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Background: During epidemics, the number of individuals whose mental health is affected is greater than those affected by the infection itself. This is because psychological factors have a direct relationship with the primary causes of the disease and mortality worldwide. Therefore, an increasing investment in research and strategic actions for mental health is essential globally, given the prevalence of infectious diseases. The aim of this study was to elucidate and describe the strategies for mental health preparedness and response during epidemics, with a focus on the COVID-19 pandemic in Iran., Methods: A qualitative study was conducted in Iran from 2022 to 2023. Purposeful Sampling was employed, continuing until data saturation was achieved. Data collection involved semi-structured interviews and observational notes with 20 managers and experts possessing expertise, experience, and knowledge in mental health. Ultimately, the participants' opinions, based on their experiences, were analyzed using the qualitative content analysis method with a conventional approach, resulting in the categorization of data into codes, subcategories, and categories., Results: The study revealed participants' opinions and experiences, categorized into two overarching categories: Preparedness, Policy-Making, and Planning Strategies (with four subcategories), and Response Strategies (comprising thirteen subcategories)., Conclusion: The opinions and experiences of managers and experts in this study revealed that an appropriate mental health response during pandemics requires preparedness before the occurrence of such crises and the implementation of suitable response strategies after the occurrence. Managers, policymakers, and decision-makers in this field should pay attention to the solutions derived from the experiences of such crises to respond more preparedly in the future., (© 2024. The Author(s).)

Abstract Background In recent years, Iran has encountered a growing frequency of earthquake disasters. Given that nurses constitute the largest group of healthcare providers, it is imperative that they possess adequate disaster preparedness skills, irrespective of the location or time. Despite the operating room nurses’ roles in disasters, their experiences and challenges in disaster preparedness have been overlooked. Consequently, this study aimed to investigate the experiences, challenges, perspectives, and factors influencing the disaster preparedness of operating room nurses during the 2017 earthquake in Kermanshah, Iran. Methods The present qualitative research was carried out in Iran In 2022 utilizing conventional content analysis. The study involved conducting semi-structured interviews with 16 operating room nurses who had participated in disaster preparedness during the Kermanshah earthquake. The participants were selected using a purposive sampling approach that aimed to achieve maximum diversity. The interviews were continued until the point of data saturation was reached, and the verbatim transcripts were analyzed using conventional content analysis in MAXQDA software. To ensure the rigor of the research, Guba and Lincoln’s criteria were employed. Results The study conducted data analysis to identify the main theme as “insufficient disaster preparedness due to a faded preparedness”, along with six major categories and eighteen subcategories related to earthquake disaster preparedness. The major categories included: knowledge and perception of preparedness for disasters; educational and training programs for disaster preparedness; equipment preparedness for disasters; managerial-organizational preparedness for disasters; clinical skills for responding to disasters; and resilient ability in disaster response situations. Conclusion The findings of the study provide valuable insights into the dimensions of disaster preparedness in earthquake disasters among operating room nurses. Nursing managers can utilize these findings to develop effective strategies and provide support in areas such as improving knowledge and educational level, equipment preparedness, strengthening plans and managerial structures, enhancing skills, and explaining resilience strategies to improve the disaster preparedness of operating room nurses and medical organizations’ disaster response teams.

BackgroundOccupational burnout is a mental health problem that among nurses may lead not only to physical and psychological complications, but also to a decrease in the quality of patient care. Considering the stressful nature of surgery, operating room nurses may be at a greater risk. Therefore, the present study aimed to identifying factors associated with the occupational burnout from the perspective of operating room nurses.Materials and methodsThis qualitative study was conducted in Iran in 2021 using conventional content analysis. Sampling was performed using purposeful sampling method with maximum variation. In order to collect data, individual, semi-structured interviews were performed with 18 operating room nurses. Interviews continued until data saturation. Data were recorded, transcribed and analyzed using steps proposed by Graneheim and Lundman. Data management was performed using MAXQDA-2020 software. Four criteria provided by Guba and Lincoln were used to improve the study’s trustworthiness and rigor.ResultsA main theme, 4 categories and 15 subcategories were extracted from the data. The main theme is “gradual burnout due to job tension” and categories and subcategories include organizational factors (manager incompetence, organizational indifference, ambiguity in organizational role, organizational inconsistency), interpersonal factors (surgeon aggression, surgeon authoritarianism, surgeon failure to manage stress, unprofessional behavior of nurses), Occupational nature factors (psychological factors and occupational hazards) as well as individual factors (occupational attitude, unprofessional behavior, emotional involvement, demographic factors, physical factors).ConclusionNumerous factors associated with burnout in operating room nurses, which may put the personnel under more pressure. According to these factors, nursing managers and operating room nurses can consider effective strategies to prevent or coping with burnout.

BACKGROUND: Heat wave adaptation is a new concept related to experiencing heat. The present study aims at investigating a conceptual definition, that is, the mental framework of heat wave adaptation and its strategies. MATERIALS AND METHODS: A phenomenological study was performed to explain the mental concept. At the same time with the data collection process, data analysis was also performed using Colaizzi method. Semi-structured interview method and purposeful sampling with maximum variety were used. Interviews were conducted with 23 different subjects in the community. The accuracy of the data was guaranteed using Lincoln & Guba scientific accuracy criteria. RESULTS: The two main themes of the adaptation paradigm as well as its strategies were divided into the main categories of theoretical and operational concepts, as well as personal care measures and government measures. Under the category of individual measures, we obtained “clothing, nutrition, building, place of residence and lifestyle,” and under the category of governance actions, the “managerial, research, health, organizational” subcategories were obtained. CONCLUSION: According to the results of the conceptual-operational definition, heat wave adaptation is an active process and an effort to reduce the adverse effects of heat waves on individual and social life, and striking a balance that will not only result in individual awareness and actions that will lead to lifestyle changes, but also mostly requires integrated and comprehensive planning in the community. On the one hand, heat waves could not only be regarded as a threat or danger, but can also become an opportunity for the development of a community through identification and smart measures, and for adaptation, the community must take it as a risk. The community should have a plan in advance, apply the necessary rules and training, and use the new facilities and rules where necessary. This practical concept definition includes the main features of heat wave adaptation.

Introduction: Identifying what adolescents perceive as their lifestyle and exploring the factors persuading their decisions to engage in or avoid healthy or unhealthy lifestyle behaviors could improve the ability of healthcare professionals to develop innovative preventive strategies and modify negative health behaviors in adolescents. Hence, the literature on adolescent health-related issues reported by adults showed a rarity of information from adolescents themselves. Materials and Methods: A qualitative study using the thematic analysis approach was conducted. Data were collected by semi-structured, digitally recorded interviews from 32 male adolescents. Interviews were transcribed verbatim, and after collecting the data, the thematic analysis process was started and conducted in six phases. Results: After data collection, the interview texts were transcribed, and approximately 800 initial codes were extracted. The initial codes were reevaluated to yield 48 main themes. Hence, the final thematic map was created as having 5 overarching themes and 12 subthemes, showing that interviewees emphasized unhealthy lifestyle. Conclusions: The components of unhealthy lifestyle seem important to them because they consider that they could lead a healthy lifestyle through elimination of negative behaviors.

Introduction: Recognition of reproductive and sexual needs of HIV-positive youth provides health planners and policy-makers with required information to take practical measures in addressing this challenge. Therefore, this study targeted at explaining the reproductive and sexual health concerns of HIV-positive youth. Material and methods: The present descriptive qualitative study was performed using content analysis approach. To collect data, in-depth semi-structured personal interviews were conducted in a calm and private environment. As a result, 19 interviews were done among 17 HIV-positive young people, aged 15 to 24 years (11 girls and 6 boys). Data were analyzed using MAXQDA software, version 12. Results: Followed by analyzing the content of interviews, focusing on the reproductive-sexual health concerns of HIV-positive youth, five categories and 16 sub-categories were obtained. Categories included mental disorders, social exclusion, sexual problems, physical problems, and lack of optimal health services. Conclusions: Patients' psychological, physical, and sexual problems, along with incomplete awareness of their reproductive and sexual issues, can cause irreparable personal and social health consequences. In this manner, the reproductive and sexual needs of young people should be considered, and more practical interventions are required in this field. [ABSTRACT FROM AUTHOR]

Aims A significant number of chemical events happen every year in Iran, which may require admission and management of victims in the hospital. The results of studies have shown that Iranian hospitals, like many developing countries, are not sufficiently prepared for these events. The aim of this study was to explain the challenges of hospital preparedness in chemical events in Iran. Participants & Methods This qualitative research was conducted with the content analysis approach in Tehran. Ten participants were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation. The selected interviewees consisted of physicians, nurses, members of the Hospital Risk Management Committee, and experts of Health in Emergencies and Disasters, who had experience in responding to and treating chemical casualties. All interviews were recorded, transcribed, imported into the MAXQDA 10 software, and analyzed using the Graneheim and Lundman method. Findings The main theme was "Lack of priority of chemical events for policy makers". Five categories and eleven sub-categories were extracted. Categories relating to challenges of hospital preparedness in the management of chemical casualties included "Lack of updated plans and protocols", "Ineffective training", "Organizational challenges", "Lack of legal and financial support", and "Lack of infrastructure and decontamination equipment". Conclusion Iranian hospitals are facing challenges to acquire and maintain preparedness in response to chemical events. Therefore, national standards for hospital response to chemical events should be agreed upon by policy makers, and their implementation should be evaluated in hospital accreditation. [ABSTRACT FROM AUTHOR]

Background: Occupational burnout is a mental health problem that among nurses may lead not only to physical and psychological complications, but also to a decrease in the quality of patient care. Considering the stressful nature of surgery, operating room nurses may be at a greater risk. Therefore, the present study aimed to identifying factors associated with the occupational burnout from the perspective of operating room nurses. Materials and methods: This qualitative study was conducted in Iran in 2021 using conventional content analysis. Sampling was performed using purposeful sampling method with maximum variation. In order to collect data, individual, semi-structured interviews were performed with 18 operating room nurses. Interviews continued until data saturation. Data were recorded, transcribed and analyzed using steps proposed by Graneheim and Lundman. Data management was performed using MAXQDA-2020 software. Four criteria provided by Guba and Lincoln were used to improve the study's trustworthiness and rigor. Results: A main theme, 4 categories and 15 subcategories were extracted from the data. The main theme is "gradual burnout due to job tension" and categories and subcategories include organizational factors (manager incompetence, organizational indifference, ambiguity in organizational role, organizational inconsistency), interpersonal factors (surgeon aggression, surgeon authoritarianism, surgeon failure to manage stress, unprofessional behavior of nurses), Occupational nature factors (psychological factors and occupational hazards) as well as individual factors (occupational attitude, unprofessional behavior, emotional involvement, demographic factors, physical factors). Conclusion: Numerous factors associated with burnout in operating room nurses, which may put the personnel under more pressure. According to these factors, nursing managers and operating room nurses can consider effective strategies to prevent or coping with burnout. [ABSTRACT FROM AUTHOR]

Background: Disasters may result in mass casualties and an imbalance between health care demands and supplies. This imbalance necessitates the prioritization of the victims based on the severity of their condition. Contributing factors and their effect on decision-making is a challenging issue in disaster triage. The present study seeks to address criteria for ethical decision-making in the prioritization of patients in disaster triage.Methods: This conventional content analysis study was conducted in 2017. Subjects were selected from among Iranian experts using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis.Results: Efficient and effective triage and priority-oriented triage were the main categories. These categories summarized a number of medical and nonmedical factors that should be considered in the prioritization of the victims in disaster triage.Conclusion: A combination of measures should be considered to maximize the benefits of the prioritization of causalities in disasters. None of these measures alone would suffice to explain all aspects of ethical decision-making in disaster triage. Further investigations are needed to elaborate on these criteria in decision-making. [ABSTRACT FROM AUTHOR]

Communication, behavioural disturbances and low motivation influence the functional potential and the effectiveness of interventions in adolescents with cerebral palsy (CP). While the model of human occupation (MOHO) is a conceptual model in occupational therapy, no research on the volition of adolescents with CP in daily activities has been undertaken. To explore the elements contributing to the volition of adolescents with CP based on their own experience A qualitative approach using directed content analysis with volition of MOHO as a framework was applied. Semi-structured in-depth interviews were carried out with five adolescents with CP and five parents of the same adolescents. In this study primary codes were categorized into eight categories: family and community-related values, individual values, individual perceptions of ability level, sense of control over conditions, enjoying performing activities, enjoying interpersonal relationships, physical context features and social context features. Personal causation in interaction with environmental features is strongly influenced by adolescents' motivation. Occupational therapists could improve the motivation of adolescents with CP in interaction with the individual's volition with focussing on self-efficacy for promoting personal causation. Adapting to the physical environment and changing the attitudes of others to these adolescents is necessary. [ABSTRACT FROM AUTHOR]

Aim: Considering the wide impact of endometriosis on various aspects of health, this study aimed to explore the impact of endometriosis on Iranian women's lives. Design: The present study used a qualitative approach and conventional content analysis. Methods: Twenty patients suffering from endometriosis referring to Imam Khomeini Hospital in Tehran took part in this study. The sampling was done purposefully until data saturation. After deep semi‐structured interviews, the content analysis of the interviews was done according to the steps proposed by Zhang and Wildemuth. Results: The mean age of the participants was 34.53 (SD: 5.81) years (range: 23–43) with duration of illness of 6.30 ± 5.86 years. Their educational level varied from high school to university, and most of them were employed. Analysis of the data from participants' experiences led to the formation of 5 categories under the titles "Physical suffering, instability of marital life, mental disorder, disruption in social life and self‐care" and 11 subcategories. Conclusion: The findings of the present study showed that endometriosis can adversely affect women's lives including physical, sexual, psychological and social problems. Although in some cases patients adopt different strategies for self‐care, the need for more support is felt. [ABSTRACT FROM AUTHOR]

Objectives: The communication is not just being able to verbally pronounce words and sentences, but it includes understanding information through inspiration, inner instinct, or external guidance. To achieve a better quality of life (QoL), there is a need for determining pleasant communication. The current study aimed to explore the women's perception about different aspects of communication in their life. Materials and Methods: This qualitative content analysis aimed to understand the meaning of communication as a key factor in Iranian women's QoL, which was conducted on 40 women. The data were gathered through depth interviews from May to November 2016 in Tehran, Iran. The interviews were transcribed verbatim and analyzed using conventional qualitative content analysis in 8 stages recommended by Zhang. Results: Two categories were identified based on the interviews, including constructive spiritual and pleasant peripheral communication and each theme consisted of some categories. Conclusions: Overall, awareness about different aspects of communication in women's life must be considered by politicians and health care providers in Iran. In addition, efforts would be made to improve nurses' understanding of different aspects of the QoL, especially pleasant communication in women's life which could help their health promotion. [ABSTRACT FROM AUTHOR]

Background: Dignified care is one of the main objectives of holistic care. Furthermore, paying attention to dignity as one of the fundamental rights of patients is extremely important. However, in many cases, the dignity of hospitalized patients is not considered. Dignity is an abstract concept, and comprehensive studies of the dignity of Iranian patients hospitalized in general hospital settings are limited. Objective: The aim of this study was to explore the concept of dignity from the perspective of patients hospitalized in general hospital settings in Iran. Research design: This study takes a qualitative approach. Data were gathered using individual, semi-structured interviews. Qualitative content analysis was the method used to analyse and interpret the data. The criteria suggested by Guba and Lincoln were used ensure the trustworthiness of the study. Participants and research context: A total of 14 hospitalized patients in general hospital settings in Shiraz participated in this study. Ethical considerations: The Research Ethics Committee of the Shiraz University of Medical Sciences approved the protocol of the study and the ethical principles were followed throughout. Findings: The findings of this study revealed four main themes – 'respectful atmosphere', 'patient privacy', 'preservation of authority' and 'receiving attention' – and 10 categories. Discussion: Patients need to be hospitalized in a respectable environment in which their privacy is preserved and paid attention, providing them with sufficient authority in terms of medical decisions and their life-related issues. The dignity of hospitalized patients will be preserved under these conditions. Conclusion: Patients hospitalized in general hospital settings need to retain their dignity. This can contribute to the optimal therapeutic outcomes for them. Therefore, it is suggested that a cultural, professional and institutional background, in which all components of the patient's dignity are protected and emphasized, should be provided. [ABSTRACT FROM AUTHOR]

Background: An important part of the spiritual needs of patients is 'presence'. The increased demand for holistic care has led to increased attention on 'presence' and its quality. Aims and objective: Given the importance of understanding the phenomenon of presence in order to promote the spirituality dimension among hospitalised patients, this study aimed to describe the lived experience of hospitalised patients in the context of presence. Research methods: This was a descriptive phenomenological qualitative study carried out on 12 admitted patients in general hospital settings. The data were collected through individual and semi‐structured interviews. The Colaizzi method was used for analysing and interpreting the data, while the criteria of the Guba and Lincoln method were used to ensure the trustworthiness of these data. Results: The experience of hospitalised patients concerning 'presence' appeared in the form of three main themes: 'multidimensional connection', 'receiving support' and 'dignity'. During hospitalisation, patients need to experience effective connection with the transcendent and individuals, and receive various types of comprehensive support, such that their and others' dignity is preserved. Patients considered that 'presence' was beyond 'being' and able to provide them with comfort. Conclusions: Patients' need is very important in the field of presence. In the social and religious context of Iran, in which both supernatural and human aspects of presence are emphasised, it seems that healthcare teams, health authorities and policymakers must provide an appropriate supportive environment in terms of providing a healing presence in its different dimensions. [ABSTRACT FROM AUTHOR]

Introduction: Identifying what adolescents perceive as their lifestyle and exploring the factors persuading their decisions to engage in or avoid healthy or unhealthy lifestyle behaviors could improve the ability of healthcare professionals to develop innovative preventive strategies and modify negative health behaviors in adolescents. Hence, the literature on adolescent health-related issues reported by adults showed a rarity of information from adolescents themselves. Materials and Methods: A qualitative study using the thematic analysis approach was conducted. Data were collected by semi-structured, digitally recorded interviews from 32 male adolescents. Interviews were transcribed verbatim, and after collecting the data, the thematic analysis process was started and conducted in six phases. Results: After data collection, the interview texts were transcribed, and approximately 800 initial codes were extracted. The initial codes were reevaluated to yield 48 main themes. Hence, the final thematic map was created as having 5 overarching themes and 12 subthemes, showing that interviewees emphasized unhealthy lifestyle. Conclusions: The components of unhealthy lifestyle seem important to them because they consider that they could lead a healthy lifestyle through elimination of negative behaviors. [ABSTRACT FROM AUTHOR]

Background: The women harassment at work is one of the examples of violence against them, which requires the attention of the society and politicians. Objectives: The purpose of this study is to investigate and describe the women harassment in Iranian workplace. Methods: A qualitative design was used based on a content analysis approach to reach this study aim. 20 women who were worked in different places in Tehran, Iran, semi-structured interviews were carried out to gather data. Results: From the data of this study, 52 cods and 9 sub category and 3 main themes were extracted. Three main themes emerged including "The perceived harassment by women", "gender discrimination", and "harassment facilitators". Conclusions: According to the results of this study, the experience of harassment at the workplace occurs in a context where power relations between women and men are unequal. On the other hand, women believe their lifestyle is affecting the harassment. Female harassment brings many problems to them, including reducing self-esteem and reducing workplace performance. So, paying attention to this issue and more monitoring in work environments can partly reduce this issue. [ABSTRACT FROM AUTHOR]