The association between self-efficacy, perceived social support, and family resilience in patients undergoing hemodialysis: a cross-sectional study.

BACKGROUND: Self-efficacy of patients on hemodialysis is considered a main component of the successful management of chronic kidney diseases. The self-efficacy of these patients may be influenced by many individual and social factors. This study aimed to assess the association between perceived self-efficacy and social support by patients on hemodialysis treatment and the resilience of their families. METHODS: This cross-sectional study was conducted on 183 patients and 183 families of hemodialysis patients in the largest hemodialysis center in northwest of Iran. Data was collected from July to December 2021 using chronic kidney disease self-efficacy, multidimensional perceived social support (MSPSS), and the Walsh family resilience questionnaire (WFRQ). The collected data were analyzed by SPSS software using descriptive and inferential statistical tests. RESULTS: The findings showed that the mean score of patients' self-efficacy was 171.63 ± 38.19 in a possible range of 25 to 250. Moreover, the mean score of perceived social support was 62.12 ± 16.12 in a possible range of 7 to 84. The mean total score of family resilience was 119.08 ± 26.20 in a possible range of 32 to 84. Also, the results of the study showed a positive and significant relationship between the self-efficacy of patients with their perceived social support and the resilience of their families (p < 0.01). CONCLUSION: The results of the study showed that there is a significant relationship between patient self-efficacy and family resilience and social support received in chronic kidney patients undergoing hemodialysis. Therefore, it is suggested to consider practical strategies in the field of family resilience and social support to improve patients' self-efficacy.

Internalized Stigma and its Association with Hope, Self-Esteem, Self-Efficacy, and Treatment Adherence among Outpatients with Severe Mental Illness: A Cross-Sectional Survey.

Background: This study investigated the association between internalized stigma and hope, self-esteem, self-efficacy, and treatment adherence and explored the most influential and predictive factor of internalized stigma among patients with severe mental disorders. Materials and Methods: This correlational descriptive study was conducted on 257 outpatients diagnosed with severe mental illness according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) diagnostic criteria. The participants were seeking treatment at outpatient and affiliated clinics of Razi Hospital, Iran, from October 2018 to May 2019. We used a convenient sampling design. Internalized Stigma of Mental Illness scale, Dispositional Hope Scale, Rosenberg's Self-Esteem Scale, General Self-Efficacy Scale, and Drug Attitude Inventory were used to gather data. The data were analyzed using inferential statistics (Pearson correlation, coefficient logistic, and regression analyses) at a 0.05 significance level. Results: The mean (standard deviation) score of internalized stigma was 1.57 (0.49), and 58% of the participants reported moderate to high internalized stigma. A negative significant relationship was found between internalized stigma and hope (r = -0.55, p < 0.05), self-esteem (r = -0.66, p < 0.05), and self-efficacy (r = -0.64, p < 0.05). Treatment adherence was not found to be significantly associated with the internalized stigma. In the final regression model, self-esteem and self-efficacy significantly predicted internalized stigma. Conclusions: Given the crucial role of self-esteem and self-efficacy in predicting internalized stigma, nurses should devote special attention to these factors and use strategies to improve individuals' self-esteem and self-efficacy.

The impact of effective communication-based care on the childbirth experience and satisfaction among primiparous women: an experimental study.

BACKGROUND: There is insufficient scientific evidence on the effect of communication skills of childbirth care providers on maternal childbirth experience and satisfaction. The present study aimed to determine the effect of communication-based care on the childbirth experience and satisfaction among primiparous women. METHODS: A total of 80 primiparous women participated in this experimental study who were randomly assigned into the intervention and control groups. According to the World Health Organization (WHO) care model, the intervention group received effective communication-based care, and the control group received the routine care. Data were collected using demographic and obstetric questionnaires, Labor Agentry Scale (LAS) and Birth Satisfaction Scale-Revised (BSS-R), and Support and Control in Birth (SCIB) scale applied 12 to 24 h after the intervention. RESULTS: After controlling the effect of confounding variables, the mean scores of childbirth experience (51.23(1.54) and satisfaction (26.03(0.81) in the intervention group were significantly higher than that in the control group (45.33 (1.54) and 22.66 (0.81) respectively; [adjusted mean difference (AMD) = 5.90, CI = 95%: 1.17 to 10.62, P = 0.01] versus AMD =3.37, CI: 95%: 0.87 to 5.87, P = 0.001]. CONCLUSION: Eeffective communication-based care improved childbirth experience and satisfaction of primiparous women. Therefore, it is recommended that health-care providers should be trained on the communication skills in the delivery room especially during a vital threatened crises such as the Covid pandemic.

Internet gaming disorder and its relationship with behavioral disorder and mother's parenting styles in primary school students according to gender in Iran.

BACKGROUND: The problem of students' gaming addiction has been related to the individual student's characteristics and the influence of family environment. Researchers aimed to investigate if and how internet gaming disorder (IGD) of the elementary school boys and girls is related to behavioral disorder and their mother's parenting style in Iran. METHODS: This is a descriptive correlational study, involving 657 fifth and sixth-grade elementary school students in 2019. Researchers used a multistage stratified random sampling of students, their parents and their teachers. Data were collected using internet gaming disorder questionnaire (IGD 20), Rutter teacher behavioral disorder questionnaire and Baumrind Parenting Styles questionnaire (PSI). Obtained data were analyzed using SPSS version16 for descriptive statistics and Pearson correlation coefficient test. RESULTS: Findings showed that IGD prevalence was 5.9% among primary school students with significant relationship between IGD and behavioral disorder among all participants (r = 0.23, p = 0.04); although it was insignificant among boys (r = 0.13, p = 0.11). Also the relationship between IGD and mother's parenting style was significant in the total sample (r = 0.12, p = 0.03), in particular for girls and their mothers (r = 0.2, p = 0.001). CONCLUSIONS: The results of this study indicate the importance of family and parental involvement in prevention and management of IGD chiefly among girls. Healthcare professionals will benefit from knowing the problematic consequences of online gaming among school-age children and try to promote safe and healthy online behavior supported by a supervised family environment.

Effectiveness of education based on family-centered empowerment model on health-promoting behaviors and some metabolic biomarkers in elderly women: A stratified randomized clinical trial.

OBJECTIVE: The purpose of family-centered care interventions is to enhance the abilities of family members in certain areas that overcome the barriers to health and well-being, The purpose of the present research was to determine the effect of education based on family-centered empowerment model on health-promoting behaviors and some serum metabolic indicators in elderly women. MATERIALS AND METHODS: In this stratified randomized controlled trial, 60 elderly women aged 60 years and older referring to elderly-friendly health centers in Tabriz-East Azerbaijan were divided randomly into intervention and control groups in 2019. Intervention group received a family-centered healthy lifestyle intervention once a week for 10 sessions and the control group received the routine care. The mean score of health-promoting behaviors using the Health Promoting Lifestyle Profile-II questionnaire, glycemia and serum lipid profile, liver and renal function, 25-hydroxy Vitamin D, and calcium serum levels were assessed before the intervention, 2 and 6 months after the intervention through SPSS/version 23 using independent t-test, ANCOVA, and repeated measure analysis. RESULTS: The ANCOVA test showed a significant increase in total lifestyle score in the intervention compared to the control group, 2 (adjusted mean difference [aMD]: 13.7; 95% confidence interval [CI]: 5.6-21.8) and 6 months (aMD: 17.2; 95% CI: 7.7-26.7) after education. The score of the nutrition and health responsibility domains significantly increased two (P < 0.05) and 6 months (P < 0.001) after the intervention in the intervention group compared to control. In both groups, serum levels of total cholesterol, low-density lipoprotein cholesterol, urea, and creatinine showed a significant decrease, and high-density lipoprotein cholesterol and calcium levels showed a significant increase (P < 0.05). CONCLUSION: A healthy lifestyle education based on family-centered empowerment model increased the total lifestyle score. So, it is recommended as an effective educational approach to improve the health of elderly.

Resilience and its Predictors among the Parents of Children with Cancer: A Descriptive-Correlational Study.

CONTEXT: As a common debilitating illness, cancer is among the leading causes of child mortality in developed and developing countries. Cancer diagnosis for children is considerably stressful for their parents. Resilience is a key factor behind effective coping with cancer-related problems. This study evaluated resilience and its predictors among the parents of children with cancer. AIM: This study evaluated resilience and its predictors among the parents of children with cancer. SETTINGS AND DESIGN: This cross-sectional descriptive-analytical study was conducted in 2017 on 400 parents of children with cancer in Tabriz Children's Hospital, Iran. METHODS: A demographic questionnaire and the Connor-Davidson Resilience Scale were used to collect the data. Parents were conveniently recruited from Tabriz Children's Hospital. STATISTICAL ANALYSIS: Data were analyzed using the SPSS for Windows program (v. 16) via descriptive and inferential statistical methods. RESULTS: The mean score of parents' resilience was 66.83 ± 14.28. Fathers obtained significantly higher resilience scores than mothers (P < 0.001). The predictors of parents' resilience were financial status, parents' gender, fathers' employment status, and children's gender. CONCLUSION: The parents of cancer-afflicted children, particularly their mothers, have low resilience and therefore may be at risk for different physical and mental health problems. Health-care providers need to identify at-risk parents and provide them with greater psychological and educational support.

Providing a Safe Environment in a Psychiatric Ward: Nurses and Vigilance in Iran.

The aim of this study was to explore nurses' use of vigilance in the provision of inpatient psychiatric care. In this qualitative exploratory descriptive design study, 16 nurses working in inpatient psychiatric units were recruited through purposive sampling. Data were collected by semi-structured interviews and fieldwork observations and analysed using conventional content analysis. According to participants, nurses' vigilance is related to synthesising knowledge, experience, communication, and presence. This conclusion was derived from four main themes: understanding the context of the psychiatric ward; continuous monitoring; cognitive assessments; and involving others. The study highlights the significance of education for all mental health staff and provision of appropriate information to all patients and their companions about psychiatric disorders and the side effects of prescribed medications. Of importance is the skill of active listening to the concerns of patients and the demonstration of commitment by nurses to follow-up on reports from stakeholders. Imparting the skills and experiences of senior nurses to novice nurses and their presence alongside other nurses on work-shifts can be effective in promoting vigilance.

Adapting life to the reality of diabetes.

BACKGROUND: Diabetes is one of the most challenging and burdensome chronic diseases of the 21st century. Adaptation to disease is a mental, multidimensional, interactive process and is influenced by social and cultural factors. It should be explained in the cultural context of each society with qualitative studies. AIMS: In this study, we explored the subjective experiences of adaptation to type 2 diabetes among Iranian patients. METHODS: This was a qualitative study using a grounded theory approach. Purposeful sampling was used initially, followed by theoretical sampling based on derived codes and categories as the sampling method. Twenty patients as main participants and 7 from the healthcare system and family members were selected based on a purposeful and theoretical sampling method. Data were collected through semistructured and deep interviews. Data were analysed using the approach of Strauss and Corbin simultaneous with data collection. RESULTS: Five categories that emerged from the data included: perceived threat of disease, reality compliance, comprehensive reconstruction, normalization of living with illness, and return to resources. Finally, data analysis on selective coding led to recognition of "endeavour to reconstruction of life" as the core variable. The core variable showed the way participants adapted to diabetes. CONCLUSIONS: This study showed that the process of adaptation to diabetes has a dynamic nature in which participants make major changes in their cognitive, emotional and behavioural structures in order to have a normal life.

Therapeutic Relationships and Safety of Care in Iranian Psychiatric Inpatient Units.

Enhancing therapeutic relationships between patients and staff is of central importance to improve the quality and safety of care in psychiatric inpatient units. However, there is limited evidence as to how therapeutic relationships may be enabled in this specific context. This paper presents findings of a study that explored the link between therapeutic relationships and safety in Iranian psychiatric inpatient units. In this exploratory, descriptive study, seven patients at the point of discharge and 19 staff in psychiatric inpatient units in Iran were interviewed regarding their experiences of care. The quality of staff-patient relationship in providing a safe environment was categorized into two groups of "facilitators" and "inhibitors". Facilitators of a safe environment included "supportive relationship with patients" and "improving patient capacity for self-efficacy/self-control". Inhibitors, on the other hand, included "detachment from patients" and "domination over patients", which ultimately limited safety on the ward. Findings indicate interrelated environmental, patient and staff factors mediating the potential for therapeutic relationships and quality and safety of care. Findings suggest the need for more effective preparation and support for staff working within psychiatric inpatient settings. In addition, environments more conducive to collaborative recovery-oriented practice are required to enhance therapeutic relationships and improve quality and safety of care. Both individual staff responsibility and effective leadership are required to realize change.

Health Care Providers' Perception of Their Competence in Providing Spiritual Care for Patients.

BACKGROUND: Spiritual care is an important part of health-care provision. Spiritual care can improve patients' health. One of the requirements for providing appropriate spiritual care for patients is having the required competence. AIM: This study was conducted to investigate the perception of health-care providers of their own competence in providing spiritual cares for patients hospitalized in medical-educational centers of Iran. SUBJECTS AND METHODS: This study is a cross-sectional, analytical research conducted on 555 nurses of medical-educational centers in Tabriz, Iran, in 2014. Data were collected using a two-part questionnaire including demographic information and the spiritual care competence scale. Data analysis was performed using descriptive (frequency, percentage, mean, and standard deviation) and inferential (independent t-test, Pearson, Spearman, ANOVA with Tukey test) statistics in SPSS software version 13. RESULTS: Results showed that the mean score for nurses' perception of their competence in providing spiritual care for patients was average, that is, 95.2 ± 14.4. Mean score of nurses' perception of their competence in providing spiritual care in each aspect was significantly higher than average (P < 0.05). The highest score was related to individual support and consulting with patients, that is, 21.1 (4.0), and the lowest score was related to reference to experts, that is, 9.5 (2.3). The type of employment and participation in workshops had significant relationships with nurses' perception of their competence for providing spiritual care (P < 0.05). CONCLUSION: The findings indicate that authorities and policymakers should take steps in planning for nurses' training for promoting their competence in providing spiritual care for patients; therefore, holding workshops is necessary.