route to coping" which contained six categories comprising work management, self-control, emotional, spiritual, cognitive, and interactional strategies. CONCLUSIONS: We conclude that in nursing it is inevitable that different kinds of strategies are used to cope with the many stressors. The conceptual model emerging from the data indicate that nurses are engaged in a dynamic process of struggling to cope with job stressors. In fact, they are "on the route to coping" with the job stressors. Considering the high level of stress in the nursing profession, the findings of this study have implications for both hospital managers and Iranian clinical nurses.