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This document is a list of references from various research articles related to pain management in different contexts and populations. The articles cover topics such as cancer pain management in Mexico, nurses' perceptions of pain assessment in Estonia, barriers to pain management in Saudi Arabia and Kenya, and cultural factors affecting Chinese migrants' responses to cancer pain. The document also includes references on non-pharmacological pain management methods, attitudes and knowledge of healthcare professionals towards pain management, and barriers to pain relief at the end of life. [Extracted from the article]

We aimed to examine the relationship between body image and the meaning of life among women with breast cancer. The analytic sample included 142 women with breast cancer, and data were collected using a standardized questionnaire through face-to-face interviews. We used Kolmogorov–Smirnov test, Pearson test, Spearman and Mann–Whitney U test to determine the relationship between the research variables. We found an association between the mean score of body image and the mean score of the meaning of life. As the average score of body image increases, the score of the meaning of life increases (p < 0.05). Findings indicated that the body image score increases by increasing the score of the meaning of life and its dimensions, especially existential vacuum and acceptance of death. Future research and targeted treatments should consider the role of body image in shaping the meaning of life among women with breast cancer. [ABSTRACT FROM AUTHOR]

Background: Death anxiety is a negative consequence of cancer that influences the quality of life of many patients. This study determined the predictors of death anxiety and the contribution of the sense of coherence to this disorder among Iranians with cancer. Methods: The present research was a descriptive-analytical study that examined cancer patients referring to one of the educational hospitals in Tehran, Iran. Two hundred eligible patients selected by purposeful sampling filled out a clinical and demographic questionnaire. The data were analyzed by the SPSS 20 software. Results: The correlational results revealed a negative and significant relationship between death anxiety and a sense of coherence (r = −0.610). Likewise, age, gender, marital status, occupational and economic circumstances, and cancer type were among the variables that correlated with death anxiety and predicted 85% of this psychological state. Conclusion: The researchers recommend mental assessment in oncological care to identify psychological challenges to realize the ultimate goal of palliative care, i.e. improving patients' quality of life. [ABSTRACT FROM AUTHOR]

Breast cancer is especially prevalent among women. It can affect patients' sexual function, body image, and marital relations. The aim of present study was to investigate the relationship between body image and sexual function among women with breast cancer. This case–control study was done online on patients admitted to the clinic of breast cancer in 2021 in Jahrom, Iran. The sample consisted of 222 women (111 with breast cancer who had undergone mastectomy and 111 without breast cancer). To collect data, two questionnaires, female sexual function index and body image scale, were used. p < 0.05 was significant. Sexual dysfunction among women with breast cancer was 91%. The most common disorder was sexual arousal. Comparing sexual domains: desires disorder (OR: 3.11, 95% CI: 1.63–5.49), arousal disorder (3.31, 95% CI: 1.16–9.45), orgasm (OR: 4.08, 95% CI: 1.57–10.55), vaginal lubrication (OR: 2.68, 95% CI: 1.06–6.76), sexual satisfaction (OR: 2.65, 95% CI: 1.11–6.36), and painful intercourse (OR = 2.03 95% CI = 0.95–4.35) saw a decrease in the women with breast cancer group compared to the control group. The body image concern among women with breast cancer (51.56 ± 15.09) compared to the control (45.80 ± 16.82) was significant (OR = OR: 2.66, 95% CI: 1.22–5.81). Women with breast cancer undergo problems in sexuality and are afraid of their body image. Moreover, there is a correlation between sexuality and body image. Therefore, it is necessary to inform patients about the effects of treatments and the side effects of breast cancer on sexuality. Sexual dysfunctions are highly prevalent among women with breast cancer, and have been associated with body image. This study examined the relationship between body image and sexual function among women with breast cancer. Orgasm and libido, lubrication, and satisfaction decrease in women with breast cancer compared to healthy women. [ABSTRACT FROM AUTHOR]

Background: In this study, we decided to investigate the state of depression, anxiety, and quality of life and its relationship with some demographic characteristics of lung neoplasm patients who were candidates for surgery. Materials and Methods: In a cross-sectional study, all patients with lung neoplasm who were referred to medical centers affiliated to Isfahan University of Medical Sciences and were candidate for lung surgery in 2020--2021. Based on the inclusion and exclusion criteria, 52 people were assigned to the study consecutively. Then, the patients completed the demographic information questionnaire, the Hospital Anxiety and Depression Scale, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) (EORTC QLQ-C30). Results: The score of depression and anxiety was normal (range 7-0) and the score of quality of life was in the relatively good range (50-175). As the patient's age increases (P = 0.014) and the duration of the disease increases (P = 0.041), the level of depression increases significantly. People with higher education had lower depression (P = 0.001) and anxiety (P = 0.003). People living in the city had a significantly better quality of life (P = 0.039). The higher the depression (P < 0.0001) and anxiety (P = 0.037) of the people, the lower the quality of life of the patients. Conclusion: As anxiety and depression increase, the quality of life of lung neoplasm patients decreases. Some demographic characteristics such as old age, insufficient education, rurality, and increased duration of the disease can be the risk factors for depression, anxiety, and reduced quality of life of patients with lung neoplasm. [ABSTRACT FROM AUTHOR]

Death anxiety in cancer patients can cause and exacerbate mental disorders and affect the healing process and survival. In this study, percentage score of death anxiety among Iranian cancer patients was reported. The databases of Scopus, PubMed, ISI, MagIran, and Scientific Information Database were searched and 396 articles were retrieved. Twenty-three eligible studies were included in the analysis considering the inclusion criteria. Heterogeneity among selected studies was assessed through the Cochrane Q test and I2 test. The percentage of death anxiety scores in Iranian patients with cancer was 59.91% (95% confidence interval: 51.57–62.24). The results of subgroup analysis showed that the percentage of death anxiety scores in patients with breast cancer was 67.55% (95% CI: 56.50–78.60) and in patients with other malignancies was 53.78% (95% CI: 50.20–57.36). Death anxiety is high among Iranian patients with cancer and counseling sessions to control and manage this challenge seems necessary. [ABSTRACT FROM AUTHOR]

Childhood maltreatment is a risk factor for loneliness and is linked to breast cancer. Parental bonding experienced during one's childhood also plays a significant role in increasing or decreasing the risk of loneliness later in life. Previous research has highlighted the significance of ambivalence over emotional expression (AEE) and self-discrepancy in the psychological adaptation of breast cancer patients, particularly concerning the impact of parental care and control experienced by patients in their relationship with their parents during childhood. Nevertheless, previous studies have not examined the mediating effects of AEE and self-discrepancy on parental care and control, as well as loneliness, in breast cancer patients. This study aimed to investigate whether AEE and self-discrepancy mediate the association of childhood parental care and control with loneliness in breast cancer patients with a history of childhood maltreatment. One hundred and thirty-three breast cancer patients who were receiving chemotherapy within the first 3 months post-diagnosis were recruited from one private and three public hospitals in Tabriz, Iran, to complete questionnaires. Parental bonding, loneliness, AEE, and self-discrepancy were assessed using the Parental Bonding Instrument (PBI), University of California Los Angeles (UCLA) Loneliness Scale, Ambivalence over the Expression of Emotion Questionnaire (AEQ), and Self-Discrepancies Scale (S-DS). Mediation models were tested using structural equation modeling. Effects of parental care (β = −.17, p <.05) and control (β =.21, p <.001) on loneliness were significant. Furthermore, both AEE (β =.19, p <.05) and self-discrepancy (β =.23, p <.01) significantly predicted loneliness. The pathway between parental care and AEE was significant (β = −.21, p <.001), as was the direct effect of parental control on self-discrepancy (β =.19, p <.05). Bootstrapping results showed that AEE significantly mediated the relationship between parental care and loneliness (95% confidence interval [CI] [−0.09, −0.01]). In addition, there was a significant indirect effect from parental control to loneliness via self-discrepancy (95% CI [0.11, 0.01]). These findings suggest that AEE and self-discrepancy could potentially be utilized in preventing or addressing loneliness in breast cancer patients who have a history of childhood maltreatment. Future research could, for example, assess whether integrating psychosocial interventions focusing on these variables as part of medical care can improve the mental health status of this subgroup of breast cancer patients who have experienced childhood maltreatment. [ABSTRACT FROM AUTHOR]

Background & Objective: This research aimed to study the role of the meaning of life in death anxiety and suicidal thoughts in women with cancer. Materials & Methods: The method of this research is correlation. The statistical population of the study included all women with cancer referred to Tawheed Hospital in Sanandaj City in 1400-1401. The sample size consists of one hundred people selected by purposive sampling. To collect data, Steger's Meaning in Life (MLQ), Templer's Death (DAS), and Beck's Suicidal Thoughts (BSSI) questionnaires were used. SPSS software was used in this research. Results: The information was analyzed using correlation tests and regression analysis. The regression conclusions showed that the meaning of life has an inverse relationship with suicidal thoughts, and death anxiety has a direct relationship with suicidal thoughts. The Pearson correlation results showed that the meaning of life predicts death anxiety and suicidal thoughts. Conclusion: In general, it can be concluded that the meaning of life plays an instrumental role in the death anxiety and suicidal thoughts of women with cancer. [ABSTRACT FROM AUTHOR]

This study examined the effectiveness of a group spiritual care program on leukemia patients' hope and anxiety. This randomized controlled trial involved 94 leukemia patients hospitalized in the two oncology departments of Shahid Beheshti Hospital, Hamadan, Iran. This study was carried out from November 2022 to April 2023. The participants were selected based on the study inclusion criteria using the convenience sampling method then they were randomized to either the experimental (N = 46) or the control group (N = 48). The participants completed the written informed consent form, the demographic information form, and Beck's anxiety and Snyder's hope questionnaires. The spiritual care program was provided in six sessions (one 45–60 min per week), including a spiritual needs assessment, religious care, spiritual care, psychological-spiritual care, supportive-spiritual care, and evaluation. The participants then completed Beck's anxiety and Snyder's hope questionnaires immediately, one and two months after the intervention. At baseline, there was no significant between-group difference in leukemia patients' mean scores of hope (P = 0.313) and anxiety (P = 0.141); however, immediately, one and two months after the intervention, a significant between-group difference in the mean scores of hope and anxiety was observed (P < 0.001). Also, from baseline to two months after the intervention, a significant decrease and increase in anxiety and hope mean scores, respectively, were observed in the experimental group (within-group difference) (P < 0.001). However, in the control group, from baseline to two months after the intervention, a significant increase and decrease in mean scores of anxiety and hope, respectively, were observed (within-group difference) (P < 0.001). As a result, it is recommended that nurses should consider providing spiritual care to leukemia patients as a part of holistic care. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is a severe life-threatening condition in which many women are involved yearly. One factor that has recently been noticed and investigated as a diagnostic predictor of this type of cancer is the number of tumor buds and the relation of this factor with a patient's survival rate. Materials and methods: This study includes 150 female patients over 18 years old with a mean age of 53.99 ± 12.56 years old with breast cancer, which was diagnosed at various medical centers, including Rouhani Hospital itself, and referred to Rouhani Hospital Medical Center, Babol, Iran. The number of intratumoral and peritumoral buds in patients' microscopic slides were archived and evaluated along with tumor microenvironment on hematoxylin and eosin (H&E) slides and compared to other clinicopathological findings. This article precisely investigated the relationship between the number of intratumoral and peritumoral buds with patients' 5-year survival rate. Also, the relationship between age, tumor stage, grade, size, the number of lymph nodes involved, and the presence of metastasis with the number of intratumoral and peritumoral buds was studied. Results and discussion: The result showed a significant statistical association between the number of intratumoral and peritumoral buds with tumor size, tumor stage, presence of metastasis, the number of lymph nodes involved, and 5-year survival rate. On the other hand, there is not a significant statistical association between the number of intratumoral and peritumoral buds with age and tumor grade. Conclusion: Our investigation revealed a significant statistical relationship between the number of tumor buds and patients' survival rate. So, this factor should be considered significant to help those patients increase their survival ratio. [ABSTRACT FROM AUTHOR]

Background. As the second leading cause of death in women in the world, breast cancer has several physical and psychological effects. Nowadays, nonclinical approaches such as patient empowerment have been considered by physicians along with clinical care. Given the increasing number of breast cancer women worldwide, promoting the empowerment of these patients is one of the key factors affecting their survival and quality of life. Therefore, because of no comprehensive research on the empowerment needs and related improvement strategies, this study is aimed at determining the empowerment status of breast cancer patients referred to the Shahid Motahari Breast Cancer Clinic in Iran, Shiraz, and at providing strategies to improve their empowerment in 2021. Methods. This applied study was conducted in two phases. In the quantitative phase, 310 Cancer-Related Patient Empowerment Scale questionnaires (Persian format) were distributed among the studied patients selected through the random sampling method in the clinic, and the items with "unacceptable status" became the basis for determining the empowerment strategies through the scoping review and semistructured interviews with 22 medical staff and patients through the thematic analysis. The collected data were analyzed using the SPSS 20.0 and MAXQDA10 software. Results. The mean score of the participants' empowerment strategies was 3.58. The results showed that trust in the physician, family support, and spiritual beliefs could affect the empowerment of the studied patients. Moreover, the participants needed empowerment strategies in 11 scale items with unacceptable status, for which 46 strategies were determined in the scoping review and interview phase. Conclusion. The results of this study provided useful strategies for empowering breast cancer patients, the most important of which were classified into five categories of financial support, informational support, interaction with the physician, occupational support, and complementary therapies, the use of which by the stakeholders could help to improve the patients' quality of life while improving their empowerment. [ABSTRACT FROM AUTHOR]

The first step to evaluate spiritual health as an essential component of multidimensional patient care is using a valid scale. This study aimed to provide a psychometric evaluation of the Spiritual Dryness Scale. This cross-sectional study was conducted on 136 patients with cancer in Arak city, Iran. Face and content validity, and confirmatory factor analysis were used to assess the validity and construct validity respectively, and Cronbach's alpha, and test-retest were calculated to measure internal consistency. The results indicated that the scale had appropriate face validity and the total mean score was 1.514 ±.74. All items had suitable CVR and CVI higher than.8. The ICC of the scale was.999, and Cronbach's alpha was.899 in the test– retest. The fit index was satisfactory (χ2 /df = 1.187). This scale had appropriate validity and reliability after translation into Farsi and was convenient, accessible, inexpensive, and easy-to-use. [ABSTRACT FROM AUTHOR]

Background: Sleep quality is a notable factor of well-being. It also may play a role in the development and progression of chronic diseases and cancers. Therefore, this study was performed to investigate poor sleep quality and its influencing factors among Iranian patients with esophageal and gastric cancer. Methods: In this cross-sectional study, a total of 312 Iranian adult patients who suffered from esophageal and gastric cancers were employed from a gastrointestinal cancer-based cohort study conducted in a referral hospital in Tehran between 2015 and 2018. Persian version of the Pittsburg Sleep Quality Index (PSQI) was used to measure poor sleep quality. Univariate and multiple logistic regression models were applied to determine the related factors to poor sleep quality. Results: Of the participants, 203 (65.06%) were men, and 75.96% had gastric cancer. The mean age was 63.13 ± 12.10 years. The results demonstrated that more than 62% of the patients had poor sleep quality. 148 (62.44%) patients out of 237 patients with gastric cancer had poor-quality sleep. Also, 46 (64.38%) patients out of 237 patients with esophageal cancer had poor-quality sleep. Based on the results of multiple logistic regression models, marital status has a negative association with poor sleep quality (odds ratio [OR] = 0.32, P = 0.015). In addition, having chronic disease (OR = 2.16; P = 0.028) and wealth index (OR = 3.11, P = 0.013; OR = 3.81, P = 0.003; OR = 3.29, P = 0.009; OR = 3.85, P = 0.003 for rich, moderate, poor, and poorest subgroups, respectively) had a positive association with poor sleep quality. Conclusion: The findings showed that about two-thirds of the patients studied were poor sleepers. Also, it was observed that marital status, chronic disease, and wealth index were important factors associated with poor sleep quality. [ABSTRACT FROM AUTHOR]

Background: Cancer recurrence is an important care challenge for breast cancer survivors. It is necessary to understand and identify the barriers and facilitators that affect the decision to start retreatment by those facing breast cancer recurrence compared to factors affecting their decision to start the initial treatment, which is different. Objectives: This study is part of a qualitative study with a grounded theory approach, which was conducted to explain the facilitating and inhibiting factors affecting the decision to start retreatment in survivors of breast cancer recurrence, using a qualitative content analysis method. Methods: This study was conducted based on the experiences of 16 patients with breast cancer recurrence and 2 oncologists to confirm the findings of the effective inhibiting and facilitating factors in patients' decisions to start retreatment for breast cancer recurrence in one of the hospitals in Tehran, Iran. The samples were selected, using the purposeful sampling method trying to have maximum diversity. Data were collected through in-depth semi-structured telephone interviews from November 2020 to November 2021 and analyzed, using the conventional content analysis method following the Elo and Kyngas method, which includes 3 phases, including the preparation phase, the organizing phase, and the reporting phase. Credibility, transferability, dependability, confirmability, and authenticity were used for determining the trustworthiness of data. Results: Both groups of inhibiting and facilitating factors were divided into 5 categories, including individual factors, social factors, family factors, illness characteristics, and treatment-related factors. Also, each category included sub-categories in two groups of inhibiting and facilitating factors affecting the decision to start treatment again. Conclusions: Based on the results of the present study, it is necessary to increase the awareness of patients with breast cancer by the treatment staff about the possibility of recurrence and to know the factors influencing their decision-making process to start retreatment. Nurses should play the role of advisors, educators, and supporters of the patients in this field. [ABSTRACT FROM AUTHOR]

Background: In recent decades, many long non-coding RNAs (lncRNAs) have been reported to play a prominent role in tumorigenesis and the progression of human cancers, including gastric cancer (GC), a leading cause of cancer death in Iranian men and women. Studies have demonstrated that thymopoietin antisense transcript 1 (TMPO-AS1) was upregulated indifferent cancers by acting as an oncogenic lncRNA. Objectives: This study aimed to evaluate the expression of lncRNA TMPO-AS1 in Iranian patients with GC. Methods: In order to conduct the present study, 40 gastric tumor samples and 40 marginal noncancerous counterparts were collected. The characteristics of patients' samples were recorded, and the TMPO-AS1 expression levels were evaluated by qRT-PCR analysis. The Cancer Genome Atlas (TCGA) data for TMPO-AS1 were used and analyzed through GEPIA and TANRIC online tools. Receiver operating characteristic (ROC) curve analysis was used to estimate the diagnostic value. Student t-test, one-way ANOVA, and chi-square test were accomplished via SPSS software. Results: Our data demonstrated that TMPO-AS1 was overexpressed in cancerous tissues compared to adjacent nonmalignant ones (P = 0.0076). None of the demographic and clinicopathological data were associated with TMPO-ASl expression levels. The TCGA data demonstrated that TMPO-AS1 was upregulated in GC tissues in comparison to adjacent nonmalignant ones (P = 0.001). ROC curve analysis suggested that TMPO-AS1 expression levels could discriminate GC tumor tissues from normal ones (AUC = 0.699, P = 0.001). Conclusions: Altogether, in our study, we demonstrated that lncRNA TMPO-AS1 maybe considered a biomarker in Iranian patients with GC. However, further investigations are required to confirm the potential application of this lncRNA in diagnosis, prognosis, and therapeutic applications of GC. [ABSTRACT FROM AUTHOR]

Aims In patients with cancer, sleep quality is disturbed, and they need treatment. Considering the side effects of medication, complementary therapy can be helpful. Therefore, this research aimed to compare the effect of two methods of compassionate hypnotherapy and acceptance and commitment therapy on the sleep quality in breast cancer patients. Materials & Methods The research method was quasi-experimental with a pre-test-posttest design with a control group. The sample size was 45 people selected by convenience sampling method and using block randomization were allocated into 3 groups: compassionate hypnotherapy, acceptance and commitment therapy, and a control group (each group 15 patients). In group 1, compassionate hypnotherapy intervention and group 2, acceptance and commitment therapy intervention were performed during eight sessions. Before and after the intervention, the study groups completed the Pittsburgh Sleep Quality Questionnaire. The data was analyzed by SPSS 26 using Chi-square, ANCOVA, and MANCOVA. Findings The average sleep quality in companionate hypnotherapy and acceptance and commitment groups was significantly higher than in the control group (p=0.001). The compassionate hypnotherapy group indicated a significant improvement in the sleep quality score compared to the acceptance and commitment therapy group (p=0.001). Conclusion Compassionate hypnotherapy has a better effect than acceptance and commitment therapy on improving sleep quality. [ABSTRACT FROM AUTHOR]

Background. Due to pathological differences with other chronic diseases, breast cancer causes psychological and emotional problems, such as negative feelings, anxiety and stress. Objectives. The present study aimed to measure the perceived level of stress and its socio-demographic predictors among women with breast cancer. Material and methods. This cross-sectional study was conducted on 166 women receiving treatment for breast cancer in Ghazi Tabatabaie, Al-Zahra, Vali-Asr and Shams hospitals of Tabriz-Iran in 2017. A convenience sampling method was employed to select the participants. The required data was gathered using Cohen’s Perceived Stress Scale (PSS) and then statistically analysed using the independent t-Test, one-way ANOVA, the Pearson correlation coefficient and multivariate linear regression analysis. Results. The mean (standard deviation) score of perceived stress was 32.9 (5.2) out of 56. The multivariate linear regression analysis showed that income, education of the mother and marital satisfaction were predictors of perceived stress. These variables predicted 21.5% of the observed variance in the total score of perceived stress. Conclusions. The results indicated that the mean score of perceived stress was higher than average in women receiving treatment for breast cancer. Therefore, it is necessary to develop and execute strategies to reduce stress in such patients, especially those with a family history of breast cancer. [ABSTRACT FROM AUTHOR]

Background: Diagnosis of cancer and its long and hard treatment process induce great stress and anxiety in patients. Cancer patients may also suffer from severe pain due to their primary disease, metastases, or the received treatments. However, the patients' chief physical complaint is the main aspect that physicians pay attention to, and the mental health of these patients is usually neglected. Objectives: This study aimed to predict the effect of music therapy (MT) on pain, perceived stress, anxiety, and biochemical parameters in patients with cancer. Methods: This semi-experimental study was conducted on cancer patients referring to the Oncology Clinic at Amir Hospital in Shiraz (affiliated with Shiraz University of Medical Sciences) from April to September 2016. A total number of sixty cancer patients were recruited using a random sampling method and divided into two groups of control and intervention. Patients in the intervention group listened to light music for at least 20 minutes for 8 weeks (two continuous sessions weekly). After the intervention group, a follow-up test and questionnaires were conducted on both groups. Data were analyzed by SPSS version 21 using the t-test, chi-square test, and paired t-test. Results: The results of this study showed that the control group had no significant difference regarding the McGill Pain Questionnaire (MPQ)(P-value = 0.797), cortisol(P-value = 0.841), and the Perceived Stress Scale (PSS)(P-value = 0.001) variables before and after the study, but it had a significant increase in the Beck Anxiety Inventory (BAI) (P-value = 0.026). Our findings indicated a significant difference in the MPQ, BAI, and cortisol variables in the MT group (P-value ≤ 0.001). In general, the PSS showed no significant difference between the two groups. Conclusions: The results of the present study showed that MT for eight weeks, selected by patients from a list, could significantly reduce patients' anxiety, pain, and perceived stress. Therefore, we recommend the inclusion of this intervention in the routine care of patients with cancer. [ABSTRACT FROM AUTHOR]

Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors. Materials & Methods: Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types. Results: Totally 337 participants were recruited with a mean±SD age of 30.7±6.6 years. Gynecological cancers accounted for 166 (49.3%) of all cases followed by breast (107 (31.8%)) and other cancers (64 (19.0%)) respectively. Of those, 144 (42.7%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between 3 groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers. Conclusion: Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients. [ABSTRACT FROM AUTHOR]

Background: This is a case-control study aimed at investigating the predictors of sexual function, depression levels, and quality of life in cervical cancer patients. Methods: The study enrolled women aged 18 years and older who were at least six months post cervical cancer diagnosis and treatment in a single institution and underwent surgery or radiotherapy. The control group was selected from women referred for routine gynecologic screening. The study excluded women who had a history of sexual trauma and mental disorders, any general health problems, and therapy potentially affecting sexual life, such as hormonal therapies other than contraception. Demographic and clinical data of all participants were gathered, and all participants were asked to respond to two questionnaires: the Female Sexual Function Index (FSFI) and the Medical Outcomes Study 12-item Short Form health survey (SF-12) in a face-to-face interview. The study analyzed the data using descriptive statistics and comparison of demographics, clinical data, tumor and surgical characteristics. Linear regression tests were used to predict numerical outcomes, and a p-value <0.05 was considered statistically significant. Results: The study concluded that there were no baseline characteristics identified to have statistically significant differences among study groups, and all three groups had similar distributions of socioeconomic and demographic variables. Conclusion: This study showed that cervical cancer and route of treatment may affect the patients' quality of life and sexual health. Health care systems and health care providers may screen these patients and take early actions to prevent more morbidities. [ABSTRACT FROM AUTHOR]

Background: Chemotherapy is associated with a wide range of physical and psychological side effects, so complementary and alternative therapies may be practiced as an independent treatment or combined with the standard ones to improve health-related quality of life of cancer patients. Laughter yoga has predominantly been used as a complementary therapy to enhance health and wellbeing of ordinary people and patients with chronic diseases. However, to date, few studies have evaluated the effects of this modern exercise on cancer patients undergoing chemotherapy in clinical settings, to the best of the authors' knowledge. the present study aimed to investigate the effects of Laughter Yoga on the health-related quality of life of cancer patients undergoing chemotherapy. Methods: This study was a two-group randomized clinical trial on 69 cancer patients undergoing chemotherapy at Reza Radiotherapy and Oncology Center, Iran in 2018. Patients were randomly divided into intervention and control groups. The intervention group received laughter yoga for four sessions at one-week intervals. Each session consists of one part and lasts for 20–30 min. Patients' health-related quality of life was assessed before and after the laughter yoga sessions using Quality of Life Questionnaire European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) version 3.0. SPSS Statistics (v.20 software was used to conduct Chi-square, independent t-test, Mann-Whitney, Wilcoxon and paired t-tests analyses of the data. Results: The number of participants in intervention and control groups were 34 and 35, there was no significant difference of demographic and disease related characteristics and pre-intervention HRQOL between two groups. In the intervention group, there is significant difference between pre- and post-intervention scores (Mean ± Standard Deviation) of emotional functioning (12.99 ± 10.49), physical functioning (0.78 ± 6.08), role functioning (3.43 ± 7.97), fatigue (-8.82 ± 22.01), pain (-8.33 ± 11.78), sleep disturbance (-15.68 ± 18.77), and global health and quality of life (6.37 ± 5.04) (p < 0.05). There was no significant change in the control group. Participants reported no adverse events. Conclusions: A structured laughter yoga intervention in a hospital setting effectively improved health-related quality of life for cancer patients undergoing chemotherapy. Benefits to many patients could be expected if this would become a part of routine care. Trial Registration: This study was registered in the Iranian Registry of Clinical Trials (no. IRCT20180429039463N1) on 21/08/2018. [ABSTRACT FROM AUTHOR]

Background & Aims The present study aims to determine the fear of COVID-19 in the elderly newly diagnosed with cancer referred to selected hospitals affiliated to Alborz University of Medical Sciences. Materials & Methods In this longitudinal study, 174 elderly people newly diagnosed with cancer referred to the selected hospitals participated, who were selected using a continus sampling method. To collect data, a demographic form, the Abbreviated Mental Test, and the 7-item fear of COVID-19 scale were used before diagnosis, one month after, and two months after. The data were analyzed in SPSS software, version 22. Results Fear of COVID-19 level at the time of cancer diagnosis was moderate (mean score: 17.69±4.74). In the second stage (one month after the diagnosis), the mean score was 14.26±4.09. In the third stage (two months after diagnosis), the mean score was 11.81±4.13. Fear of COVID-19 at the time of cancer diagnosis was significantly different based on marital status (P=0.049), underlying diseases (P=0.014), and perception of health (P=0.004). Conclusion Fear of COVID-19 can disrupt the process of treatment and chemotherapy in elderly patients with cancer. It is recommended to develop interventions to improve the mental health of the elderly with cancer during the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Oral Squamous cell Carcinoma (OSCC) is the most common oral cancer and is treated with surgery, radiotherapy and chemotherapy. Various complications of treatment include xerostomia, mucositis, and trismus, which affect patients' quality of life. The aim of this study is to evaluate the mortality, recurrence rate and prevalence of oral complications in treated patients. Method and materials: This cross-sectional study reviewed 326 cases of patients with OSCC who were referred to public health centers in Shiraz (Khalili Hospital and Dental School) from 2010 to 2020. All patients were contacted, and the survivors were called and examined by an oral physician. A medical record was created for them, including demographic information, location of the lesion, type of treatment, history of recurrence, metastasis and oral complications. Results: 53.5% of patients were male and 46.5% were female. The mean age of patients was 58.68 years. Mortality and recurrence rate was respectively 49.8% and 17.8%. The most common location of the lesion was tongue (64%). Surgery was done for all patients. 97.4% of patients complained of xerostomia, 46.2% of mucositis and 44.3% of trismus. Conclusion: The most common complications of treatment are xerostomia, mucositis, and trismus, respectively. Frequent and regular follow-ups and supportive therapies reduce these complications and improve patients' quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is one of the diseases which is mostly affected by negative emotions. However, the context factors that leads to lack of positive valence in these patients is not clear. The current study aimed to identify the context factors in the lack of positive valence system in women suffering from breast cancer. Method: Research method was qualitative grounded theory and data was obtained from in-depth interviews with patients at the Motamed Jihad University Cancer Research Institute during 2022. Participants were voluntarily and purposefully selected and sampling continued until data saturation. At the end, 10 individuals participated. Data were coded in three levels according to the Strauss and Corbin method. Results: In relation to the positive valence system, we extracted three theoretical, nine axial and 24 open codes. The theoretical codes contained reward response (with axial codes of reward prediction, initial response to reward and reward saturation), reward learning (with axial codes of prediction error and reward habit) and reward valuation (with the axial codes of uncertainty of risk, delay in reward valuation, frustrated non-reward and attempt to value rewards). Theoretical, axial and open codes were evaluated by experts to obtain internal and structural validity as well as conceptual framework model and therapy protocol that were designed by extracted codes. Conclusion: The possibility of decreasing or increasing the incidence of cancer depends on the presence or absence of the positive valence system. The suggested therapy protocol represented that the positive valence factors enhancement might limit the possibility of breast cancer. [ABSTRACT FROM AUTHOR]

Introduction: Patient participation in treatment decisions has been associated with improved treatment results. By checking the level of knowledge of patients and informing patients about the risks and benefits of treatment methods, the level of participation of patients in treatment can be checked. This study was conducted with the aim of determining the participation rate in the treatment of breast cancer patients. Materials and Methods: The current cross-sectional study was conducted in descriptive and analytical form in 2019. The statistical population includes 15 doctors who worked in the field of breast diseases and 300 patients with breast cancer who visited clinics and doctor's offices in the cities of Shiraz, Kerman, Rasht and Tabriz, who were selected by cluster random sampling. In order to measure the level of participation, a researcher-made questionnaire was used after validity and reliability. The data were analyzed using SPSS 20 software with the help of descriptive statistics and chi-square inferential tests. Results: The findings of the research showed that patients' participation in treatment has a significant and direct relationship with age, education, duration of illness and income of patients (P value < 0.05). Based on the findings of this study, patient participation was reported in three areas (decision-making process (53%), doctor's practical behavior (67.6) and patient preferences (66.2)) and in general, the level of participation in the treatment of patients with Breast cancer was estimated at 52%. Conclusion: Empowering patients by increasing awareness about diagnosis and treatment, as well as covering breast cancer as a special disease and receiving treatment allowances, can help increase patient participation. [ABSTRACT FROM AUTHOR]

Introduction: Lack of cognitive flexibility intensifies an individual’s negative thoughts about oneself. Aim: The present study aimed to design and validate an educational program based on the posttraumatic growth model and to evaluate its effectiveness in the cognitive flexibility of leukemia patients. Method: In this quasi-experimental study with a pretest-posttest control group design, the statistical population consisted of all patients referred to Firouzgar Hospital of Tehran, Iran, in 2022. The sample size 30 patients were selected by the convenience sampling method and randomly allocated into the experimental and control groups. The Cognitive Flexibility Questionnaire (2010) was used to collect the required data. The educational program based on the posttraumatic growth model was held in 12 sessions, and a follow-up experiment was conducted to evaluate the durability of intervention effects. The results were analyzed using the multivariate analysis of covariance and repeated measures ANOVA in SPSS version 22. Results: The results showed that the F-values measured for the components of cognitive flexibility, including the perception of controllability, perception of different options, and perception of behavior justification, were significant (P<0.01), suggesting the impact of the training program based on the posttraumatic growth model on cognitive flexibility. The results of repeated measures ANOVA also indicated the persistence of the effects of the training program on cognitive flexibility (P<0.01). Conclusion: The result of the research showed that the training program according to the posttraumatic growth model was effective in cognitive flexibility, and its effect persisted until the follow-up period. Therefore, this program can be used as an effective intervention to improve the cognitive flexibility of patients with leukemia. [ABSTRACT FROM AUTHOR]

Introduction: Cancer patients experience chronic pain and excruciating pain, which makes it difficult for them to tolerate and adapt. Aim: This research was conducted with the aim of determining the effectiveness of an educational program based on compromise with pain on depression and anxiety of cancer patients. Method: The present research was conducted in a semi-experimental way with a pre-test and post-test design along with a control group. The statistical population of this research included all cancer patients referred to health centers and clinics in Sanandaj city in 2019, and 30 cancer patients were selected by available sampling and then randomly assigned to experimental and control groups. The participants in the experimental group received the educational program based on compromise with pain in 10 sessions 2-hour, and the participants in the control group did not receive any intervention. Data collection tools were Beck Anxiety Questionnaire (1990) and Beck Depression Questionnaire (1961). Data were analyzed using SPSS-22 statistical software, descriptive indices and covariance analysis. Results: The results showed that the program based on compromise with pain had a significant effect (P<0.01) on the depression of cancer patients and reduced depression in cancer patients, and the program based on compromise with pain had a significant effect on the anxiety of cancer patients (P<0.01) and has improved anxiety in cancer patients. Conclusion: Based on the results of the research, this program can be used in counseling clinics to help cancer patients, considering the key role of the educational program based on compromise with pain in reducing depression and anxiety of cancer patients. [ABSTRACT FROM AUTHOR]

One of the many problems cancer patients experience is death anxiety. This descriptive-analytical cross-sectional study aimed to investigate the relationship between authenticity and death anxiety in cancer patients. The participants were 172 cancer patients who referred to medical centers in southeast Iran. The data were collected using authenticity inventory, and death and dying anxiety scale. There was a negative correlation between authenticity and death anxiety, i.e. patients who indicated higher authenticity scores showed lower levels of death anxiety. It seems that developing a comprehensive care program for increasing awareness of authenticity in patients, may be effective in reducing patient death anxiety. [ABSTRACT FROM AUTHOR]

Objectives: Hot flashes are unpleasant long-term complications of breast cancer. This study aimed to evaluate the effects of a traditional Persian medicine containing extracts of Cichorium intybus L. (chicory) and Fumaria parviflora L. (Fumitory) extract syrup (CFS) compared with placebo when used as intended. Design: Randomized, double-blind, placebo-controlled clinical trial. Setting/Location: The Oncology Ward of Shahid Modarres Hospital (Tehran, Iran). Subjects: Breast cancer survivors undergoing hormone deprivation therapy. Interventions: Patients were randomly allocated to receive 5 mL CFS or placebo syrup three times a day, for 4 weeks. Outcome measures: The co-primary outcomes were self-reported daily hot flashes frequency and severity scores assessed using self-reported daily dairies, including 1 week of baseline data. Results: Of the 148 patients screened, 137 were eligible, and 96 were randomly allocated to receive either CFS (n = 48) or placebo (n = 48). All participants who returned their dairies were compliant and analyzed as randomized in the a priori per-protocol analysis. After 4 weeks of treatment, both the mean daily hot flashes frequency and severity score had reduced by 57% in the CFS group and 10% in the placebo group. The overall weekly mean daily hot flashes frequency (effect size ηp2 0.221, p < 0.001, n = 66) and severity scores (effect size ηp2 0.160, p = 0.001, n = 66) were significantly lower in the CFS group compared with the placebo group (one-within one-between repeated-measures analysis of variance adjusted for baseline). CFS was well tolerated, with similar proportions of serious and nonserious adverse events occurring in both groups. Conclusions: This is the first study to report the effects of chicory or fumitory for the treatment of hot flashes. The findings provide preliminary evidence that CFS can improve hot flashes in breast cancer survivors undergoing hormone deprivation therapy. More research is warranted to confirm its effectiveness, safety, and mechanisms of action. Clinical Trial Registration: IRCT20210226050506N1. [ABSTRACT FROM AUTHOR]

Background: Hospice care is a perceived need in the Iranian health system. Aim: This qualitative study is explaining the stakeholders' perception of what is required to develop a hospice care system for patients living with cancer in Iran. Methods: A total of 21 participants (specialists, policymakers, healthcare providers, cancer patients and family caregivers) were selected through purposeful sampling and interviewed in-depth in 2020. Interviews were analysed through directed content analysis. Findings: A total of 1054 codes, 7 categories and 21 subcategories were extracted. The requirements include the need to provide: multiple settings and diverse services; participatory decision making; integration into the health system; specialised human resources; an organised system of accountability; the preparation of the existing health system; and wider capacity-building in existing Iranian society. Conclusion: It is essential that Iranian services create a participatory comprehensive care plan, utilise expert manpower, integrate hospice care into the existing health system and organise a system of accountability. Policymakers should focus on the preparation of the health system and capacity building in society. [ABSTRACT FROM AUTHOR]

Insomnia and sleep disorders are common and can be severe amongst patients with cancer, especially during chemotherapy. The aim of this study was to evaluate the efficacy of lettuce seed syrup in breast cancer patients who suffer from insomnia or disordered sleep. This pilot study was a double-blinded randomized controlled clinical trial conducted in Shoha-e-Tajrish Hospital (Tehran, Iran) from September 2018 to June 2019. 50 adult patients with breast cancer with insomnia or sleep disorders were enrolled. Participants were randomly allocated to lettuce seed syrup (5 mL twice daily), or placebo syrup at the same dose for four weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality before and after the intervention. Compared to placebo, the mean of the total PSQI score decreased significantly in participants who received lettuce seed syrup (p=0.014). In addition, there were statistically significant reductions in the mean scores of subject quality sleep (p=0.002), sleep duration (p=0.038), habitual sleep efficacy (p=0.029) and sleep disturbance (p=0.032) in patients who received lettuce seed syrup. Lettuce seed syrup may improve self-reported sleep quality in participants with breast cancer. Larger trials are indicated in diverse samples of participants with caner to learn if these finds are generalizable. [ABSTRACT FROM AUTHOR]

Introduction: Cancer is one of the most common diseases in the world today that in addition to causing physical problems causes psychological problems for patients. One of these problems is pain catastrophizing. Aim: The purpose of this study was to investigate the role of psychological resilience and mindfulness in predicting pain catastrophizing through mediating role of positive emotions in patients with cancer. Method: This study was a descriptive and correlational research. The statistical population included all Adult cancer patients (over 18 years old) in Kerman in summer and autumn of 2021, that a total of 141 patients were selected as the sample using purposive sampling. For data collection, Standard Pain Catastrophizing Scale, PANAS Positive Affect Schedule, short form of the Freiburg Mindfulness Questionnaire and Connor and Davidson Resilience Questionnaire, were used. For data analysis, path analysis and Pearson correlation methods were applied by using AMOS software version 24 and SPSS version 23. Results: Results showed that the direct path of resilience (-0.27) and positive emotions (-0.32) to pain catastrophizing and direct path of resilience (0.24) and mindfulness (0.16) to positive emotions were significant. Also, the results of path analysis showed that the final model of the research had the goodness of fit (CMIN=0.373, NFI=0.99). Conclusion: The results showed that positive emotions mediate the prediction of pain catastrophizing based on psychological resilience and mindfulness. It is suggested that therapists and cancer-related institutions include treatment programs related to these factors. [ABSTRACT FROM AUTHOR]

Introduction: Depression in children with cancer can complicate the course of the disease and cause many problems in the treatment process. Aim: The aim of this study was to determine the prevalence of depression in children and adolescents with cancer. Method: This study was a descriptive cross-sectional study. Forty children with cancer admitted to the oncology ward of Besat Hospital, Sanandaj, with an age range of 7- 17 years in 2016, who were selected and assessed using a demographic information checklist and the Children's Depression Inventory (Kovacs, 1979). After collecting data, the data were analyzed by SPSS-20 software using descriptive statistical tests and chi-square. Results: The 15% of the subjects had depressive symptoms and 47.5% were on the verge of depression. The prevalence of depression was 21.1% in girls and 9.5% in boys (p=0.54), and there was no significant difference in terms of cancer type (p=0.99), treatment method (p=0.81) and demographic indicators (p>0.05). Conclusion: Due to the relatively high prevalence of depression in this group of patients, it is recommended that the necessary screenings be performed to identify and refer patients with depression to psychiatric or psychological clinics to receive appropriate and timely treatment to help improve the quality of life of these patients and their families. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the effect of emotional freedom technique (EFT) on sleep quality and happiness of women who underwent breast cancer surgery and lived in military and nonmilitary families. Design and Methods: The patients were randomly divided into four groups of military intervention (n = 34), nonmilitary intervention (n = 33), military control (n = 31), and nonmilitary control (n = 35). Data were collected using demographic information form, Pittsburgh Sleep Quality Index, and Oxford Happiness Questionnaire. Findings: The mean scores of sleep quality and happiness in military and nonmilitary intervention groups improved significantly immediately and 1 month after the intervention compared to control groups (p < 0.001). However, there was no statistically significant difference between the military and nonmilitary intervention groups regarding the mean scores of sleep quality and happiness before, immediately, and 1 month after the intervention (p > 0.05). Practice Implications: Given the efficacy of EFT in improving sleep quality and happiness, it is recommended that this technique be taught to nurses to implement in the entire process of providing nursing care to cancer patients. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer (GC) is a frequent and multifactorial malignancy worldwide. The aim of this study was to investigate the relationship between some risk factors of GC and the 1-year or 5-year survival rates in newly diagnosed patients in Isfahan in 2016. Methods: We included 274 newly diagnosed patients in this survival analysis from a database of 484 GC cases. We used a checklist to collect information. To inform about missed data, we call the patients or their families in non-survived cases. We evaluated each patient's age, sex, body mass index (BMI), education, salt, salty foods, and red meat consumption. In addition, we asked patients about the intake of fresh fruits and vegetables, tobacco smoking, opium usage, and alcohol consumption. We surveyed the patient's job, physical activity, Helicobacter pylori infection, family history of GC, history of gastric surgery, and survival status after 1 or 5 years. Variables were evaluated between survived and dead patients and compared for means and frequencies using the independent samples t-test or Mann-Whitney, or chi-square test. The univariate relationship of each risk factor, with 1- and 5-year survival, was examined by the log-rank test and the Kaplan-Meyer method and their multivariate relationship with Cox regression. Results: 1- and 5-year survived patients were younger than dead patients with GC (P < 0.001; HR for 1-year survival: 1.014, 95% CI: 0.997 to 1.030; HR for 5-year survival: 1.005, 95% CI: 0.994 to 1.017), and had more frequent higher educational levels (P < 0.05; HR for 1-year survival: 1.887, 95% CI: 1.046 to 3.406; HR for 5-year survival: 1.482, 95% CI: 0.987 to 2.223). The death rate after 5 years was higher in men than in women (P = 0.009; HR: 1.009, 95% CI: 0.593 to 1.717) and depended on the job status of the patients (P = 0.021). The other studied variables were not significantly different between 1- or 5-year survived and dead patients. Conclusion: GC development depends on genomic changes, environmental factors, and lifestyle status. But all risk factors that play a role in its development are not notable for a patient's survival. We suggest that risk factors for these patients' survival become elucidated in future studies. It helps to gather the necessary pieces of evidence for the enhancement of survival in patients with GC. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) emerged in December 2019 in China and exhibited as a highly contagious viral infection which led to a high level of mortality and morbidity. It is followed by a great deal of complications, such as serious psychological disorders. There are a few studies evaluating the psychological status of COVID-19 on the patients with cancer in Iran. Method: This was a cross-sectional study carried out on 94 patients with cancer who referred to Haft-e-Tir hospital for radiotherapy and chemotherapy from 20 April to 15 may, 2020. The data collection tool was the impact of events scale-revised (IESR). Results: The prevalence of anxiety disorders and obsessive compulsive disorder based on past psychiatric history in the patients was 11.7% and 2.1%, respectively. The results revealed that age was significantly related to avoidance dimension score (B = -0. 209, 95% CI: -0.084 to - 0.335). Regarding hyper arousal dimension score, the results were as follows: rural residency (B = 5.091, 95% CI: 0.610 to 9.573), past psychiatric history (PPH) (B = 8.312, 95% CI: 4.314 to 12.310), and radiotherapy (B = -2.976, 95% CI: -5.878 to -0.074) had a statistically significant relationship with the hyper arousal dimension score. Conclusion: The patients with cancer had a severe form of COVID-19. Individuals with cancer who had a previous psychiatric history are more vulnerable to posttraumatic stress disorder symptoms after trauma. [ABSTRACT FROM AUTHOR]

A cross-sectional study with a convenience sample of 241 patients with breast cancer was conducted to investigate death depression and its explanatory factors in Iranian women who were diagnosed and undergoing treatment for breast cancer. Patients with significantly higher death depression were those who were housewives (β = 0.6, p = 0.016), unskilled workers (β = 15.8, p = 0.002), and retired (β = 13.1, p = 0.002) as compared with those who were professionally employed with higher socio-economic status (β = 17.4, p = 0.002); and those receiving combination therapy as compared to surgery only (β = 6.3, p = 0.02). For patients with higher spiritual health scores, death depression was significantly lower (β = −0.2, p < 0.001). [ABSTRACT FROM AUTHOR]

Cancer survivors face numerous therapeutic and health challenges during the COVID-19 epidemic. These patients experience high levels of anxiety and stress due to illness, external stresses, and crises, such as the COVID-19 epidemic. The present study showed a positive relationship between FCR and COVID-19 anxiety as well as moderate levels of FCR (according to the midpoint score of the questionnaire) and COVID-19 anxiety among cancer survivors. Factors affecting the mental condition of cancer survivors can play an important role in completing treatment and preventing disease exacerbation. [ABSTRACT FROM AUTHOR]

Background & Aims: Mental health is one of the most important components of a healthy life. Mental health seeks to reduce negative emotions such as anxiety, depression, and hopelessness and to prevent the occurrence of morbid symptoms in people. During the last few decades, the issue of mental health has been considered as one of the important aspects of health. Risk factors for mental health problems include family history, stressful life conditions, chronic illness, history of trauma, drug use, neglect or abuse in childhood, and lack of social support. The importance of mental health is due to its close connection with physical health. Mental health plays an important role in people's ability to maintain physical health. Mental illnesses such as depression and anxiety affect people's ability to participate in healthpromoting behaviors. In turn, physical health problems such as chronic diseases can have a serious impact on mental health and reduce people's ability to participate in treatment and recovery. Specialists and researchers are looking for factors that can affect mental health. Meanwhile, marital satisfaction and self-efficacy are among the factors affecting the mental health of cancer patients, and the need for more investigations in this field is felt. The psychological effects caused by this diagnosis and the physical effects caused by its treatments are accompanied by many side effects, and due to the changes, sometimes self-confidence is jeopardized. Personal communication is disrupted due to uncertainty about the future. The previous adaptation mechanisms seem insufficient and being admitted to the hospital may induce a feeling of loneliness. It should be noted that chronic diseases, including cancer, can have destructive effects and affect the satisfaction of couples. Marital satisfaction is the most important component of marriage. It seems that mental health as a component of individual characteristics is related to marital satisfaction. The perception of self-efficacy is also a cognitive mechanism that creates the ability to control fearful things in a person and enables him to face problems. Understanding the ability makes a person avoid behaviors. People who have a clear, defined, harmonious, and almost stable sense of self-efficacy have more psychological health. These people have reached a clear view of themselves and are less influenced by daily events and evaluations of these events. Therefore, the present study aims to investigate the role of marital satisfaction and self-efficacy in the mental health of these patients. Methods: For this purpose, 135 cancer patients undergoing chemotherapy in Shiraz city who were referred to chemotherapy centers in Shiraz in 2013 were selected. In this study, Goldberg's general health (1972), Fores and Elson's (1989) marital satisfaction, and Sherer et al.'s (1982) general self-efficacy questionnaires were used. The data were analyzed using multiple regression analysis methods. Results: The results of these analyzes showed that marital satisfaction and self-efficacy predict mental health in cancer patients undergoing chemotherapy. Conclusion: In a general summary and according to the results of the present study, it can be stated that marital satisfaction and self-efficacy predict the level of mental health in cancer patients undergoing chemotherapy, so the attention of patients and Caregivers of these patients are important to the categories of marital satisfaction and self-efficacy. Just as every research has its limitations, this research also has limitations in several areas due to the special physical and mental conditions of these patients. The current research has been conducted on a special group of people (cancer patients) who may have many problems with attention and concentration, which may have affected their answers to the questions in the questionnaires. The small number of subjects may also be one of the other limitations of this research. Another limitation of this research is the non-uniformity of the sample group in terms of gender, type of cancer, and benign and malignant disease, which may have affected variables related to mental health. Using the available sampling method and collecting data using a self-report questionnaire by patients is another limitation of the present study. Considering that the statistical population studied in this research are cancer patients undergoing chemotherapy and a lot of psychological pressure is imposed on these patients, it is suggested that the role of other predictive variables in the mental health of this group of patients Review. Considering the importance of the concept of mental health and because this construct is relatively new and few types of research related to it have been done in our country, it is suggested to investigate it in different chronic and clinical patients to validate the results of this research. Also, considering the limitations of the current research in evaluating mediating and moderating variables, it is suggested that in future research, the role of these variables should be controlled and investigated, and various researchers in different formats (descriptive, experimental, longitudinal, etc.) to be done in connection with it. This research should also be done in single patients because the stress and type and amount of support in these patients are different. Also, regarding the effect of self-efficacy in cancer patients, this research is still in its development period and the need for more research in this field is felt. [ABSTRACT FROM AUTHOR]

Background: The rate of childhood cancer death has dropped steadily over the past 50 years. The pediatric cancer risk has remained under investigation. Objectives: This study aims at investigating the associated factors with the survival of pediatric patients with retinoblastoma, sarcoma, brain tumor, and leukemia cancer. Methods: The cohort study of 1879 children with retinoblastoma, sarcoma, brain tumor, and leukemia aged < 1, 1 - 5, 6 - 10, 11 - 15, and > 15 years in Mahak Hospital and Rehabilitation Complex from 2007 to 2016 were enrolled in the study. Median survival time was reported for each cancer. Parametric survival models including Gompertz, Weibull, lognormal, and log-logistic models were fitted. Then, the model with almost minimum Akaike information criterion (AIC) was chosen. The hazard ratio (HR) and the analysis were performed by R3.5.1. Results: Totally, 270 (14.37%) patients with Retinoblastoma, 667 (35.5%) with leukemia, 625 (33.26%) with a Brain tumor, and317 (16.87%) with Sarcoma were included in this study; 815 (43.37%) patients were female. Gompertz's model was chosen to fit the data due to the minimum AIC. The associated factors with the survival of childhood cancers were as follows: age < 1 year, parental relation, locoregional relapse and chemotherapy alone (HR: 7.63, 1.56, 4.61, 1.12) in leukemia, other nationalities, metastasis or metastasis and loco-regional relapse and chemotherapy alone (HR = 3.74, 5.75, 2.12) in retinoblastoma, loco-regional relapse and metastasis (HR = 2.40, 3.71) in brain tumor, other ages except for 5 - 10 years, parental relation, chemotherapy alone, and metastasis (HR = 33.3, 1.80, 3.57, 3.8) in sarcoma. Conclusions: Age, parental familial relationships, combination therapy, and metastasis of primary cancer were the risk factors for survival of children with 4 common cancers of leukemia, retinoblastoma, brain tumors, and sarcoma, using the Gompertz model. [ABSTRACT FROM AUTHOR]

Objective: Perceived social support (PSS) and emotional self-regulation have customarily been related to greater psychological well-being, but the pathways via which perceived social support and emotional self-regulation increase psychological well-being have not been revealed. We investigated how much self-compassion mediated the association between perceived social support and emotional self-regulation in psychological well-being of breast cancer sufferers. Method: A cross-sectional study design was used. Participants were recruited from three oncology departments in Zanjan, Iran. Data was collected from breast cancer patients (n = 300). Participants completed self-report measures, the short Ryff scale Psychological Well-being (RSPWB), Emotion Regulation Questionnaire (ERQ), Multidimensional Scale of Perceived Social Support (MSPSS) and Self-Compassion Scale (SCS). Pearson correlation coefficient was used to assess association among the study variables and multivariable regression analysis was used to assess linear relationships among predictor variables (emotional self-regulation, perceived social support and self-compassion) and criterion variable (psychological well-being). Bootstrapping analyses were used to test the significance on indirect effects. Results: Bootstrapping analyses revealed significant indirect effects of perceived social support (β = 0.055, SE = 0.45, P = 0.049, 0.95 CI: LL = 0.0092, UL = 0.1345) and emotional self-regulation (β = 0.079, SE = 0.079, P = 0.004, 0.95 CI: LL = -0.0331, UL = -0.1358) on psychological well-being through self-compassion. Conclusion: These findings present new evidence that self-compassion may be a target for psychological interventions attempted at enhancing psychological well-being in cancer populations, particularly breast cancer survivors. [ABSTRACT FROM AUTHOR]

Background and Objectives: Breast cancer is the most commonly diagnosed cancer in women which can cause spiritual distress in them. This study aims to assess the effects of mindfulnessbased schema therapy (MBST) and transdiagnostic intervention on spiritual distress of women with breast cancer. Methods: This is a quasi-experimental study (Clinical trial) with a pre-test/post-test/followup design using a control group. Participants were 41 women with breast cancer referred to Omid and Imam Reza hospitals in Mashhad, Iran during 2017-2020, who were selected using a convenience sampling method and randomly assigned into two experimental groups and one control group. For both experimental groups, the intervention was performed at ten weekly sessions. The used instrument was the Spiritual Distress Scale of Ku et al. Data were analyzed using repeated measures analysis of variance and Bonferroni post hoc test in SPSS software, version 25 software. Results: There was a significant difference in the mean scores of spiritual distress in the experimental groups compared to the control group in the post-test and follow-up phases (P<0.001). There was no significant difference between the effectiveness of transdiagnostic intervention and MBST in the post-test and follow-up phases (P>0.05). Conclusion: Both transdiagnostic intervention and MBST can reduce the spiritual distress of women with breast cancer. [ABSTRACT FROM AUTHOR]

Background: Adherence to the treatment regimen is among the behaviors, which predict the successful control of the disease and decrease its intensity and negative consequences, which is influenced by several factors. The patient's beliefs and attitudes toward the disease are effective factors in disease management and adherence to treatment, and spiritual health is one of these influential variables. Objectives: The aim of this study was to determine the mediating role of spiritual health in adherence to treatment in patients with cancer. Methods: In this descriptive correlational study, the participants were 234 Iranian patients with cancer, who were selected through convenience sampling, admitted to the oncology wards of 9 selected teaching hospitals in the northern, southern, eastern, and western provinces of the country, as well as the capital in 2021. The research instruments included the Demographic and Clinical Information Questionnaire, Spiritual Well-Being Scale, and Morisky Medication Adherence Scale-8. The path analysis was done to determine the factors related to the degree of adherence to treatment, taking into account the mediating role of spiritual health. Results: The mean age of the participants in the study was 47.27 15.36. The mean scores for spiritual health and adherence to treatment were 76.7013.75 and 6.472.1, respectively. A positive and significant relationship was found between spiritual health and adherence to treatment (P-value < 0.05). The variables of marital status, the time of diagnosis, and being a religious person had a direct effect on spiritual health, and the time of diagnosis indirectly affected treatment adherence. Conclusions: According to the results, the level of spiritual health and adherence to the treatment in patients with cancer was moderate. In addition, the variable of diagnostic time affected adherence to treatment indirectly. Besides, in examining the factors affecting spiritual health, the findings indicated the effect of the variables "being religious", "marital status", and "the time of diagnosis". In addition to strengthening spiritual health, it is necessary to highlight the need to follow therapeutic diets in these patients. Therefore, it is suggested to consider a program to meet the patients with cancer spiritual needs along with the physical care program. [ABSTRACT FROM AUTHOR]

Background: Patient awareness plays an important role in integrating palliative care into the patient care process. Lack of awareness can create a negative attitude towards palliative care and affect patients' decisions during the treatment process. The present study was conducted to determine the level of knowledge about palliative care in Iranian patients with cancer. Methods: The descriptive study was conducted with a convenience sample of 103 cancer patients admitted to an oncology center in Yazd, Iran, A three-part questionnaire including demographic information, sources of palliative care information and the Palliative Care Knowledge Scale (PaCKS) was used to collect data. All statistical analyses were performed using software SPSS 21. Results: The mean age of patients was 36.2 ± 13.5 years. Of the total, 38.8% of patients received information about palliative care through the media and 36.9% from the treatment team. On a scale of 0 to 13, the mean PaCKS score was 6.7 ± 3.7. A 'good' level of knowledge was reported by 29.1% of participants; however 84.5% stated that they should leave other doctors at the time of receiving palliative care, 71.8% considered palliative care for patients in the last six months of life, 84.5% considered palliative care for patients with cancer, and 70.9% stated that palliative care encourages people to discontinue treatments aimed at treating their disease. Conclusion: Our study found most cancer patients have a moderate to weak level of knowledge and considerable misinformation about palliative care, which highlights the importance of providing palliative care education. The development of training programs in this area could play an effective role in improving patients' knowledge of palliative care. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to explore the protective role of social support and spirituality in the prevention of depression, anxiety and fatigue severity. Design: In a cross‐sectional study, 305 women of breast cancer survivors were recruited in the study. Methods: The participants answered a self‐reported the hospital anxiety and depression scale, fatigue severity scale (FSS), social support and spiritual health questionnaires. The data were analysed using a multiple linear regression model to estimate the adjusted regression coefficients. Results: A greater proportion of patients had moderate depression (62.9%) and moderate anxiety (67.3%). The higher level of social support was significantly associated with a lesser degree of depression (β=−0.05, p =.001) and anxiety (β=−0.04, p =.001), but there had been no association with the severity of fatigue score, while the association of spiritual health with depression and anxiety was not independently significant. This study highlights the importance of perceived social support in the prevention of depression and anxiety. [ABSTRACT FROM AUTHOR]

Background and Purpose: Adult Hope Scale is one of the most popular tools for hope measuring. The study aimed to evaluate the psychometric properties of the Persian Version of Hope Scale among Iranian patients with cancer. Methods: In this methodological study, patients with cancer (n = 400) were recruited by convenience sampling from June to December 2019. The construct and content validity and reliability of the scale were evaluated. Results: A two-factor structure for the scale was indicated with the factors being optimism life, and despair that explained 60.483% of the total variance of the scale. The model has the goodness of fit and acceptable internal consistency (Cronbach's alpha:.701–.897). Conclusions: The Persian Version of Hope Scale demonstrated acceptable validity and reliability among patients with cancer. [ABSTRACT FROM AUTHOR]

Background & Aims: Cancer is one of the significant health problems in this century. The suffering caused by cancer can decrease the patient's sense of self-efficacy and psychological well-being. However, cancer patients' psychological well-being and self-efficacy are considered two essential variables in motivating them to follow the prescribed treatment program and increase the probability of successful treatment response. Psychological well-being refers to a sense of health that includes full awareness of all aspects of the individual's integrity. Psychological well-being is a core feature of mental health. It may be defined as having hedonic (enjoyment, pleasure) and eudaimonic (meaning, fulfillment) happiness, as well as resilience (coping, emotion regulation, healthy problem solving). The Six-factor Model of Psychological Well-being is a theory developed by Ryff which determines six factors that contribute to an individual's psychological well-being, contentment, and happiness. Psychological well-being consists of positive relationships with others, personal mastery, autonomy, a feeling of purpose and meaning in life, and personal growth and development. Psychological well-being is attained by achieving a state of balance affected by both challenging and rewarding life events. People with high well-being experience mainly positive emotions and have a positive evaluation. Self-efficacy refers to the perception of one's ability to act according to one's desire. Self-efficacy reflects confidence in exerting control over one's motivation, behavior, and social environment. A strong sense of self-efficacy promotes human accomplishment and personal well-being. A person with high self-efficacy views challenges as things that are supposed to be mastered rather than threats to avoid. These people can recover from failure faster and are more likely to attribute failure to a lack of effort. They approach threatening situations with the belief that they can control them. These things have been linked to lower levels of stress and a lower vulnerability to depression. According to numerous studies, in cancer patients, interventions to increase the sense of self-efficacy facilitate the treatment process, increase the therapeutic response and reduce the disease's symptoms. Also, higher self-efficacy increases the adaptation of cancer patients to infection and improves the quality of life. Compassion-Focused Therapy has received a lot of attention recently. Compassion-focused therapy aims to help promote mental and emotional healing by encouraging people in treatment to be compassionate toward themselves and other people. Compassion-focused therapy was founded by Paul Gilbert (2000) in response to the observation that many people, particularly those high in shame and self-criticism, were experiencing difficulties generating kind and self-supporting inner voices when engaging in traditional therapy. It was observed that although these individuals were able to engage with cognitive and behavioral tasks, they still responded poorly to therapy. Self-compassion focus on kindness to oneself in the face of self-judgment, human commonalities in front of isolation, and mindfulness. Self-compassion is associated with positive emotions and the ability to hold negative emotions in a non-judgmental consciousness. Compassion, both toward the self and toward others, is an emotional response believed by many to be an essential aspect of well-being. Therefore, the present study seeks to answer whether compassion-focused Therapy is effective on psychological well-being and self-efficacy in people with cancer. Methods: The design of the present study was quasi-experimental with a pretest-posttest and control group. The necessary permission was first obtained from the ethics committee of Hormozgan University of Medical Sciences with the code IR to conduct this study. HUMS.REC.1398.306. This study's statistical population included all cancer patients referred to Shahid Fayyaz Bakhsh Hospital in Tehran in 1398, of which 34 people who met the inclusion criteria and were willing to participate in the study were purposefully selected and randomly assigned to experimental and control groups. The experimental group underwent eight sessions of 90-minute treatment focused on compassion in a group and weekly manner. Patients in both groups answered the research questionnaires at the beginning and immediately after the intervention. Inclusion criteria included: maximum age of 65, lowest literacy, at least six months after diagnosis, no severe mental disorder, and substance abuse. Exclusion criteria include the absence of more than two sessions in treatment, unwillingness to continue to participate in the study, and the occurrence of acute physical and mental disorders that do not allow continued participation in the sessions. At the end of the treatment sessions, two people from each group were excluded due to non-participation in the study, and finally, 15 people remained in each group. Generalized self-efficacy scale AND Ryff's psychological well-being scales were used to collect data. Results: Based on demographic information from the experimental and control groups, 15 cancer patients each participated; the mean age of the subjects in the experimental group was 38.12 years and in the control group was 36.94 years. The mean duration of the disease in the experimental group was 4.97, and in the control group was 5.33 years. Multivariate analysis of covariance was used to compare the differences between groups in psychological well-being subscales. The multivariate analysis of covariance showed a significant difference between the two groups in the linear composition of the dependent variables (Lambda Wickels = 0.03, F = 0.001, p < 0.001). Also, to compare the two groups in each of the components of psychological well-being as a dependent variable, the test of effects between subjects in the text of the univariate analysis of covariance test was used. The results showed that after controlling the effect of pre-tests on the post-test score, the group effect on the components of psychological well-being in the post-test has become significant. Univariate covariance analysis was used to compare the two groups in self-efficacy score and total psychological well-being score. The results showed that by controlling the pre-test scores, the group's effect on the self-efficacy post-test score and the total score of psychological well-being is significant. Conclusion: This study aimed to determine the effectiveness of compassion-focused Therapy on cancer patients' psychological well-being and self-efficacy. The results showed that compassion-focused Therapy could significantly positively affect cancer patients' psychological well-being and self-efficacy. Explaining these results, it should be noted that according to the compassionate view, people who have high self-judgment are more likely to blame themselves for stressful life events. The basic premise of compassion-focused Therapy is that not only are feelings of shame about brokenness and self-blame not helping to solve problems, but such a reproachful pattern can be the source of many mental disorders and poor well-being. In compassionate Therapy, by creating a new perspective, people who constantly criticize themselves are helped to achieve growth and development and choose the options they can. Also, in case of failure, instead of being unkind and judgmental towards themselves, they should appear with a state of compassion and acceptance towards themselves, which can gradually help to strengthen one's self-efficacy and psychological well-being. Some of the critical steps involved in compassion-focused therapy sessions are the use of imagery, compassionate thinking to the self and others, responding to self-criticism through self-compassion, and practicing human behavior, often complimented with letter or diary writing. Compassion-focused Therapy encourages the client to focus on, understand, and feel compassion to the self during negative thought processes, with a strong focus on nurturing compassion within the self. Compassion-focused Therapy helps the individual to accept problems and failures and illness and disability as part of shared human experiences by teaching the components of self-kindness, a shared sense of humanity, and mindfulness. [ABSTRACT FROM AUTHOR]

Background: Respect for human dignity has been the focus of various studies on patients' health and treatment. Despite the increasing number of cancer patients, to date, the dimensions of dignity have not been fully identified for this group. This study was conducted with the aim of the development and psychometrics evaluation of a dignity assessment questionnaire for Iranian cancer patients. Method: This mixed-method design with a sequential exploratory approach was conducted in Iran. In the first phase, a purposive sampling method was used to recruit the participants and the sampling continued until data saturation. The data were collected through individual semi-structured interviews. In the second phase, the validity and reliability of this instrument were assessed among 300 cancer patients. Results: The dignity assessment questionnaire for cancer patients included four domains and 27 items. The domains of the questionnaire were "the performance of the treatment team", "respect for patients' personal space", "family support", and "adequate equipment and facilities". The internal consistency of the questionnaire was assessed using Cronbach's alpha coefficient and the split-half method. To confirm the stability, test-retest was utilized and the result of the interclass correlation coefficient for the entire questionnaire was 0.94. Conclusion: A dignity assessment questionnaire has been developed based on the perception and understanding of cancer patients, their family caregivers, and oncology nurses. The findings of the present study could help healthcare providers to implement a scheme with the aim of strengthening support for and better treatment and care of cancer patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the barriers to effective pain management in Iranian people with cancer. Design: A qualitative descriptive design was used. Methods: This qualitative descriptive study was performed on 14 people with cancer. Data were collected using semi‐structured interviews and analysed by Graneheim and Lundman's content analysis method. Results: Four main categories emerged in relation to barriers to pain management from the perspective of people with cancer. Categories included 1) accepting and enduring divine pain, 2) negative attitudes towards the effectiveness of analgesics, 3) patients' low knowledge of pain self‐management methods and 4) neglected pain management. Barriers to pain management are multidimensional in nature consisting of patients, healthcare providers and system components. Therefore, attempts should be focused on the education of patients and healthcare providers about pain management and eliminating the shortcomings of the healthcare system. [ABSTRACT FROM AUTHOR]

This paper reports on the psychometric properties of the Religious Orientation Scale (ROS) with a sample of 311 Iranian patients who were suffering from cancer between September and December 2020. A cross-sectional study design was used, and convenience sampling was employed. Reliability was evaluated by internal consistency Cronbach's alpha, McDonald's omega, and average inter-item correlation. The exploratory factor analysis showed that the ROS had 15 items and two factors (religious identity and personal identity) that explained 43.2% of the total variance of religious orientation in Iranian patients with cancer. Construct validity was assessed by means of confirmatory factor analysis. The internal consistency and composite reliability were acceptable. The results indicate that the ROS can produce reliable and valid data on religious orientation in a sample of Iranian patient with cancer. [ABSTRACT FROM AUTHOR]