Designing a truth-based communication model in patient ethical care process.

INTRODUCTION: Providing information based on truth is very important in patients' treatment-related decisions and reduces emotional and physical sufferings as well as patient costs. The aim of this study was to design a model that is based on the culture and health-care context of Iran in order to establish a truth-based communication and provide accurate information to patient. MATERIALS AND METHODS: This qualitative study was conducted in 2019. Data were collected through semi-structured interviews with 18 nurses who had been selected by purposeful sampling method. Data analysis was performed in two steps. In the first step, the participants' experiences were determined using the grounded theory approach. In the next step, using Walker and Evant's (2011) method, the concepts and statements were combined and presented in a central concept. RESULTS: The central concept in this study was "an attempt to establish a truth-based communication with patient," and then, a truth-based communication model was presented. The components of the model were presented in three parts: improving patient communication skills, managing the situation in which the truth is presented, and the patient's participation in decision-making. CONCLUSION: To present the truth of the treatment, which can sometimes be unpleasant and bitter, it is very important to improve communication skills and choose an effective communication strategy. To establish a truth-based communication, it is necessary to create a suitable ground for communication, which should be provided in clinical setting and community.

Taking Refuge in Spirituality, a Main Strategy of Parents of Children with Cancer: a Qualitative Study

Background: Due to the rise in prevalence of childhood cancer the impact on family caregivers is increasing. Spirituality may be an alleviating factor for improving the quality of parent life. There is a lack of organized spiritual care in health care facilities, so that this aspect needs more emphasis. Thus this study aimed to evaluate the spiritual strategy of parents of children with cancer. Materials: This qualitative study was conducted with a conventional content analysis approach. Fifteen parents of hospitalized children with cancer at the Oncology and Hematology departments of governmental pediatric hospitals nationwide were purposefully selected. Semi-structured in-depth interviews were conducted for data collection and inductive content analysis. Results: Eleven sub-themes were extracted in the data analysis, which resulted in the generation of three themes: "spiritual strategy," "spiritual escape" and "spiritual growth". Conclusion: The spiritual approach of parents of children with cancer had a significant influence on spiritual care and consequently the acceptance of disease and coping with the associated conditions. Spiritual care clearly should be introduced into the health care system of Iran, particular for the parents of children with cancer.

Psychological Limbo as a Barrier to Spiritual Care for Parents of Children with Cancer: A Qualitative Study

Background: Pediatric cancer causes reduced life quality and psychological problems for parents. It is necessary to pay attention to spirituality, which plays a significant role in increasing the life quality of these parents and their patient children and managing the conditions associated with the disease. This study was performed to determine factors predisposing to spiritual care in parents of children suffering from cancer. Methods: This qualitative study was conducted by conventional content analysis. Fifteen parents of children with cancer hospitalized in the oncology and hematology wards of governmental hospitals in Iran were selected using a purposive sampling method and underwent semi-structured deep interviews from 2015.1.10 until 2017.3.10. Results: On data analysis, 12 subcategories emerged leading to extraction of three : "projection", "mental concern", and "psychological pains". The final result was a focus on the theme "psychological limbo". Conclusion: Our findings showed that cancer induces psychological problems in parents, which may serve as factors that drive them towards spiritual affairs. Hence, attention should be paid to predisposing factors of spiritual care to facilitate tranquility and an ability to adapt to their circumstances in affected parents.