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Mothers of children with an intellectual disability often experience challenges that affect their mental health and the relationship with their children. The present study assesses the correlation between the mental health and relationship patterns of mothers of children with an intellectual disability. In this descriptive-correlational study, the mothers of 53 female and 92 male children with an intellectual disability were selected. The data were collected by: (a) a demographic questionnaire; (b) a general health questionnaire; and (c) the assessment scale of mother-child relationship. The results revealed that the acceptance relationship pattern had a significant negative correlation with somatisation (p = 0.006, r = -0.206), anxiety (p = 0.018, r = 0.174), and the general mental health (p = 0.009, r = 0.195). The rejection pattern had a significant positive relationship with depression (p = 0.026, r = 0.163). The present study showed that mothers who had experienced symptoms of anxiety or who had lower general mental health scores were less likely to use acceptance patterns in relationship with their child. Also, mothers who had symptoms of depression significantly rejected the relationship with their child. So, it is suggested that programs should be developed and implemented to maintain mothers' mental health.

The complexity of multiple sclerosis (MS) due to psychological, emotional, physical, family, and social dimensions complicates the care of these patients. MS patients need hospitalizations and long-term care to treat and control the progression of the disease. Therefore, the competence of caring for MS patients is one of the important issues in clinical nursing.

Accessible Summary: What is known on the subject?: Taking care of an autistic child at home can be tough for parents.They struggle to balance caring for their child and other tasks.This can affect their emotional well‐being and cause guilt and other psychological problems. What does the paper add to existing knowledge?: Eye movement desensitization and reprocessing with finger movements can reduce guilt in parents of autistic children.Eye movement desensitization and reprocessing with Elite mobile health software movements can reduce guilt in parents of autistic children.The bilateral eye stimulation method using finger movements has a more sustained impact than the Elite app's bilateral stimulation method. What are the implications for practice?: Healthcare providers are encouraged to learn Eye Movements Desensitization and Reprocessing.Healthcare providers are encouraged to use these methods to help with psychological issues in children with autism.Psychiatric nurses are encouraged to utilize this treatment approach for parents of children with autism, as well as to help alleviate feelings of guilt more broadly. Introduction: Caring for an autistic child at home can be challenging for parents, as it can make it difficult to balance their responsibilities. This imbalance can negatively affect the emotional well‐being of the caregiver and lead to feelings of guilt. While this is a known issue, there may be gaps in knowledge specific to Iran. In this study, a new method was introduced to address this issue. Aim: This study aimed to examine the impact of desensitization with eye movements and reprocessing (EMDR) on reducing parental guilt among autistic children's families. We aim to examine the effectiveness of two different treatment methods. Methods: This study involved 90 parents (60 mothers, 30 fathers) of autistic children randomly assigned to either an experimental or control group. The two experimental groups received a 45‐min intervention session once a week for 3 weeks, while the control group did not receive any intervention. Data on feelings of guilt was collected using a questionnaire. After 30 days, both groups took a follow‐up test. The data were analysed using statistical software. Results: This study found that there were significant differences in guilt feelings among different groups of EMDR therapy and a control group. Specifically, no significant differences were observed in the mean guilt scores between the experimental and control groups at the pre‐intervention stage (p >.05). However, the experimental groups exhibited significantly lower mean guilt scores immediately after the intervention and 1 month later than the control group (p <.05). Immediately after the intervention and 1 month later, no significant differences were observed between the two experimental groups (p >.05). Conclusions: The findings of this study demonstrate the efficacy of desensitization treatment using eye movements and reprocessing in reducing feelings of guilt among autistic children's parents. In the follow‐up phase, it seems that the two‐way stimulation method with finger movements is more effective than Elite software in terms of the continuity of the effect. Healthcare providers are encouraged to learn and use these methods to help prevent and treat psychological issues in autistic children. [ABSTRACT FROM AUTHOR]

Background: Family caregivers of stroke patients often experience a decline in quality of life (QOL) and resilience due to the challenges posed by the patient's disability, inadequate support systems, and difficulty adapting to the new circumstances. Objectives: This study investigated the impact of a self-care support program (SSP) for stroke patients and their family caregivers on improving their QOL and resilience. Methods: This randomized controlled trial was conducted in Beesat Hospital, Hamadan, Iran, in 2022, involving stroke patients and their family caregivers. A total of 80 patients and 80 family caregivers were randomly assigned to either the intervention group or the control group. The intervention group received the SSP, which included four weeks of continuous face-to-face and telephone follow-up. The control group followed the routine care program provided by the neurology ward. The patients' quality of life was assessed using the stroke specific quality of life (SS-QOL) tool, while family caregivers' QOL and resilience were evaluated using the Short Form-12 and Sixbey 2005 tools, respectively, both before and after the intervention. Data were analyzed using descriptive and inferential statistics, including chi-square, paired t -tests, independent t -tests, and Fisher's exact test. The significance level was set at 0.05. Results: Among patients, the difference in the control group's total QOL score before and after the intervention was not statistically significant (P = 0.065), with scores of 83.77 ± 3.39 and 86.70 ± 8.25, respectively. Conversely, in the intervention group, the total QOL score significantly improved from 83.95 ± 1.43 to 119.72 ± 4.54 (P < 0.0001). For family caregivers, the total QOL score in the control group showed no significant improvement, increasing from 17.30 ± 1.60 to 18.17 ± 2.45 (P = 0.096). However, the intervention group experienced a significant increase in QOL scores, from 17.70 ± 1.11 to 25.37 ± 2.31 (P < 0.0001). Additionally, the resilience score in the control group slightly decreased from 129.15 ± 3.40 to 124.25 ± 5.31 (P = 0.12). In contrast, the resilience score in the intervention group increased significantly, from 130.25 ± 2.81 to 194.20 ± 2.15 (P < 0.0001). Conclusions: The findings of this study demonstrate the effectiveness of the SSP in improving the QOL of stroke patients and their family caregivers while significantly enhancing the resilience of family caregivers. It is recommended that medical and treatment teams prioritize involving family caregivers in care plans for debilitating diseases such as stroke and consider integrating SSPs into standard care protocols. [ABSTRACT FROM AUTHOR]

Purpose: To explore the perspectives and experiences of mental health care workers (MHCWs) when speaking up about patient safety concerns. Method: A qualitative study was performed at Farshchian (Sina) Hospital in Iran, involving the purposive sampling of MHCWs from three inpatient psychiatric wards. From July to October 2022, semi-structured interviews were conducted with 23 participants. Data were analyzed using conventional content analysis. Results: Three major patient safety themes were identified: (a) Voicing Concerns for Daily Safety (subthemes: daily safety check-ins and speaking up to prevent patient harm); (b) Speaking Up to Save Future Lives (subthemes: whistleblowing, leadership, and being open to communication); and (c) Hesitating to Speak Up (sub-themes: ineffectiveness of raising one's voice and whispering). Conclusion: MHCWs have various concerns about speaking up or staying silent. Failure to communicate can result in adverse events and missed opportunities to address patient safety. [Journal of Psychosocial Nursing and Mental Health Services, 62(10), 41–49.] [ABSTRACT FROM AUTHOR]

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Introduction: Previous research has indicated that community‐based mental health services in Iran are restricted, leading to overcrowding in psychiatric wards. This overcrowding has been linked to a range of problems, such as violence, suicide and medical errors. Despite the abundance of research on patient safety, there is still a lack of understanding regarding how mental health nurses (MHNs) create a secure environment within these wards. Aim: This study focused on exploring a safe environment provided by MHNs in inpatient psychiatric wards at Farshchian (Sina) Hospital, Hamadan, Iran. Method: An explanatory mixed‐methods study was conducted. Initially, the Safe Environment Scale was distributed to all MHNs (n = 48) working in three wards at Farshchian (Sina) Hospital to evaluate the current status. The scale measured two dimensions, and descriptive statistics were used to analyse the collected data. Subsequently, 20 MHNs were selected for semi‐structured interviews using purposeful sampling at the same hospital to interpret and fill gaps in the quantitative findings. The data collected from the interviews were analysed using conventional content analysis. Results: The perception and engagement of MHNs in creating a safe environment in the inpatient psychiatric wards were found to be at a medium level, according to the Safe Environment Scale (mean ± SD, 14.67 ± 4.18 and 85.27 ± 17.57, respectively). The qualitative study identified several categories in the results, including 'Hyper‐vigilance to safety and security environment', 'Therapeutic communication gap', 'Nurse burnout', 'Staff safety and security need' and 'Environmental safety hazards'. Discussion: MHNs employ a hyper‐vigilant strategy to guarantee a secure atmosphere within psychiatric wards. However, this approach may inadvertently impede the establishment of a safe environment and even diminish MHNs' perception and involvement in its maintenance. Implications for mental health nursing: According to our research, it appears that MHNs need to improve their education and training in order to successfully implement the vigilance strategy for establishing a secure environment. Additionally, it is essential for them to prioritize therapeutic communication with patients, as this plays a vital role in promoting a safe environment within inpatient psychiatric wards. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nurses' clinical competence (CC) is critical in providing high-quality and safe nursing care. Assessment of nurses' CC and its predictors is a key step to improve their CC and the quality of their services. The aim of this study was to determine the predictors of CC among hospital nurses in Iran. METHODS: This analytical cross-sectional study was conducted from September 2020 to May 2021. Participants were purposively selected from four university hospitals in Hamadan, west of Iran. A demographic questionnaire and the 73-item Nurse Competence Scale were used for data collection. A total of 300 questionnaires were distributed and 270 questionnaires (response rate: 90%) were completed and returned to the researcher. Data were analyzed using the SPSS software (v. 16.0) and the one-way analysis of variance, the independent-sample t, the Mann-Whitney U, and the Kruskal-Wallis tests, the Pearson and the Spearman correlation analyses, and the linear regression analysis. RESULTS: The mean score of CC was 40.28±8.6 (in the possible range of 0-100) and the highest and the lowest dimensional mean scores were for the situation management (56.13±11) and the ensuring quality (25.3±8.1) dimensions, respectively. The mean score of CC had significant relationship with age, work experience, and ward of working and these variables significantly predicted 77% of the variance of CC (adjusted R = 0.778, P<0.05). CONCLUSION: According to the results of this study, age, work experience and ward of working weresignificant predictors of CC in hospital nurses. Nursing managers should employ strategies such as reducing nurses' workload, improving their employment status, and providing them with quality in-service education in order to improve their CC and the quality of their services. [ABSTRACT FROM AUTHOR]

Ethical sensitivity affects the moral performance and relationship of nursing students with their clients. On the other hand, moral burnout may be associated with reduced empathy during their training course. This study was conducted to determine the relationship between moral sensitivity and empathy for clients among nursing students. In this correlational study, 200 nursing students were randomly selected from Hamadan University of Medical Sciences in 2020 and completed demographic questionnaires based on Lutzen's concept of moral sensitivity and Jefferson's scale of empathy. Data were analysed by means of a t-test, one-way analysis of variance and a Pearson correlation coefficient using the Statistical Package for the Social Sciences (SPSS-24). The mean age of the nursing students was 23 ± 2.5 years, and most of them were male (60%) and in the fourth academic year (39.5%). The mean score of moral sensitivity was 88.9 ± 9.9, and students' empathy was 92.3 ± 6.5. There was a direct and significant correlation between the variables (P = 0.001, r = 0.392). Also, a significant and indirect correlation was observed between the number of semesters passed and the degree of empathy shown to clients (P = 0.037, r = -0.14). Moral sensitivity among nursing students at Hamadan University of Medical Sciences is desirable, and there is a relationship between moral sensitivity and showing empathy to clients. It was also revealed that students' empathy levels towards clients decrease with increasing semesters. Decreasing the amount of empathy over time can affect the care of patients, so this component can be given more attention in the training of future nurses. [ABSTRACT FROM AUTHOR]

The current qualitative study sought to identify return to work (RTW) perception among people with serious mental illness (SMI) referred to a psychiatric hospital affiliated with Hamadan University of Medical Sciences. In total, 24 individuals were recruited, including working people with SMI, families, employers, and mental health team members who participated in in-depth, semi-structured interviews. Forty interviews were conducted. Interviews were analyzed based on the conventional content analysis approach. Accordingly, two themes were found, including The Need to Continue Working and Flexible and Supportive Strategies. The first theme included two categories: personal obligations and socioeconomic necessities. The second theme included three categories: coping with mental illness, requesting support from others, and coping with work conditions. Findings revealed that the need to continue working has a significant effect on RTW perception among people with SMI. [Journal of Psychosocial Nursing and Mental Health Services, 60(4), 11–20.] [ABSTRACT FROM AUTHOR]

BACKGROUND: Making appropriate decisions for cardiopulmonary resuscitation (CPR) is very challenging for healthcare providers. This study aimed to evaluate knowledge, attitude, and decision making about do-not-resuscitate (DNR) and termination of resuscitation (ToR) among nurses in the resuscitation team. METHODS: This descriptive cross-sectional study was conducted in April-September 2020. Participants were 128 nurses from the CPR teams of two hospitals in Kermanshah and Hamedan, Iran. A valid and reliable researcher-made instrument was used for data collection. Data were analyzed using the Chi-square, Fisher's exact, and Mann-Whitney U tests, the Spearman's correlation analysis, and the logistic and rank regression analyses. RESULTS: Only 22.7% and 37.5% of participants had adequate knowledge about ToR and DNR. The significant predictor of DNR and ToR knowledge was educational level and the significant predictors of decision making for CPR were educational level, gender, and history of receiving CPR-related education (P<0.05). When facing a cardiac arrest and indication of DNR or ToR, 12.5% of participants reported that they would not start CPR, 21.5% of them reported that they would terminate CPR, and 14.8% of them reported that they would perform slow code. The DNR decision had significant relationship with educational level, DNR knowledge, and ToR knowledge (P< 0.05), while the ToR decision had significant relationship with educational level and ToR knowledge (P<0.05). CONCLUSION: Nurses' limited DNR and ToR knowledge and physicians' conflicting orders and documentation can cause ethical challenges for nurses. Clear guidelines for DNR orders or TOR is necessary for nurses, in order to prevent any potential confusion, legal or psychosocial issues and concerns surrounding CPR and improve their involvement in CPR decision making process. [ABSTRACT FROM AUTHOR]

BACKGROUND: Spiritual health is one of the important dimensions of the elderly's health, which plays an important role in other dimensions of their health. This study aimed to explain the process of spiritual health of the elderly living in nursing homes. METHODS: This grounded theory study was conducted in 4 nursing homes in the city of Arak Iran between October 2019 and September 2020. The participants were 24 elderly people living in nursing homes, two health care providers, one nurse and one family member, first selected through purposive sampling and then, through theoretical sampling. The data were collected through semi-structured interviews and field notes. All the interviews were transcribed verbatim and analyzed based on Strauss and Corbin approach (2008). RESULTS: Six main categories were identified, including helplessness, inefficient supportive environment, spiritual distress, seeking support, relative improvement of spiritual health and factors affecting spiritual health, each of which explains a part of the whole process of spiritual health of the elderly living in nursing homes. CONCLUSION: Supporting the elderly living in nursing homes is necessary in order to meet their spiritual needs and preserve and promote their spiritual health. [ABSTRACT FROM AUTHOR]

The autonomy of chronic patients in Iranian hospitals is challenged by impaired functioning resulting from chronic illness, a negative image in society, and effects related to hospitalization. Comprehensive interviews and observations of 34 patients, nurses, and physicians were performed to assess the autonomy of chronic patients in Iran. Conceptualization, constant comparison, and the combination of data resulted in the identification of 5 main categories related to autonomy: welcoming paternalism, self-expression, self-proof, shared decision making, and self-determination. Authority scrambling was a central category describing chronic patients’ perceptions of their autonomy during hospitalization. These patients sought to maintain their independence despite serious threats to their autonomy. [ABSTRACT FROM PUBLISHER]

Background: Consideration of patient autonomy is an essential element in individualized, patient‑centered, ethical care. Internal and external factors associated with patient autonomy are related to culture and it is not clear what they are in Iran. The aim of this study was to explore contextual factors affecting the autonomy of patients in Iranian hospitals. Materials and Methods: This was a qualitative study using conventional content analysis methods. Thirty‑four participants (23 patients, 9 nurses, and 2 doctors) from three Iranian teaching hospitals, selected using purposive sampling, participated in semi‑structured interviews. Unstructured observation and filed notes were other methods for data collection. The data were subjected to qualitative content analysis and analyzed using the MAXQDA‑10 software. Results: Five categories and sixteen subcategories were identified. The five main categories related to patient autonomy were: Intrapersonal factors, physical health status, supportive family and friends, communication style, and organizational constraints. Conclusions: In summary, this study uncovered contextual factors that the care team, managers, and planners in the health field should target in order to improve patient autonomy in Iranian hospitals. [ABSTRACT FROM AUTHOR]