Barriers to Applying Integrative Oncology from the Perspective of the Care Providers in Iran: A Mixed-Methods Study.

OBJECTIVE: The present study aims to explain and determine the use of integrative oncology from the perspective of the care providers in Iran. DATA SOURCES: This mixed-methods study is a convergent type of study with quantitative and qualitative phases that have been performed simultaneously. The quantitative phase was a descriptive study that was conducted through convenience sampling. With the use of a psychometrically evaluated questionnaire with 10 items, 202 nurses and physicians were included in the study to assess their views on the integration of traditional and complementary medicine (TCM) within supportive cancer care. The qualitative part of the study was conducted through semistructured interviews with 11 care providers. The interviews were analyzed through conventional content analysis and the method proposed by Graneheim and Lundman with the use of MaxQDA software. CONCLUSION: After the quantitative and the qualitative data were combined, we identified four main categories as the important dimensions of using TCM: patients' main expectations of TCM services, reasons for using these services, existing challenges and barriers, and recommendations and strategies to improve the interaction between physicians and patients to facilitate the use of integrative oncology . IMPLICATION FOR NURSING PRACTICE: Although cancer patients use TCM due to a wide range of expectations, there are many barriers to integrative oncology in Iran. Therefore, it is necessary to pay attention to the benefits of conventional medical and TCM treatments, conceptualize integrative oncology, and try to meet the existing challenges.

The predictors of spiritual dryness among Iranian cancer patients during the COVID-19 pandemic.

Background: Spiritual struggles affect the wellbeing of religious people. Among them are strugglers with God which is perceived as non-responsive and distant. These perceptions were so far analyzed predominantly in Western societies with a Christian background, but not in Muslims from Iran. The aim of this study was to determine the predictors of spiritual dryness among cancer patients in Iran during the COVID-19 pandemic. Methods: Cross-sectional study with standardized questionnaires (i.e., Spiritual Dryness Scale, WHO-5, BMLSS-10, Awe/Gratitude Scale) among 490 cancer patients (mean age 49.50 ± 14.92 years) referring to the selected educational hospitals in Tehran (the capital of Iran), who were selected through convenience sampling and based on the inclusion criteria, enrolled between December 2020-May 2021. Data analysis was done using SPSS software version 26 and the statistical methods including calculating the mean and the standard deviation, correlation coefficients, as well as regression analysis. Results: The overall experience of spiritual dryness was perceived regularly in 10.2% of Iranian cancer patients, sometimes in 22.9%, rarely in 22.9%, and never in 43.3%. The mean ± SD was 25.66 ± 5.04, and the scores ranged from 10 to 55. A higher score means greater spiritual dryness. The strongest predictors of spiritual dryness were praying activities Furthermore, the perception of burden due to the pandemic was positively correlated with spiritual dryness. Moreover, each 1 unit increase in its score changed the spiritual dryness score by 0.2 units. The regression of spirituality-related indicators, demographic-clinical variables, and health-related behaviors accounted for 21, 6, and 4% of the total SDS variance, respectively. These findings show that with an increase in praying, performing daily prayers, and the indicators related to spirituality, spiritual dryness will decrease. Most patients were able to cope with these phases often or even regularly, while 31.1% were never or rarely only able to cope. Conclusion: The results of this study showed that in times of crisis, cancer patients' faith and confidence in God could be challenged. It is not the disease itself which seems to be associated with this form of crisis, but their religious practices. Therefore, it is necessary to support these patients during their struggle, especially as spirituality is one of the best approaches to cope with the disease.

Experiences of nurses within a nurse-led multidisciplinary approach in providing care for patients with diabetic foot ulcer.

BACKGROUND AND AIMS: Diabetic foot ulcers require special attention due to their complex and chronic nature and special care and the Nurse-led approach has emerged in the current situation in response to the increasing need for health care as a way to treat chronic patients and provide them with ongoing care. Providing this specialized duty in nursing can be promoted and enhanced the professional independence of nurses and presents challenges. This study has been conducted to make an understanding of the nurses' experiences about their participation in a nurse-led multidisciplinary team to providing care for patients with Diabetic Foot Ulcer. METHODS: This was a qualitative, phenomenological research, carried out with the participation of 8 nurses of Shariaty Hospital of Tehran. Data collection was done through in-depth and semi structured interview. Dieklemann method was used for data analysis. RESULTS: 2 themes and 4 categories emerged during data analysis: antecedents (background and nursing skills) and manifestation of multidisciplinary function (from despair to tranquility, professional worthiness, promotion of self-confidence, preference of multidisciplinary approach). CONCLUSION: The findings of this study, which were the lived experiences of the participants, indicated that most of them had experienced positive effect of nurse-led multidisciplinary team care, training and development, appropriate skill mix, quality and outcome of care. Therefore, despite working on a multidisciplinary team is complex and demanding, management attributions and communication strategies is well situated to meet the challenge.