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Background: Patients with an intestinal ostomy may experience significant sexual dysfunction that may have adverse impacts on quality of life. Appropriate sexual health counseling can be beneficial for these patients., Aim: This study was conducted to determine the effect of sexual counseling on the sexual function and sexual quality of life of women with a permanent intestinal ostomy., Methods: For this experimental study, 60 female patients with a permanent intestinal ostomy were selected through convenience sampling and then randomly assigned to either the intervention or control groups. Patients in the intervention group received four 90-minute individual counseling sessions based on the PLISSIT (permission [P], limited information [LI], specific suggestions [SS], and intensive therapy [IT] model over a period of 4 weeks). The control group underwent routine training. Data were collected by use of a demographic information questionnaire, the Female Sexual Function Index, and the Sexual Quality of Life Female questionnaire. Both groups completed the questionnaires before and after the intervention., Outcomes: Study outcomes were the resulting data for the Female Sexual Function Index and the Sexual Quality of Life Female questionnaire., Results: The results revealed a significant increase in the mean score of sexual function in the intervention group after counseling (P = .001). No significant difference was observed in the mean score of sexual quality of life between the 2 groups before the intervention (P > .05). In contrast, a significant increase was noted in the intervention group's sexual quality of life after the intervention (P = .001)., Clinical Implications: The results indicate a need to sexual counseling interventions directed toward sexual function and sexual quality of life in women with permanent intestinal ostomy., Strengths and Limitations: Study strengths include utilization of the PLISSIT model for sexual counseling as an invaluable roadmap for healthcare professionals, systematically addressing patient needs within a tailored framework, and prescribing appropriate strategies over 4 distinct phases. Limitations include the use of convenience sampling and no follow-up duration., Conclusions: This study demonstrated the efficacy of counseling in enhancing sexual well-being of women with permanent intestinal ostomy., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: To investigate mirror therapy (MT) influence on shoulder pain/disability and quality of life in mastectomy women., Materials and Methods: Sixty unilateral mastectomy women were recruited and randomly assigned to an MT group ( N  = 30) or a sham therapy (ST) ( N  = 30). Women in the MT and ST group attended a nurse-led, unsupervised, 30 min a day, five days a week, and at home training program for three weeks with and without a mirror, respectively. Shoulder pain and disability scale and QOL outcomes were assessed at baseline and 3 months after intervention., Results: Shoulder pain and disability were significantly improved in the MT group but there was not meaningful difference between groups in the EORTC-QOL scales except for some functional scores of QLQ-BR23 scale in the MT group after 3 months follow-up., Conclusions: Nurses should instruct MT as a rehabilitation program to mastectomy patients during or after hospitalization to reduce their post-op shoulder pain and disability. This intervention may have also positive impact on their self-care outcomes. It is recommended that further studies should be performed with nurse-supervised exercises, a validated tool for measuring QOL for a long period after surgery, and a longer follow-up period at least for 6 months.Implication for rehabilitationThis study aimed to investigate whether an unsupervised, nurse-led mirror therapy (MT) can alleviate shoulder pain and disability of mastectomy patients and improve their quality of life.Our findings indicated that nurse-led MT as a novel rehabilitation option for mastectomy patients, may reduce shoulder pain and disability even after long period after the surgery.Rehabilitation centers can equip rooms for MT so breast cancer women can use it immediately after mastectomy.Mirror therapy can be used as a rehabilitation method for mastectomy patients because it is easy-to-use, inexpensive, and without the need to attend a rehabilitation center.Rehabilitation centers can provide mirrors along with nursing instructions to women who want to use this method at home.

Spiritual sensitivity refers to awareness and perception of the attitudes and feelings of others and helps nurses to recognize and take responsibility for the spiritual values and needs of patients. The dimensions of spiritual sensitivity remain unknown as there is no comprehensive and standardized scale for assessing nurses' spiritual sensitivity; therefore, the current research aimed to design and validate the nurses' spiritual sensitivity scale. We conducted this exploratory sequential study using eight stages suggested by DeVellis (2016) when developing the scale. We conducted this study among Iranian nurses from March 2021 to October 2022. Results suggested a 20-item scale with two components (nurses' professional spiritual sensitivity and nurses' internal spiritual sensitivity) that explained 57.62% of the total variance extracted. We were able to confirm convergent validity based on an acceptable correlation between the nurses' spiritual sensitivity scale and the King's spiritual intelligence scale (r = 0.66), which showed good stability (cronbach's alpha coefficient = 0.927, omega coefficient = 0.923, and icc = 0.937). Spiritual sensitivity in nurses is difficult to evaluate. Considering the acceptability of the psychometric properties of the "Nurses' spiritual sensitivity" scale, this scale can be used in clinical environments to evaluate nurses' spiritual sensitivity. Therefore, it is suggested that managers and policy makers should consider developing related guidelines to help nurses to become more spiritually sensitive and also to meet the spiritual needs of patients. We suggest further studies to confirm the study results in the nursing community., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: This study aimed to evaluate associations between resilience and ostomy adjustment in a group of patients with a permanent ostomy., Design: Descriptive, correlational study., Subjects and Setting: One hundred participants were interviewed; most were male (N = 56; 56%), married (N = 77; 77%), illiterate (N = 46; 46%), and self-employed (N = 35; 35%). The most frequent condition leading to ostomy surgery was colorectal cancer (N = 24; 24%). A majority (N = 43; 43%) had been diagnosed with cancer 1 to 5 years before data collection, and 35 (35%) had lived with an ostomy for 1 to 5 years. Participants were recruited from an ostomy clinic of in Kerman, located in southeastern Iran. Data were collected from August to October 2019., Methods: Data were collected via interviews. A questionnaire, developed for purposes of this study, was developed that included items querying demographic and pertinent clinical characteristics and 2 validated instruments, the Resilience Scale and the Ostomy Adjustment Inventory-23 (OAI-23). Data were analyzed using t tests, analysis of variance, Pearson correlation coefficient, and linear regression., Results: The mean score for ostomy adjustment was 43.37 (SD = 11.57) indicating less than optimal adjustment to life with an ostomy. The mean score of the Resilience Scale was 104.56 (SD = 25.98); most participants (n = 67, 67%) had very low and low resilience. Resilience was weakly associated with ostomy adjustment; specifically, participants who scored higher on the Resilience Scale tended to score higher on the OAI-23 (r = 0.32, P = .006). Linear regression indicated that resilience had the greatest predictive effect on ostomy adjustment (P = .004)., Conclusions: Results suggest that higher levels of resilience may facilitate adjustment to a permanent ostomy. Findings indicate that nurses should design and implement programs to aid ostomy adjustment via resilience assessment., Competing Interests: The authors have no conflict of interest to declare., (Copyright © 2023 by the Wound, Ostomy and Continence Nurses Society.)

Background: Thalassemia is a genetic and chronic congenital disorder composed of physical problems that severely impair patients' cognitive, psychological and social processes. The rehabilitation of patients is particularly important because they have a high rejection sensitivity and low resilience. The present study aimed to determine the effects of mindfulness-based stress reduction counseling on rejection sensitivity and resilience in patients with thalassemia referring to a dedicated disease center in Kerman, Iran., Materials and Methods: We conducted this randomized controlled trial study on 66 patients with thalassemia referring to the Kerman Thalassemia Center in Kerman, Iran in 2022. Using convenience sampling and the stratified block randomization method, we divided the samples into two intervention (N = 33) and control (N = 33) groups. Patients in the intervention group received eight 60-min online mindfulness-based stress reduction counseling sessions (one session per week) and completed the Rejection Sensitivity Questionnaire, Adult Version (A-RSQ) and the Conner-Davidson Resilience Scale before and after the intervention. We collected data using the SPSS 25 trial and descriptive statistics (frequency, percentage, mean and standard deviation), Chi-Square test, Independent-samples t-test, Fisher's exact test, and Analysis of covariance. A significance level of 0.05 was considered., Results: We found no significant difference in the mean scores of rejection sensitivity between the intervention (8.75 ± 4.86) and control groups (9.87 ± 5.16) before the intervention. Mean scores for rejection sensitivity were 10.23 ± 4.94 in the control group and 7.11 ± 4.13 in the intervention group after the intervention, the results of analysis of covariance showed that, there was a significant difference between two groups after the intervention (F = 7.52, p = 0.008). The mean resilience score in the control group was 63.69 ± 19.43, while it was 67.72 ± 17.98 in the intervention group before the intervention and there is no significant difference between them, but the mean resilience scores in the control and intervention groups were 58.06 ± 22.81 and 74.18 ± 17.46 after the intervention, respectively. the results of analysis of covariance showed that, there was a significant difference between two groups after the intervention (F = 9.28, p = 0.004)., Conclusion: Our results showed that in addition to other physical treatments, mindfulness-based stress reduction counseling was effective in reducing the patient's rejection sensitivity and increasing the resilience of patients with thalassemia., (© 2023. The Author(s).)

Introduction: Constipation can be one of the biggest health problems for the older people that has negative effects on their quality of life. Some studies have reported that new non-pharmacological interventions such auricular acupressure have promising results in the management of constipation. This study was performed to investigate the effect of auricular acupressure on constipation and health-related quality of life in the older people living in the residential care home., Methods: Sample of this randomized clinical trial consisted of 53 older people with chronic constipation living in a residential care home in the southeast of Iran (Kerman city). The participants were randomly assigned to intervention (n = 27) and control (n = 26) groups. Auricular acupressure was applied to seven auricular acupoints (large intestine, rectum, San Jiao, spleen, lung, sympathetic, and subcortex) using Vaccaria seeds for the intervention group and for the control group, seedless auricular plasters were used at the seven auricular acupoints for 10 days. Data were collected before the intervention, end of the intervention, and 10-day follow-up using demographic and clinical, Patient Assessment of Constipation-Symptom, and Patient Assessment of Constipation-Quality of Life questionnaires. The SPSS-22 software was used for data analysis., Results: The difference between groups and times was significant in constipation and related quality of life and scores. The mean score of constipation at the end of intervention was 0.41 less in the intervention group than the control group (P < 0.0001). This mean score, in the intervention group also on the 10-day follow-up was 0.09 less than the control group (P = 0.004), which indicates a decrease in the severity of constipation symptoms. In the intervention group, mean score of quality of life related to constipation at the end of intervention and the 10-day follow-up was 0.56 and 0.19 less than the control group (Decrease in the mean score of quality of life related to constipation indicates an improvement in the quality of life) (P < 0.0001)., Conclusion: The results showed the positive effect of auricular acupressure on reducing the severity of constipation symptoms and improving the quality of life in old patients living in the residential care home. This non-pharmaceutical practice can be used by nurses as an inexpensive, safe, acceptable, and non-invasive nursing care for older people with constipation in homes, medical centers, or nursing homes., (© 2023. The Author(s).)

Background: Spiritually sensitive nurses perceive the spiritual attitudes and feelings of others. They play a positive role in providing spiritual care to patients. Spiritually sensitive nurses deal appropriately with suffering, frustration, and spiritual dysfunction. Therefore, the present study aimed to explain Iranian nurses' experiences of spiritual sensitivity., Methods: This qualitative descriptive explorative study used conventional content analysis and purposeful sampling to explain the experiences of Iranian nurses (n = 19). This study used in-depth semi-structured interviews with 19 nurses, as well as maximum variation sampling to gather rich information (age, sex, religion, work experience, level of education, marital status, type of hospital and ward) from March 2021 to January 2022. The current study also employed Guba & Lincoln criteria to increase data trustworthiness and Graneheim and Lundman approach to analyze the content., Results: The research data showed 497 codes, 1 theme, 3 categories, and 6 subcategories. The theme of "Nurse's spiritual sensitivity as a higher perception and reflection toward spiritual care" included three categories of the spiritual and professional character of the nurse, perception of the spiritual needs of patients and their families, and the nurse's reflection on the religious beliefs of patients and their families., Conclusion: Spiritual sensitivity helps a nurse to provide holistic care for patients and their families. Therefore, managers and policymakers should create guidelines to help nurses become more spiritually sensitive as well as to meet spiritual needs of patients. Further quantitative and qualitative research should confirm these results in other social and cultural contexts., (© 2022. The Author(s).)

As a significant health challenge, chronic disease can have critical spiritual consequences for patients. Therefore, the study of spiritual well-being as an aspect of health is essential but has been less considered with regard to chronic diseases. Thus, this systematic review and meta-analysis were conducted to investigate spiritual well-being in patients with chronic diseases. For this purpose, in the initial search that was performed of valid databases, a total of 615 descriptive studies published between 2000 and 2018 were found. After carefully assessing these, only 24 studies were included in the review. Overall, the spiritual well-being of 3289 patients with chronic disease was investigated. This study showed that the total mean score of the spiritual well-being of patients with chronic diseases was 86.65 (P < 0.001, 95%, CI: 80.34-92.96), indicating a moderate level of spiritual well-being in these patients. Thus, patients with chronic diseases are recommended to consider spiritual consultation programs., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and Objectives: The present study aimed to assess the effectiveness of guided imagery on fatigue, stigma, and mood in patients with multiple sclerosis., Methods: This clinical trial is a double-blind study that was conducted on 60 patients with multiple sclerosis referred to the largest center for special diseases in the southeast of Iran in 2020. The convenience sampling method was used to select the participants who were later divided into two groups of intervention (n = 30) and control (n = 30) using block randomization method. The intervention group listened to the guided imagery audio file at home for 25 min. The control group did not receive any intervention. Data were collected by demographic information questionnaires, Fatigue Severity Scale (FSS), Reece Stigma Scale for Multiple Sclerosis (RSS-MS), and the Profile of Mood States (POMS) before and one month after the intervention., Results: According to the results, there was no significant difference between the two groups before the intervention in terms of the score of fatigue (P < 0.0 = 67), stigma (P < 0.64), and mood (P < 0.17). However, after the intervention, a significant differences was observed in this regard (P < 0.0001). In the intervention group, the mean score of fatigue decreased from 59.72 ± 18.32 to 35.8 ± 16.15, and the mean score of stigma decreased from 17.31 ± 15.62 to 5.09 ± 8.06, showing a significant reduction in the levels of fatigue (P < 0.0001) and stigma (P < 0.0001) compared to before intervention. Also, the mean score of mood decreased from 36.90 ± 12.21 to 28.55 ± 11.87, indicating an improvement in the mood of samples in the intervention group (P < 0.0001)., Conclusions: The results indicated that guided imagery, as a cost-effective method, can decrease the fatigue and stigma, and enhance the mood of patients with MS. Therefore, nursing staff can use this method to improve MS patients' mood and decrease their fatigue and stigma., (© 2022. The Author(s).)

Introduction: This study investigated the effect of aromatherapy massage with lavender, chamomile, and rosemary oils on the depression and anxiety of elderly adults living in nursing homes., Methods: This randomized controlled trail was conducted on elderly adults living in nursing homes in Kerman, Iran. Through convenience sampling, 38 elderly adults were recruited and assessed using demographic questionnaire and Hospital Anxiety Depression Scale (HADS), respectively. Then, elderly adults were randomly allocated to either a control (19) or an intervention (19) group through block randomization. Elderly adults in the intervention group received aromatherapy massage using lavender, chamomile, and rosemary. Each massage session lasted 20 min and was performed three times per week for two three-week periods with an intervening one-week break, while their counterparts in the control group solely received routine nursing homes care services. HADS Scale completed with repeated measurements before the intervention, at the end of the third week, at the beginning of the fifth week and at the end of the seventh week., Results: According to the results, mean anxiety in the intervention group went from 11.9 ± 4 to 6.26 ± 3.38 ( p <.0001), and the mean depression went from 9.94 ± 3.2 to 4.15 ± 2.14, indicating that anxiety and depression were significantly reduced compared with before intervention ( p <.0001)., Conclusion: Aromatherapy massage with lavender, chamomile, and rosemary oils is effective in significantly reducing anxiety and depression of elderly adults living in the nursing homes., Competing Interests: CONFLICT OF INTEREST NOTIFICATION The authors declare there are no conflicts of interest., (Copyright© The Author(s) 2022. Published by the Massage Therapy Foundation.)

Background: Time management is of particular importance in nursing. One of the most effective variables associated with time management is emotional intelligence (EI). This study assessed the relationship between time management and EI and the level of EI and time management skills in head nurses in emergency and intensive care units., Methods: A cross-sectional study was conducted on all head nurses in the emergency and intensive care units of nine educational hospitals at Isfahan University of Medical Sciences in Iran in 2015 using Bradberry-Greaves' EI and Macan's Time Management Questionnaires., Results: Participants' total time management score was (104.15 ± 6.98); total EI score was (128 ± 15.80). There was no significant relationship between overall EI and time management skills. There was a significant relationship between age and the emotional self-awareness dimension of EI ( p = .027) and the mechanics dimension of time management ( p = .037), and between work experience and overall time management skills ( p = .049) and the mechanics dimension of time management ( p = .038)., Conclusions: Specific EI and time management skills may help head nurses to cope with the challenges they face, which may improve the quality of nursing care. Nursing leaders should consider the importance of time management and EI in increasing motivation and satisfaction of nursing staff and improving quality of care., (© Copyright 2022 Creative Health Care Management.)

Background: Integration of clients' religion/spirituality (R/S) into nursing practice can have effective outcomes in clients' health. In this regard, nurses' lack of competency can disrupt this process and interfere with the treatment process. Limited studies examined the impact of training programs on nurses' competency in spiritual care and integration of clients' R/S into clinical practice. This study aimed to investigate the impact of an online training program on nurses' empowerment for integrating clients' R/S into clinical practice., Methods: In the present interventional study, 80 nurses were selected by stratified sampling from two hospitals in the southeastern Iran. Nurses were randomly divided into the intervention (n = 40) and control (n = 40) groups. An online training program was performed for the intervention group in four 2-hour sessions during three weeks. Data were collected from all participants using the R/S Integrated Practice Assessment Scale (RSIPAS) before and one month after the intervention., Results: Prior to the intervention, scores of integrating clients' R/S into clinical practice were not significantly different between the intervention and control groups (t = 0.23, p = 0.81). However, after the training program, these scores increased significantly with a very large effect size compared to the control group (t = 4.31, p = 0.001). Although the control group scores improved significantly after the intervention compared to the pre-intervention stage, the effect size was very small (t = -2.55, p = 0.01)., Conclusions: The online training program had a positive effect on nurses' competency for integrating clients' R/S into clinical practice in the intervention group. Due to the importance of integrating clients' R/S into clinical practice, nurses' competency should be strengthened in this area. Managers are suggested to consider appropriate strategies in order to empower nurses in integrating clients' R/S into clinical practice. Nurse educators can benefit from our experiences in application of online training programs in nursing schools., (© 2021. The Author(s).)

Early motherhood may develop various stresses for the teen mothers and have adverse consequences. Current research aims at exploring experiences of teen mothers with stress and stressors of early motherhood. This qualitative study was conducted using conventional content analysis through in-depth semistructured interview. Eighteen Iranian teen mothers, who experienced parenting stress, with maximum variation in the age of first pregnancy, child's age, place of residence, and financial condition took part in this research. Data collection continued until saturation and were analyzed using MAXQDA10 software. Data analysis led to extraction of five categories including "storm of anxiety," "wander identity," "an unaccompanied way," "unarmed combat," and "a tired body." Teen mothers experienced tensions such as fear and worry, isolation and loneliness, regret, shame, depression, and doubt. These tensions originated from identity conflicts, inadequate social support, role inefficiencies, physical problems, and responsibilities. Teen mothers are influenced by various physical, psychological, social, and economic stressors which are in relation with the teenage, motherhood role, and the environment. Nurses are the major source of support for the teen mothers. Nurses should identify stress and stressors in teen mothers and strengthen well-being feeling in the teen mothers and their children through care, educational, consultative, and coordination interventions.

Background: Near-Death Experience (NDE) refers to a broad range of subjective experiences associated with forthcoming death. The majority of Cardiopulmonary Resuscitation (CPR) survivors experience NDEs. It seems that near-death events are experienced differently by people with different cultural and religious viewpoints. Thus, this study aimed to explain NDEs in Iranian Muslim CPR survivors., Materials and Methods: A qualitative hermeneutic phenomenological approach influenced by Ricoeur was used to understand the meaning of CPR survivors' NDEs. Eight survivors were interviewed in private. The study was conducted in southeast Iran. In-depth, semi-structured interviews were used for data collection, and probing questions were added when necessary. The duration of the interviews was between 40 and 65 min. According to Lindseth and Norberg, in the naive understanding phase, we read the interviews several times for achieving naive understanding. In the structural analysis phase, the whole text is divided into meaningful units. Finally, the researchers formulated a comprehensive understanding of the contextualization of the text., Results: Four main themes emerged including 1) pleasing experiences along with flying and seeing light, 2) the experience of transport to the beyond, 3) out-of-body experience, and 4) reviewing life and memories in a religious context., Conclusions: Iranian Muslim CPR survivors, reported NDEs, much similar to those reported by survivors in Western countries with different theistic religions. This means that medical professionals dealing with these patients need to be aware of such experiences in Iranian Muslims., Competing Interests: Nothing to declare., (Copyright: © 2020 Iranian Journal of Nursing and Midwifery Research.)

Introduction: Urinary tract infection, as an important health element is associated with the risk of many problems in pregnancy and support consulting is effective factor in reducing the problem. Aim of this study is to evaluate the impacts of integrated intervention on life style (clothing way, food habits, urinary habits, sexual behavior habits) Related to Urinary Tract Infection Among Pregnant women., Method: This interventional used pretest- posttest design with the control group study was performed on 130 healthy pregnant women. The samples were divided randomly into two groups of 65 people. The first group received two sessions of 45 to 60 minutes Psychoeducational counseling, four telephone follow-up support and training pamphlets and the control group received routine education. The relevant questionnaires were completed by both groups before the intervention and a month later. The data were analyzed with Spss V.22 software., Results: Comparing within the groups it was shown that the variables were increased in the experimental group after consulting compared to the conditions before consulting (P < 0.001), however, no increasing was found in the average variables before consulting and after it. Moreover, comparing the variables in two experimental and control groups significant statistical difference was found in different studied areas after consulting (P < 0.0001)., Conclusions: Psychological counseling and phone follow-up are effective in improving the knowledge, attitude, and performance of pregnant women in preventing the urinary infection Therefor it is recommended these trends to be considered as training programs in order to increase capacity and primary prevention of pregnant women., Competing Interests: Conflict of interest statement The authors declare no conflict of interest., (©2020 Pacini Editore SRL, Pisa, Italy.)

Several studies have been conducted among cardiopulmonary resuscitation (CPR) survivors. Some studies have shown that positive and negative experiences coexist. Emotional distress and psychopathology in CPR survivors are related to the urgent need to make growth. Understanding the meaning of CPR survivors' lived experiences of growth may facilitate their growth. The aim of the study was to illuminate the meaning of CPR survivor's lived experiences of growth in southeast Iran. A qualitative design using a phenomenological hermeneutic approach influenced by Ricoeur was used in 12 CPR survivors. Three main themes emerged including: (1) opening up a new horizon in the meaning of life, (2) opening up a new horizon in the meaning of interpersonal connections and (3) opening up a new horizon in the meaning of God and spirituality. The interpreted comprehensive understanding conveyed a meaning that CPR survivors' experience of growth seems to be like opening the doors of perception to the higher reality. The finding may assist other CPR survivors to learn from participants in this study. Exposure to suitable narratives under health care provider supervision could develop profound learning. Training sessions with an emphasis on meditation education and how to use connecting to God in the adaptation process may approve the quality of life of CPR survivors.

Background: This study aimed to determine the relationship among bereavement, depression, and posttraumatic stress disorder (PTSD) in organ donor families in Iran., Methods: This is a correlational study of 96 family members of brain-dead patients whose organs were donated. Using census sampling method, we approached the families through the Kerman University's Organ Donation Center. Data were collected using the Core Bereavement Items, Beck Depression Inventory, and Impact of Event Scale-Revised., Results: The mean (SD) total score of bereavement, depression, and PTSD were 38.44 (9.25), 18.01 (12.92), and 41.90 (12.69), respectively. Among bereavement subscales, the highest mean (SD) score belonged to the "Images and Thoughts" (15.96 [4.16]) and the lowest belonged to "Grief" (10.57 [3.16]). Among different aspects of PTSD, the Intrusion subscale had the highest mean (SD) score (19.25 [6.22]), and the Hyperarousal subscale had the lowest (11.23 [5.34]). The Pearson correlation coefficient showed that bereavement was positively correlated with both depression (r = 0.72, P < .001) and PTSD (r = 0.59, P < .001)., Conclusion: Donor families experienced bereavement, PTSD, and depression after organ donation. Healthcare professionals should approach and assess these families for potential emotional-psychological consequences, provide emotional and practical support to alleviate their depression and PTSD, and assist them through the bereavement process.

Background: Palliative care is an important branch of nursing care. Patients with end-stage renal disease, owing to the chronic nature of the disease, will require palliative care, with nursing staff being responsible for delivering these services. Understanding the priorities of this type of care from the perspective of patients and nursing staff can be helpful in delivering it effectively and efficiently. This study was conducted to determine and compare palliative care priorities from the perspectives of patients and nursing staff in a haemodialysis ward in Iran., Method: This research is a cross-sectional and descriptive-analytic study with a sample size equal to the research population (322 patients and 45 nursing staff) in a haemodialysis ward in Kerman, Iran. Data were collected using two self-administered questionnaires that included demographic information and palliative care priorities. Data were analysed using SPSS19 with central tendency and dispersion indicators (frequency, percentage, mean and standard deviation, Mann-Whitney U-test, Kruskal-Wallis, independent t , ANOVA and one-way ANOVA). The significance level was P <0.05., Results: The mean total score (± standard deviation) of palliative care priorities from the patients' and nurses' perspective was 268.83±3.90 and 271.11±29.76, respectively, which was categorised for both groups as 'high priority'. From the patients' perspective, the highest mean score was obtained from 'supporting patient with insurance concerns', while the lowest mean score was derived from 'managing diarrhoea'. The nurses also believed that 'managing and relief of pain' had the highest priority and 'bloating' had the lowest priority in palliative care. From the perspective of both groups, holistic support and relief of physical disorders had the highest and lowest mean scores, respectively. Further, the mean scores of palliative care priorities did not differ significantly from the perspective of patients and nursing staff in the haemodialysis ward ( P =0.68)., Conclusion: Palliative care is a high priority for both haemodialysis patients and nursing staff and both groups prioritised it similarly. As palliative care has not yet been initiated formally across all treatment centres in Iran, it is necessary to prioritise its inclusion within the renal and haemodialysis wards in Iran and provide further training or education for nurses to ensure they are equipped to deliver effective and informed palliative care.

Objective: Breast cancer treatments not only affect body image but also other aspects of women's lives. Women try to accept their appearance through coping strategies. This study aimed to determine the relationship between body image and coping strategies in women with breast cancer following surgery in southeast Iran., Methods: This is a descriptive study with correlational design. This study recruited 180 women with breast cancer following surgery via convenience sampling (71 women with mastectomy, 109 women with breast conservative surgery). Data were collected by a three-part questionnaire: Background data; Body Image Scale; Body Image Coping Strategies Inventory, and were analyzed by SPSS 19 and descriptive and analytical statistics (independent t, ANOVA, Pearson's correlation coefficient and linear regression)., Results: The mean score of body image was 14.31 ± 6.61 (ranged from 0 to 30), and coping strategies was 46.16 ± 13.26 (ranged from 0 to 87). According to the mean scores, the women were, on average, satisfied with their body image. The most frequent strategy used was "positive rational acceptance" with a mean score of 23.30 ± 6.19 and the least used strategy was "avoidance" with a mean score of 10.35 ± 4.50. A significant relationship was observed between body image and coping strategies (r = .34, p = .001); women who felt worse about their own body image were found to use more coping strategies., Conclusion: Women using positive rational acceptance were likely to report favorable body image. Thus, promoting positive attitude regarding physical appearance and coping skills screening by trained nurses is recommended for all breast cancer patients after their surgery. Such screenings can result in an appropriate flow of information between nurses and patients about the body image and coping skills applied. Being aware of their positive coping strategies can help women, and prepare them to use the coping strategies required to improve their body image and to enhance their quality of life., (© 2019 John Wiley & Sons Ltd.)

Patients with ostomy are faced with several physical, psychological, and social challenges and need to be prepared to overcome these challenges. Studies have shown that training plays an important role in helping patients to adapt with ostomy, live with it, and improve their psychological well-being and quality of life (QOL). Therefore, the present study aimed to determine the effect of structured ostomy care training on QOL and anxiety of the patients with permanent ostomy. In this randomised clinical trial study, 60 eligible participants were recruited from the only ostomy clinic in Kerman, Iran. They were selected using a purposive sampling method and randomly assigned to either a control group that received routine ostomy care or an intervention group that attended oral and practical training and a question and answer session by a trained ostomy nurse and received an ostomy information booklet besides their routine care. Outcome variables were anxiety and QOL in general and its physical, mental, social, and spiritual dimensions in detail. By using the anxiety subscale of Hospital Anxiety and Depression Scale (HADS) and City of Hope-quality of life [COH-QOL], data were collected before and 2 months after intervention in both groups. Data were analysed by SPSS version 19 using χ², analysis of variance (ANOVA), independent t, and paired t test and multiple regression analysis. The results showed that the intervention group had significantly lower mean scores in anxiety (P = .001) and a higher mean score in overall QOL (P = .009) compared with the control group. The most significant increase was observed for psychological, social, and physical aspects, and the least was in the spiritual aspect, all of which improved after intervention. After controlling the effects of confounding variables such as age, ostomy period, and number of children, the structured training programme still had a positive effect on QOL. Structured ostomy care training, including face-to-face education and personal practice of using ostomy equipment, along with written material provided by the ostomy nurse specialist, may lead to an increase in the overall QOL and a decrease in the perceived anxiety level in patients. This type of training is not routinely delivered to ostomy patients in our health care setting, so it is feasible to prepare surgical wards and to educate nurses to work with their patients before and after ostomy creation. Furthermore, to ease patients' religious concerns, we recommend counselling, and the support of religious leaders in the Muslim community may play a key role to adaptation regarding religious matters after ostomy surgeries and alleviate patients' concerns., (© 2019 Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Background: Cancer treatment can be a great source of anxiety and depression for patients. Patients who experience anxiety and depression may be treated with a variety of nonpharmacologic treatments, such as guided imagery., Objectives: The purpose of this article is to determine the effect of guided imagery on patients' anxiety, depression, and other selected side effects prompted by chemotherapy., Methods: This pre- and postintervention assessment randomly selected patients with various types of cancer who were undergoing chemotherapy to listen to a guided imagery audio file for 20 minutes per day for one week. Data collection included a demographic questionnaire, the Hospital Anxiety and Depression Scale, and the Symptom Distress Scale., Findings: A significant decrease in anxiety and depression was noted in the intervention group compared to the control group. No reduction in the mean score for anxiety and depression was observed postintervention for the control group. In addition, patients in the intervention group showed improvement in all side effect categories. Patients in the intervention group reported the greatest rate of improvement in the items of pain, insomnia, appetite, and nausea.

Introduction: Drug abuse is a social event and one of the worse health problems in the current age. Nowadays, the inclination of young people has changed from traditional drugs to more sophisticated and industrial drugs such as ecstasy, glass, and crack. Increasing drug abuse can be sought in families' lifestyles as an effective factor on individuals' health. The disturbance in family functioning can be associated with an individual's antisocial behaviors like addiction. Therefore, the current study is aimed at determining the relationship between lifestyle and family functioning of family members of patients with amphetamine abuse who referred to drug rehabilitation clinics in Southeast Iran., Method: This is a correlational descriptive study conducted on 196 family members of patients with amphetamine abuse who referred to drug rehabilitation clinics in Southeast Iran. Data were collected through the use of demographic, family functioning, and lifestyle questionnaires. Data analysis was performed with SPSS 19 using independent t test, one-way analysis of variance, and Pearson correlation coefficient test., Results: The total mean score of lifestyle was observed to be 105.77 ± 24.39. Among the dimensions of lifestyle, the highest mean score was associated with health responsibility (26.28 ± 7.43), whereas the lowest mean score was associated with exercise (12.7 ± 5.1). In addition, the results showed that the total mean score of family functioning was 129.25 ± 20.97. Among the dimensions of family functioning, the highest mean score was associated with general functioning (26.07 ± 4.92), whereas the lowest mean score was associated with affective responsiveness (13.16 ± 2.88). There was a positive and significant relationship between lifestyle and family functioning, such that the increase in the mean score of lifestyle increased the score of family functioning (r = .34, p = .001)., Conclusion: Because lifestyle is associated with family functioning of patients with amphetamine abuse, basic measures can be taken in families to prevent addiction by increasing information to families, which enhances their lifestyle and functioning.

Research is limited regarding post-traumatic stress disorder (PTSD) and professional quality of life (ProQOL) in Iranian nurses, especially nurses working in psychiatric units. The current study was conducted to determine the relationship between PTSD and ProQOL among psychiatric nurses in Kerman, Iran. This cross-sectional correlational study comprised 160 nurses working in three clinical settings supervised by Kerman University of Medical Sciences. Data were gathered using two questionnaires: PTSD Checklist and ProQOL Scale. Mean total PTSD score was 35.18 (SD = 10.92, range = 17 to 85), indicating nurses experienced moderate PTSD. Among ProQOL domains, burnout had the highest mean score and compassion fatigue had the lowest mean score. According to the Pearson correlation coefficient, PTSD score had a relationship with compassion satisfaction (r = -0.29; p < 0.001), compassion fatigue (r = 0.61; p < 0.001), and burnout (r = 0.36; p = 0.001). The current study results suggest that examining work-related PTSD, burnout, compassion satisfaction, and compassion fatigue in mental health nurses can help identify strategies to improve working conditions and quality of nursing care. [Journal of Psychosocial Nursing and Mental Health Services, 57(3), 39-47.]., (Copyright 2018, SLACK Incorporated.)

Objective: The purpose of this study was to determine the effect of preterm infant massage by the mother on the mood state of mothers of preterm infants., Methods: This experimental study assessed 52 mothers of preterm infants (born at 30-37 weeks of gestation) hospitalized in the neonatal intensive care unit of Afzalipour Hospital of Kerman University of Medical Sciences, Iran. Recruitment was done using the convenience sampling method, and participants were randomly assigned into intervention and control groups. In the intervention group, massage therapy was done once a day for 5 consecutive days. Infants in the control group received the usual care. Data were collected using a questionnaire of demographic information and the Profile of Mood State questionnaire and analyzed using SPSS version 19 (IBM Corp, Armonk, New York) and Kruskal-Wallis, Mann-Whitney U, Wilcoxon, and χ 2 tests., Results: Comparison of the mothers' mean mood scores between the intervention and control groups showed no significant difference before the intervention ( P = .51), whereas mean scores differed significantly after the intervention between the groups ( P = .005). Mothers' mean mood scores improved significantly in the control group ( P = .02) and the intervention group ( P < .001), whereas the intervention group showed a greater improvement (-4.155 vs -2.238)., Conclusion: Those mothers performing massage on their preterm infants showed greater improvement in their mood compared with those in the control group. Teaching massage to the mothers of these infants could be considered as a possible intervention to enhance a mother's mood and the quality of care she provides to her infant.

Background: Patients with coronary artery disease suffer from diminished sexual activity leading to anxiety, stress, and depression. Sexual rehabilitation is the key to the care and treatment process of such patients. Purpose: The present study aimed to examine the effect of sexual rehabilitation program on anxiety, stress, depression and sexual function in men with coronary artery disease. Methods: This was a clinical trial study conducted on 80 male patients suffering from coronary artery disease referred to CCU (Coronary Care Unit) wards in Kerman, Iran. Sample was randomly assigned into two intervention and control groups. The intervention consisted of the sexual rehabilitation program which included two components of education and exercise. Using IIEF (International Index of Erectile Function) and DASS21 (Depression, Anxiety, Stress Scale) anxiety, stress, depression and sexual function have been examined before and one-month after intervention in the two groups. The collected data were analyzed with SPSS version 19 (IBM, Armonk, New York), using descriptive and inferential statistics (such as Pearson correlation coefficient, independent t test, and analysis of variance). Results: Result showed that the intervention group had significantly lower mean scores in anxiety, stress, depression and sexual function compared to the control group ( p  < 0.0001). Conclusion: According to the results, sexual rehabilitation reduced anxiety, stress, and depression and improved sexual function among men with coronary artery disease. Therefore, it is recommended sexual rehabilitation be an integral part of cardiac rehabilitation.

As a result of the complex nature of chronic heart failure (HF), these patients require an interprofessional team approach for care and treatment. This is because an interprofessional approach can manage resources more effectively and improve treatment efficacy. This research was done to evaluate the status of teamwork in caring for HF patients. In this cross-sectional study, the views of 308 members of the care team were collected through the use of Team Assessment Questionnaire (TAQ). The mean and standard deviation of teamwork was 2.4 ± 0.3. There was a significant difference between the teamwork status (total TAQ score) and age, gender and job experience (p < 0.05). The highest mean was for the team leadership dimension of the questionnaire (2.5 ± 0.5) while the lowest was for team foundation (2.4 ± 0.3). Results indicated that the status of teamwork is almost moderate. Teamwork in caring for HF patients was influenced by many factors, including age, gender, and job experience. Teamwork can be enhanced by establishing the equality of women and men's rights, continuous training and attention to proportional age and gender combinations.

Background: Gynecological surgeries associated with loss of feminine organs evoke more personal, interpersonal and psychological distress that may diminish women's quality of life. Women need and seek support to cope with various distresses which may change over the course of diagnosis to treatment. This study aimed to explore Iranian women's needs to cope with hysterectomy and oophorectomy., Methods: This qualitative study was conducted in Kerman and Tehran, Iran from 2015 to 2017. Thirty interviews were conducted with 28 eligible participants including 24 main participants including one gynecologist, one midwife and one nursing faculty member, one gynecologist and one midwife and 2 husbands. They were recruited through purposeful sampling. Data were collected through semi-structured and in-depth interviews and analyzed with Graneheim and Lundman's method of conventional content analysis. The trial version of the MAX QDA 10 Software was used to manage the coding process., Results: "Tender care" emerged as the main theme. It was comprised of three categories: "to be well-informed, "to be treated with compassion in healthcare setting", and "to be welcomed in the society"., Conclusion: Women after hysterectomy/oophorectomy were preoccupied with many physical and emotional concerns. They need a whole package of care which consists of proper information to know what to do, a well-prepared/trained healthcare setting to meet their needs, and visibility in the society as a whole person. A multidisciplinary approach must be activated to meet their coping requirements and it is necessary to address these needs in each level of healthcare services.

Background: Incidence of diabetes Type 1 in children with non-classic symptoms is one of the reasons for the delay in their follow-up. Failure in its diagnosis by the health professional exposes the mothers to many challenges. This study was conducted to explore mothers' experiences in the diagnosis pathway of diabetes Type 1 in children., Methods: Semi-structured qualitative interviews were conducted with fifteen mothers of children with Type 1 diabetes. they were selected by the purposefull sampling method. Their child had a medical file in diabetes centers in Kerman, Iran, at least one year has passed of diabetes diagnosis in their child and the maximum age of the child is 14 years. Data were analyzed using content analysis. Three themes and nine sub-themes emerged during data analysis., Results: The extracted themes included "presence in the maze path to the child's disease", "facing the reality of the child's disease", and "to grin and bear with new conditions"., Conclusions: According to the finding, these mothers experienced various challenges. Therefore, identification of these challenges by health professionals to prevent and decrease of Them, is necessary.

Background: Early motherhood is one of the most important issues in developing countries. Adolescent mothers are not sufficiently prepared to accept the maternal role. How to achieve success in the maternal role should be studied., Objective: To explore the experiences of Iranian adolescent mothers about the maternal role., Methods: This qualitative study was conducted through a conventional content analysis approach from March to December 2016. Face to face in-depth semi-structured interviews were conducted with 18 Iranian teenage mothers in Kerman province, Iran. Participants were selected purposefully and with maximum variation of the age of the first birth, child's age, place of residence and financial status. Data collection continued until data saturation and MAXQDA software was utilized to analyze the collected data., Results: Data analysis resulted in the extraction of the two main categories including optimizing the process of the maternal experience (use of maximum individual capabilities, planning and management of conditions, efforts to acquire maternal competency, and reliance on spirituality) and supporters for the acceptance of the maternal role (social support, professional services of health care providers, time lapse, care history)., Conclusion: Early motherhood is not merely an unpleasant experience; if appropriate strategies and facilitators are used, it can have positive consequences. Health care providers should provide satisfactory services in care, education and support with adequate knowledge of adolescent characteristics. Opportunities in the community should also be directed to support this vulnerable group., Competing Interests: Conflict of Interest: There is no conflict of interest to be declared.

Background: Pressure injuries are the third most expensive condition after cancer and cardiovascular disease. Nurses are responsible for the direct and continuous care, treatment, and prevention of pressure injuries. To achieve optimal quality care, nursing knowledge and attitudes must be based on the best scientific evidence. This study aimed to examine the knowledge and attitudes of nurses working in intensive care units of hospitals affiliated with Zahedan Medical Sciences University regarding the prevention of pressure injuries., Methods: This was a descriptive analytic study involving 89 critical care nurses. Data analysis was conducted using a 3-part questionnaire: demographic data, knowledge, and attitudes of intensive care nurses toward the prevention of pressure injuries. Collected data were analyzed with SPSS version 19 (IBM, Armonk, New York), using descriptive and inferential statistics (such as Pearson correlation coefficient, independent t test, and analysis of variance)., Results: The results showed that the mean ± SD score of pressure injury knowledge was 0.44 ± 0.12, and the attitude of participants toward pressure injury prevention was 2.69 ± 0.47. Scores varied widely; "nutrition" showed the highest mean score (0.71 ± 0.45), but "etiology and development" (0.42 ± 0.21) and "classification and observation" (0.42 ± 0.24) showed the lowest mean scores. Of the different aspects of attitudes toward pressure injury prevention, "the impact of pressure injuries" showed the highest mean score (2.95 ± 0.56), and "confidence in the effectiveness of prevention" showed the lowest mean score (2.56 ± 0.46). A statistically significant relationship was observed between pressure injury knowledge and attitudes toward pressure injury prevention (P < .001)., Conclusions: Pressure injury prevention is one of many nursing care priorities and is a key indicator of the quality of nursing care. In order to achieve optimal quality care in this area, nurse managers and other administrators should make efforts to improve nursing knowledge and attitudes based on the latest scientific evidence for pressure injury prevention.

Aim: This study was done to explore team member's perception regarding impediments to the care of patients with heart failure (HF)., Background: Complex, chronic HF patients require interprofessional teams to address their multiple health needs. Working in a team has some challenges in achieving goals. Sociocultural differences in Iranian therapeutic team members causes some impediments to provide effective care in the form of a team., Methods: Data were collected through unstructured in-depth interviews with 58 team members in caring for the patients with HF. The interviews were transcribed verbatim and analyzed using content analysis., Results: Twelve subcategories and 5 categories were formed: inefficient supportive network, inadequacy of training and treatment, affectability and variability challenges for the team, arduous working conditions, and heavy physicians shadow on nursing. The final theme emerged as "Invisible cobwebs in teamwork.", Conclusion: Despite teamwork being an efficient way of achieving goals, several impediments like a cobweb hinder it from becoming fully exploited. Teamwork has a desirable output when all the members feel the same sense of authority and see themselves in an integrated team and managers have a crucial role in removing these impediments., (Copyright © 2018 John Wiley & Sons, Ltd.)

Background Almost 7.2%-10.6% of patients survive CPR in Iran. Most of them experience post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG). There are limited studies to assessing the correlation between these two psychological outcomes among CPR survivors. Objective This study aimed to examine the correlation between PTSD and PTG among CPR survivors in South-East Iran. Subjects Using Quota sampling, 163 CPR survivors in two provinces in the South-East of Iran were selected to participate in this study. Method A descriptive-correlational study was used to fulfill the aim of the study. The impact of Event Scale-Revised (IES-R) for assessing PTSD and Post-traumatic growth questionnaires were used to assess PTG. Results The mean score of PTSD was 39.89 and according to the cutoff point, 87.1% of participants suffered from PTSD. The mean score of PTG was 78.6. PTSD and PTG had significant negative correlation. The result of multi-variate logistic regression showed that only the PTG score predicted PTSD (Odds ratio = 0.79, CI = 0.72-0.87; and p < 0.001). The result of multi-variate linear regression indicated that PTSD, time passed since CPR, and physical disability caused by CPR predicted PTG score significantly. Conclusion This study provides CPR survivors and health care personnel with some valuable insights about cultural aspects of PTSD and PTG among CPR survivors and that PTG is positively influenced by physical disability and time passed since CPR. CPR survivors may gain positive experience and valuable insight in group meetings and discussions with their counterparts.

Background Analysis of nursing theoretical works and its role in knowledge development is presented as an essential process of critical reflection. Health promotion model (HPM) focuses on helping people achieve higher levels of well-being and identifies background factors that influence health behaviors. Objectives This paper aims to evaluate, and critique HPM by Barnum's criteria. Methods The present study reviewed books and articles derived from Proquest, PubMed, Blackwell Databases. The method of evaluation for this model is based on Barnum's criteria for analysis, application and evaluation of nursing theories. The criteria selected by Barnum embrace both internal and external criticism. Internal criticism deals with how theory components fit with each other (internal construction of theory) and external criticism deals with the way in which theory relates to the extended world (which considers theory in its relationships to human beings, nursing, and health). Results The electronic database search yielded over 27,717 titles and abstracts. Following removal of duplicates, 18,963 titles and abstracts were screened using the inclusion criteria and 1278 manuscripts were retrieved. Of these, 80 were specific to HPM and 23 to analysis of any theory in nursing relating to the aim of this article. After final selection using the inclusion criteria for this review, 28 manuscripts were identified as examining the factors contributing to theory analysis. Evaluation of health promotion theory showed that the philosophical claims and their content are consistent and clear. HPM has a logical structure and was applied to diverse age groups from differing cultures with varying health concerns. Conclusion In conclusion, among the strategies for theory critique, the Barnum approach is structured and accurate, considers theory in its relationship to human beings, community psychiatric nursing, and health. While according to Pender, nursing assessment, diagnosis and interventions are utilized to operationalize the HPM through practical application and research.

Sexual relationships after surgical menopause matter when talking about sex is taboo and marriage is the only justified way to meet sexual needs. In this qualitative research study, 22 surgical menopausal women shared their experiences of sexual/marital relationship after surgery through in-depth, face-to-face, semi-structured interviews. Qualitative content analysis technique was used for data analysis. An overarching theme entitled "feeling an invisible wall" reflected this experience. It comprised three categories: (1) declined marital intimacy, (2) disarming, and (3) transformation of societal norms into concerns. This study proposed new contextual information about the marital relationship of Iranian women after surgical menopause that was not openly articulated before and which may be applicable for others in such contexts. Women's main concern was the emotional separation because of the sexual consequences of the surgery. Healthcare providers should be aware of women's concerns, which may alter their marital relationship. They must provide individualized care, education, and support for couples to make thoughtful decisions about rebuilding their sexual relationship. Results may also have implications for psychiatrists, sex/marital therapists, and probably clergy who have the authority to openly address this important issue to the public.

Background: Following the confirmed type 1 diabetes in children and their discharge from the hospital, the care responsibilities are transferred from nurses to mothers. These mothers are faced with many challenges to play this caring role. The aim of this study was to explore the experiences of the diabetic children's mothers from the transfer of caring role., Methods: In 2016, semi-structured interviews with Eleven Iranian mothers of children (aged≤14 year) with type 1 diabetes were conducted. Data were analyzed using Colizzi's phenomenological method., Results: The following themes emerged in this study: 'Facing the care management challenges,' 'care in the shadow of concern', and 'hard life in the impasse of diabetes'., Conclusion: The mothers of children with type 1 diabetes, who undertake the caring role that has been transferred to them by healthcare providers, are faced with many challenges. They feel a lot of concerns and experience a hard life. Thus, understanding the experiences of these mothers by the health professionals, to improve the quality of care, is necessary.

Early motherhood is a major health challenge in most developing countries. The aim of this study was to explore Iranian mothers' experiences of the outcomes of early motherhood. This qualitative study was done using the conventional inductive content analysis approach. A purposive sample of 18 Iranian mothers, with the experience of early motherhood, was recruited with maximum variation in terms of their age at their first pregnancy, their children's age, place of residence, and financial status. Data collection was done via in-depth semistructured interviews and continued up to data saturation. The MAXQDA software (v. 10.0) was employed for handling the data. Iranian mothers' experiences of the outcomes of early motherhood came into two main categories that were named "realization of the childhood dream of adulthood" and "heavy burden of adulthood on the small shoulders of childhood," The four subcategories of the first category were the acceleration of intellectual and mental maturation, strengthening of family relationships, developing a strong identity, and closer companionship with the child. The second main category also included four subcategories, namely, experiencing numerous difficulties, threats to mothers' physical and mental health, threats to children's health, and missing opportunities. Early motherhood is not merely a negative experience; rather it is also associated with different positive outcomes. Healthcare providers need to provide high-quality prenatal, perinatal, and postnatal care services to adolescent mothers and use available opportunities to strongly support them and their children.

Background and Aim: Information about spiritual needs and quality of life (QoL) is limited in Iranian cancer patients. This study was conducted to determine the relationship between spiritual needs and QoL among cancer patients in Iran., Methods: This correlational study included a convenience sample of 150 eligible cancer patients who were hospitalized in the oncology wards and outpatient clinics. Using two questionnaires; the spiritual needs survey and the European Organization for Research and Treatment of Cancer QoL Questionnaire-C30 data were collected. The data were analyzed by SPSS software version 19., Results: Our findings showed that the total mean score of spiritual needs was (64.32 ± 22.22). Among the categories, the lowest score belonged to "morality and ethics" component (2.18 ± 1.64), and the highest score belonged to "positivity/gratitude/hope/peace" component (15.95 ± 5.47). The mean score of QoL was (79.28 ± 19.20). Among the categories, the lowest score belonged to "global health status" component (8.44 ± 3.64), and the highest score belonged to "functional" component (36.57 ± 10.28). Pearson correlation coefficient showed that spiritual needs score positively correlated with QoL ( r = 0.22; P = 0.006)., Conclusion: The results of the present study suggest that information about the relationship between spiritual needs and QoL in patients with cancer. It should be improve QoL to meet spiritual need of these patients. In addition, the continuous and in-service education of cancer patients and nurses who work with them can be helpful in this area., Competing Interests: There are no conflicts of interest.

Objective: Early motherhood and its impact on mothers, children, families and communities is a prevalent health challenge in developing countries that needs to be urgently explored. The aim of this study was exploring the challenges encountered by Iranian adolescent mothers during the transition to motherhood. Materials and methods: Inductive conventional content analysis approach was used in this qualitative study. Face to face in-depth semi-structured interviews were conducted with 16 Iranian teenage mothers in the Kerman province of Iran from March to December2016. Data collection continued until the point of data saturation and MAXQDA software was utilized in the analysis of the data. Results: Six main categories increasing burden of responsibility, experiencing physical problems, receiving insufficient support, inefficiency in maternal role, emotional and mental distress; and role conflict and 18 sub-categories were extracted from the data analysis. Conclusion: The findings of this study showed that adolescent mothers experience many physical, psychological, mental and social challenges. Therefore, it is expedient that special attention and care support is made available to them by health care providers. A comprehensive understanding of the challenges encountered by adolescent mothers, will aid the development of culturally appropriate health promotion guidelines and strategie.

Background: End of life (EOL) care is newly established in the Iranian context. Context, in this case, refers to the internal and external manifestation of the nurse values, norms and experiences that are learnt throughout life., Aim: The aim of this study was to explore nurses' experiences of caring for dying patients in Iran., Methods: A phenomenological hermeneutic approach, influenced by the philosophy of Ricoeur, was used to analyse 10 oncology nurses' experiences of caring for dying persons., Findings: Three themes emerged from the analysis: 1) seeing the patient as unique person, 2) being present and open to seeing patients as unique persons and 3) personal and professional development as a result of closeness between nurse and patient. Caring for dying persons means assisting them at the end of their lives., Conclusion: Caring relationships underlie professional palliative care and are essential in EOL care. Proper palliative education and professionally led supervision should be included in the Iranian nursing curriculum.

Background: The objective of this study was to examine the effect of guided imagery on chemotherapy induced nausea and vomiting in breast cancer patients., Design: This was a quasi-experimental study in which a group of sample was evaluated pre and post intervention. A convenience sample of 55 eligible breast cancer patients enrolled to participate in this study after giving informed consent. They completed the Morrow Assessment of Nausea and Vomiting, before and after the intervention. The intervention consisted of listening to the two guided imagery tracks., Findings: After the intervention, patients at the third session of chemotherapy had significantly lower mean scores in the frequency and severity of nausea and vomiting pre and post chemotherapy (p < 0.05)., Conclusions: Guided imagery, as an inexpensive and noninvasive method, is particularly appealing option to alleviate chemotherapy induced nausea and vomiting. It can be used in addition to pharmacological strategies and can be implemented by patients independently with sufficient training. Therefore, this therapy will considerably improve severity and frequency of chemotherapy induced nausea and vomiting., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The loss of a loved one is a highly stressful event that nearly everyone experiences. Multiple losses can leave relatives feeling overwhelmed or stuck in their grief, a phenomenon commonly referred to as bereavement overload. This study aimed to elucidate the meaning of prolonged grief from the viewpoint of the survivors of the Bam earthquake (Iran, December 2003) 11 years after the earthquake in south eastern Iran. Family members who lost loved ones in the Bam earthquake were considered potential participants. A total of 12 survivors participated in this study. The interviews were analyzed with Ricoeur's phenomenological hermeneutic method. The meaning of prolonged grief was comprehensively understood as "being under the umbrella of persistent grief." This can be divided into four themes: experiencing a divine and painful destiny, experiencing heartbreaking goodbye with loved ones, losing all hopes and dreams, and being in a state of fragile peace. The results in this study suggest survivors of the Bam earthquake grief can be moderated by adequate crisis-related coping resources such as social, cultural, and religious supports. These supports are clearly important to survivors' post-earthquake recovery.

Background: Diabetes continuously disrupts a patient's well-being and quality of life. Successful self-care could potentially decrease overall costs and rates of mortality and morbidity. Patients' experiences could be used to elucidate what they believe about illness and its management. The overall aim of this study was to illuminate the meaning of self-care among diabetic patients in Southeast of Iran., Methods: Sixteen diabetic patients with a mean age of 34 and 10 years' experience in self-care for their disease were interviewed. The interviews were recorded, transcribed verbatim, and analyzed with a Ricoeur's phenomenological hermeneutic method., Results: The meaning of self- care was comprehensively understood as being empowered. This can be divided into four themes: seeking information, being independent, being optimistic or pessimistic and trust in God., Conclusion: The results in this study suggest that cultural and religious components could affect diabetic patients' self-care. Nurses might use patients' religious beliefs to relieve their stress, help them to retain a sense of control, maintain hope and sense of meaning and purpose in their life.

Aim: Bam earthquake and its profound tragedy of thousands killed has caused emotional and psychological trauma for tens of thousands of people who have survived. This study aimed to investigate general health of parents who lose their children in Bam earthquake 10 years after the earthquake., Method: General health of 166 parents who lost their children in Bam earthquake was assessed using a translated version of General Health Questionnarie-28 items., Results: The mean score of GHQ was 25.63±15.28. Among all domains, the higher mean score belonged to the category of "anxiety/insomnia" and the lower one belonged to the category of "severe depression". The results revealed significant correlation between total GHQ mean score and gender as well as educational level (0.003)., Conclusion: Providing reflective narrative environments in which survivors can express their own experiences and feelings about earthquake, their loss and how they cope with it seems to be as an effective approach to identify their psychosocial situation and its influential factors. In such narrative environments special attention should be given to older participants, females and those who are single.

Background: The increasing incidence of multiple sclerosis (MS) over the previous decade in Iran has been examined in the literature. This chronic and unpredictable disease creates psychological impairment, including uncertainty, among patients. It is important to examine the extent of uncertainty experienced by patients with MS and their spiritual wellbeing. It could also be useful to assess the relationship between these two variables., Purpose: This study was conducted to examine the relationship between spiritual wellbeing and uncertainty among MS patients in south-east Iran., Method: The sample in this cross-sectional, descriptive study comprised 200 non-hospitalised patients with MS referred to a disease centre in Kerman (south-east Iran). Using the Mishel Uncertainty in Illness Scale (MUIS-C) and spiritual wellbeing scale (SWB), data were collected and analysed., Results: The study results showed that the total mean score of SWB was 93.81 (SD=15.25). The mean score of the sub-scale of religious wellbeing was greater than the sub-scale of existential wellbeing (50.80 vs 43.01). The mean score of uncertainty scale was 67.20 (12/35). The highest mean score belonged to the sub-category of ambiguity (32.24±7.90). Pearson correlation test showed that perceived uncertainty score negatively correlated with spiritual wellbeing (r=-0.345; p=0.000), existential wellbeing (r=-0.421; p=0/00) and religious wellbeing (r=-0.172; p=0.015)., Conclusion: MS patients should be offered opportunities to reflect on their experiences, feelings, actions and reactions to spirituality to enhance the possibility of using their personal experiences as part of positive and constructive learning. The study results suggest that information about spirituality and spiritual care should be included in the continuous and in-service education of MS patients and nurses working with them.

Objective: Palliative care requires nurses to be knowledgeable about different aspects of the care that they provide for dying patients. This study, therefore, was conducted to examine oncology and intensive care nurses' knowledge about palliative care in Southeast Iran., Method: Using the Palliative Care Quiz for Nursing (PCQN), 140 oncology and intensive care unit (ICU) nurses' knowledge about palliative care in three hospitals supervised by Kerman University of Medical Sciences was assessed., Results: In PCQN, the mean score was 7.59 (SD: 2.28). The most correct answers were in the category of management of pain and other symptoms (46.07%). The lowest correct answers were in the category of psychosocial and spiritual care (19.3%)., Significance of Results: These findings suggest that nurses' knowledge about palliative care can be improved by establishing specific palliative care units to focus on end-of-life care. This establishment requires incorporation of an end-of-life nursing education curriculum into undergraduate nursing studies.

Spiritual care is an essential component in nursing practice and strongly influenced by the sociocultural context. This article aimed to elucidate the meaning of nurses' experiences of giving spiritual care in southeast of Iran. A phenomenological hermeneutic approach influenced by Ricoeur was used. Eleven staff nurses who were currently working in the 3 major hospitals under the umbrella of the Kerman University of Medical Sciences were interviewed. The meaning of spiritual care was comprehensively understood as meeting patient as a unique being. This can be divided into 3 themes: meeting patient as a being in relationship, meeting patient as a cultural being, and meeting patient as a religious being. The results in this study suggest that education about spirituality and spiritual care should be included in the continuous and in-service education of registered nurses. Spiritual and cultural assessment criteria should be included in this education to improve the provision of holistic care.