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Abstract Introduction Life-threatening illnesses in childhood are considered a crisis for the whole family, especially for the mother, which leads to experiencing different degrees of grief and emotional-behavioral problems. Objective The present study is conducted with the aim of explaining the concept of anticipatory grief from the perspective of the mothers of the children with life-threatening illnesses. Methods This qualitative study is part of a sequential exploratory research for model development in the field of anticipatory grief, which was conducted using conventional content analysis method. The data were collected through in-depth semi-structured interviews with 19 mothers of the children with life-threatening illnesses living in Shiraz and Tehran, who were selected through purposive sampling with maximum variation. When data saturation were achieved, the data were codified by MAXQDA-10 software and analyzed using Graneheim and Lundman’s approach. Findings Data analysis resulted in the identification of 8 subcategories including shock, irritability, fear of losing, feeling guilty, uncertainty, hopelessness, loneliness and isolation, and mourning without a coffin, all forming the major theme emotional upheaval. Discussion and conclusion As the result of being in a situation of imminent and possible loss of her child, the mother experiences different responses of sadness and sorrow and suffers the consequences the core of which is consisted of emotional upheaval. Therefore, by explaining the behaviors related to anticipatory grief, efficient and effective interventions can be designed to improve coping among this group of mothers.

Abstract Background Venous cannulation is among the most stressful and painful experiences of children hospitalization. Children with thalassemia need regular blood transfusion which needs venous access each time. The quality of care and quality of life of children will be improved if appropriate methods are used to reduce pain. This study aimed to compare vapocoolant spray and music in the reduction of pain of Venous cannulation in children with thalassemia. Methods The study was a randomized controlled clinical trial with a cross-over design. Thirty-six children with thalassemia from Thalassemia Patients of Pasteur Hospital in Bam from October to December 2020 and were recruited and randomly allocated to two arms. The pain of venous cannulation (no treatment) was measured in the first blood transfusion session as control. In the second and third sessions, two arms received music and vapocoolant spray before the venous cannulation with a cross-over design. The intensity of pain was measured by a Visual Analogue Scale (VAS). The change in pain scores was tested by ANOVA and Tukey post-hoc test between three measurements. Results During and after the cannulation, the pain was significantly lower in the vapocoolant measurement than in control and music (p

Introduction: Stress, anxiety and depression are common in people with chronic diseases. There is a close relationship between spiritual health and mental health. Various cultural factors such as religious and spiritual beliefs can have significant effects on the prevalence of stress, anxiety and depression in patients with chronic diseases. Objective: The aim of this study was to determine the relationship between spiritual health and stress, anxiety and depression in patients with chronic diseases. Methods: In this descriptive cross-sectional study, 360 patients with chronic disease were selected by convenience sampling method in Pasteur Hospital of Bam. Data collection questionnaires included demographic information form, DASS-21 standard questionnaire for stress, anxiety and depression and 20-item spiritual health questionnaire by Palutzian and Ellison. Data were analyzed by SPSS using descriptive statistics (mean and standard deviation) and inferential statistics (chi-square and Pearson correlation). Results: The level of spiritual health score was medium to high (80.62) and the mean scores of stress, anxiety and depression were (10.58), (6.70) and (7.32) respectively. The majority of patients had moderate levels of stress and depression and severe anxiety. There was a reverse relationship between overall score of spiritual health dimensions and stress, anxiety and depression. Conclusion: Spiritual health has a significant effect on coping with disease and recovery from illness. Mental health indicators are highly dependent to spiritual health. Identifying the spiritual needs of patients and apply appropriate care methods can reduce the complications of mental disorders in chronic patients.

Introduction: According to a breeding program that was carried out in Citrus and Subtropical Fruits Research Center, Noushin (C. reticulata cv Clementine × C. sinensis cv. Salustiana) and Shahin (C. reticulata cv Clementine × C. sinensis cv. Hamlin) mandarins were released by using crossing method in 20-year program. In general, mandarins do not have the ability of being kept in common or cold storage for long time compared to oranges. The main problem is the change of fruit taste during storage, therefore, it is an attracted subject for researchers. Furthermore, storage temperature plays an important role in the quality of the taste of mandarins. The new released mandarins, which hve not been yet studied completely for their storability, need to be evaluated. Therefore, the aim of this study was to investigate fruit physico-chemical and sensory characteristics of Noushin and Shahin varieties in common and cold storages for two years. Materials and Methods: In this study, fruits of Noshin and Shahin mandarins were harvested at seasonal harvesting time and then placed in could storage (5 oC and 85% RH) and common storage (7-10 oC and 60-70 %RH) based on completely randomized design with three replications for 60 days every year. Fruits on days 0 (at harvesting time), 20, 40 and 60 of storage were sampled. Various physico-chemical and sensory characteristics were evaluated including iuice percentage, weight loss, peel color indices (L*, a*, b*, hue angle, chroma and CCI), total soluble solid (TSS), titratable acidity (TA), technological index (TI), skin disorder index (SDI), pH, electrical conductivity (EC), total phenolic, ascorbic acid, antioxidant capacity and sensory parameters during experiment. Statistical analysis of the data was performed using statistical software MSTAT-C. Analysis of variance combined in a randomized complete design (two years) with three replications for each variety. Results and Discussion: The results showed that the amount of fruit weight loss and juice percentage did not show significant changes during storage. The ranges of weight loss in Noushin and Shahin varieties were 7-8% and 3.45-5.1%, respectively. Generally, peeling in Shahin was harder than Noushin but it gradually decreased until the end of storage. With the exception of citrus color index (CCI) in Noushin that was high at the beginning of storage, other color indices had no significant differences according to the type of variety and storage. Totally, TSS: TA ratio increased during storage depending on the type of storage, so that the ratio was higher (Noushin with 39.64 and Shahin with 13.34) in common storage than cold storage (Noushin with 31.04 and Shahin with 13.62) at the end of storage. Amount of electrical conductivity (EC) and technological index (TI) increased significantly in both varieties and storages. Shahin variety with 3.74 and 26.19% was so sensitive to rind disorder index and rind disorder percentage, respectively. Phenolic compounds in both varieties declined during both cold and common storages. The amount of reduction depends on the type of mandarin, with Shahin showing higher decline than Noushin variety. Besides, the content of ascorbic acid and antioxidant capacity in both peel and pulp showed a decreasing pattern with the passing of harvesting time during storage. According to sensory analysis, Noushin fruit can be stored in common storage for 20 days and in cold storage for 40 days. Moreover, results revealed that Shahin fruits did not have storability more than 40 days in common and cold storages. Conclusion: Generally, Noushin variety was sensitive to low moisture of the storage and fruits lost extra moisture during storage. Since Noshin was an early ripening variety, TSS: TA ratio increased rapidly at the end of storage. Although Noushin had the lowest ascorbic acid content but its fruit antioxidant capacity was higher than shahin at the end of storage. On contrast, Shahin was a mid-ripening variety with higher ascorbic acid content. On the other hand, shahin peel was so sensitive to skin disorder index (SDI), therefor it should not be maintained in low moisture and temperature storage. Based on sensory analysis and physicochemical measurements, Noushin can be stored for 20 days and shahin for 40 days in common and cold storage. Finally, we found that Noushin and Shahin cannot be maintained in storage longer than other mandarins.

Background: Various strategies such as teaching self care to hemodialysis patients have been employed to increase the level of their hope. This study aimed at examining the effects of a telephone follow-up program on the level of hope in a self care education program. Methods: In this single-blind randomized controlled clinical trial, 75 hemodialysis patients, selected by convenient sampling, were randomly assigned to 3 groups (n=25 each) including a control, a self care education, or a self care education with telephone follow-up. The control group received the routine care. The self care education group received 5 instruction sessions. The telephone follow-up group had similar instructional sessions followed by telephone calls during the subsequent 2 months. Data, collected using demographic information list and Miller’s hope questionnaire, were analyzed using Chi-Square, t-test, and one-way ANOVA followed by Scheffee test. Results: There was no significant difference among the scores of hope in the three groups before the intervention (P=0.40). However, after the intervention, the level of hope in the self care education group and self care education plus telephone follow-up groups were significantly higher than that of the control group (P=0.001). Moreover, the level of hope in the group with self care education plus telephone follow-up was significantly (P=0.001) more than that of the self care education group. Conclusion: Our findings indicated that teaching followed by telephone follow-up was associated with higher levels of hope. Therefore, such a strategy may be employed to improve the quality of life of patients with renal dialysis.

Introduction: Modern educational methods are influential in improving the quality of education and learners’ satisfaction. The aim of this study was to introduce the teaching method using “video clips” in teaching schizophrenia and survey the viewpoints of psychiatry students of Isfahan University of Medical Sciences compared to using traditional methods. Methods: This quasi-experimental study was conducted in 2013 on 101 psychiatry students of Isfahan University of Medical Sciences who were selected by convenience sampling (census) and divided randomly into traditional teaching group (n=47) and video clip groups (n=54). Research tool was a researcher-made questionnaire. Its validity was confirmed by the psychiatry and medical education experts and the reliability was confirmed by Cronbach’s alpha coefficients (α=0.92). The questionnaire was administered after teaching schizophrenia using the two methods and the viewpoints of both groups were compared. The collected data were analyzed using independent t-test and Mann whithney test. Results: Sixty of the participants were female and 41 were male with the mean age of 24 years. Despite the increase in the means scores of some items, there was only a significant difference in instructor’s scientific mastery (p=0.005, t=0.64), novelty and attractiveness of educational instrument (p=0.000, t=3.7) and greater fitting of the educational package compared to traditional note taking (p=0.005, t=1.7). Conclusion: Students’ satisfaction with lecture method in understanding the contents and their openness to new methods of learning indicate the effectiveness of the traditional method and the need for further improvement in combination with new methods. Further research is required to verify the role of using video clips in teaching psychiatry students.