The Mediating Role of Spiritual Health in Adherence to Treatment in Patients with Cancer

Background: Adherence to the treatment regimen is among the behaviors, which predict the successful control of the disease and decrease its intensity and negative consequences, which is influenced by several factors. The patient’s beliefs and attitudes toward the disease are effective factors in disease management and adherence to treatment, and spiritual health is one of these influential variables. Objectives: The aim of this study was to determine the mediating role of spiritual health in adherence to treatment in patients with cancer. Methods: In this descriptive correlational study, the participants were 234 Iranian patients with cancer, who were selected through convenience sampling, admitted to the oncology wards of 9 selected teaching hospitals in the northern, southern, eastern, and western provinces of the country, as well as the capital in 2021. The research instruments included the Demographic and Clinical Information Questionnaire, Spiritual Well-Being Scale, and Morisky Medication Adherence Scale-8. The path analysis was done to determine the factors related to the degree of adherence to treatment, taking into account the mediating role of spiritual health. Results: The mean age of the participants in the study was 47.27 ± 15.36. The mean scores for spiritual health and adherence to treatment were 76.70 ± 13.75 and 6.47 ± 2.1, respectively. A positive and significant relationship was found between spiritual health and adherence to treatment (P-value < 0.05). The variables of marital status, the time of diagnosis, and being a religious person had a direct effect on spiritual health, and the time of diagnosis indirectly affected treatment adherence. Conclusions: According to the results, the level of spiritual health and adherence to the treatment in patients with cancer was moderate. In addition, the variable of diagnostic time affected adherence to treatment indirectly. Besides, in examining the factors affecting spiritual health, the findings indicated the effect of the variables “being religious”, “marital status”, and “the time of diagnosis”. In addition to strengthening spiritual health, it is necessary to highlight the need to follow therapeutic diets in these patients. Therefore, it is suggested to consider a program to meet the patients with cancer spiritual needs along with the physical care program.info:eu-repo/semantics/publishedVersio

Psychometric properties of Persian version of wound-QOL questionnaire among older adults suffering from chronic wounds

BackgroundPatients with chronic wounds experience various biopsychosocial problems which severely affects their quality of life (QoL). Thus, a Persian instrument to assess the QoL of these patients is required. This study aimed to determine the psychometric properties of the Persian version of the wound-QOL questionnaire.MethodsThis methodological study was performed on Iranian patients during 2021–2022. The translation was carried out via forward-backward method. Face validity was addressed with 10 patients and content validity with 12 wound specialists. Construct validity was also assessed by performing exploratory factor analysis (EFA) (n = 100) and convergent validation with EQ-5D-3L plus Pain VAS Score and known-groups validity. The reliability was assessed by internal consistency using Cronbach’s alpha coefficient and test–retest.ResultsA total of 100 patients with chronic wounds were included in the study. Two factors with cumulative variance of 65.39% were extracted during EFA. The results revealed a significant and high correlation between the total scores of wound-QOL questionnaire, the Persian version of EQ-5D-3L (p = 0.000, r = 0.502), and Pain score (0–10; p = 0.000, r = 0.627). The Cronbach’s alpha was 0.743 and stability of the questionnaire (α = 0.872) was confirmed. In confirming the known-groups validity, the results showed that this tool can differentiate the QOL of patients with different wounds.ConclusionThe Persian version of the wound-QOL questionnaire is a valid and reliable questionnaire which can measure the QoL of patients with chronic wounds. This instrument can be used in clinical evaluation as well as research purposes across the Iranian population

The predictors of spiritual dryness among Iranian cancer patients during the COVID-19 pandemic

BackgroundSpiritual struggles affect the wellbeing of religious people. Among them are strugglers with God which is perceived as non-responsive and distant. These perceptions were so far analyzed predominantly in Western societies with a Christian background, but not in Muslims from Iran. The aim of this study was to determine the predictors of spiritual dryness among cancer patients in Iran during the COVID-19 pandemic.MethodsCross-sectional study with standardized questionnaires (i.e., Spiritual Dryness Scale, WHO-5, BMLSS-10, Awe/Gratitude Scale) among 490 cancer patients (mean age 49.50 ± 14.92 years) referring to the selected educational hospitals in Tehran (the capital of Iran), who were selected through convenience sampling and based on the inclusion criteria, enrolled between December 2020–May 2021. Data analysis was done using SPSS software version 26 and the statistical methods including calculating the mean and the standard deviation, correlation coefficients, as well as regression analysis.ResultsThe overall experience of spiritual dryness was perceived regularly in 10.2% of Iranian cancer patients, sometimes in 22.9%, rarely in 22.9%, and never in 43.3%. The mean ± SD was 25.66 ± 5.04, and the scores ranged from 10 to 55. A higher score means greater spiritual dryness. The strongest predictors of spiritual dryness were praying activities Furthermore, the perception of burden due to the pandemic was positively correlated with spiritual dryness. Moreover, each 1 unit increase in its score changed the spiritual dryness score by 0.2 units. The regression of spirituality-related indicators, demographic-clinical variables, and health-related behaviors accounted for 21, 6, and 4% of the total SDS variance, respectively. These findings show that with an increase in praying, performing daily prayers, and the indicators related to spirituality, spiritual dryness will decrease. Most patients were able to cope with these phases often or even regularly, while 31.1% were never or rarely only able to cope.ConclusionThe results of this study showed that in times of crisis, cancer patients’ faith and confidence in God could be challenged. It is not the disease itself which seems to be associated with this form of crisis, but their religious practices. Therefore, it is necessary to support these patients during their struggle, especially as spirituality is one of the best approaches to cope with the disease

Policy analysis of education transformation plan in Iran’s health system using Walt Gilson model

Background & Objective: Meeting the health needs of the community is the main mission of the field of medical education. Accordingly, the program of transformation and innovation in medical education has been developed as a strategic policy in the field of education in the form of 11 operational packages. Therefore, this aimed at policy analysis of the education transformation plan in the Iranian health system. Materials & Methods: This directed qualitative study was conducted using the Walt and Gilson model. Data were collected using three stages: literature review, analysis of relevant policy documents, and semi-structured interviews. All sources and texts of the interviews were coded and analyzed in the form of categories related to the dimensions of the policy model framework. Results: A total of 15 articles and 73 documents met the inclusion criteria and were included in the analysis in the present study. According to the analysis, 248 concepts were extracted, which resulted in 73 subclasses, 11 main subclasses, and 3 main classes after merging common concepts. The main categories included requirements of implementation, legislation, policymaking, and infrastructure management. Conclusion: The implementation of the transformation and innovation program in the field of health system education requires paying attention to the political, legal, economic, social, and international factors as well as the existing problems. In addition, the proper implementation of this program requires the participation of internal and external stakeholders in the stages of policy-making, implementation, and evaluation

Depression and Anxiety among Parents of Children with Blood Disease in Ahvaz, South West of Iran

Background Existence the children with blood diseases in family could cause lots of stress and anxiety for parents, this stress among parents would negative effects on children's disease process and his response to treatment. Materials and Methods This is a descriptive-analytical study which carried out on 480 parents with children affected to blood disease referring to Shafa hospital of Ahvaz, Iran.  The parents’ level of anxiety was evaluated using the Hospital Scale for Anxiety and Depression. In this study Sample size by using statistical formulas was selected 480 persons by available sampling. Data were analyzed using SPSS-16 software. Results Results showed that in 20.4% (98 cases) of parents level of anxiety was intense, in 50.7% (243 cases) level of anxiety was middle, in 15.6% (75 cases) level of anxiety was low and 13.3% (64 cases) of parents were lack of anxiety. Additionally the results of level depression study showed that 8.6% (41cases) of parents had severe depression, 35.7% (171 cases) moderate depression, 15.7% (76 cases) low depression and 40% (192 cases) no depression. According to the results of this study, there was a significant difference between level of anxiety and depression of parents and the duration of child's hospitalization (

The Relationship between Patient Safety Friendly Hospital Standards and Nurses' Safety Performance during Corona Pandemic

زمینه و هدف: عملکرد ایمن کارکنان به ویژه پرستاران و محیط كاری نقش تعیین‌كننده‌ای در كیفیت و ایمنی مراقبت از بیمار دارد. شیوع پاندمی کرونا منجر به درجه بالایی از عدم اطمینان شده است و نظام‌های سلامت را مملؤ از انواع چالش‌ها کرده است. مطالعه حاضر با هدف بررسی ارتباط استانداردهای بیمارستان دوستدار ایمنی بیمار با عملکرد ایمنی پرستاران در دوران پاندمی کرونا در سال 1399 انجام شده است. مواد و روش‌ها: مطالعه حاضر یک پژوهش توصیفی ـ همبستگی از نوع مقطعی است که بر روی 266 پرستار مجتمع بیمارستانی امام خمینی تهران که شرایط ورود به مطالعه را داشتند، به شیوه نمونه‌گیری تصادفی طبقه‌ای انجام شده است. ابزار جمع‌آوری اطلاعات پرسشنامه‌ای متشکل از سه قسمت شامل اطلاعات دموگرافیک پرستاران، استانداردهای بیمارستان دوستدار ایمنی بیمار پرویزی و همکاران و عملکرد ایمنی پرویزی و همکاران بود. برای توصیف داده‌ها از جداول توزیع فراوانی، شاخص‌های مرکزی (میانگین و میانه) و شاخص‌های پراکندگی (واریانس و انحراف معیار) استفاده شد. برای بررسی همبستگی بین استانداردهای دوستدار ایمنی بیمار با عملکرد ایمنی پرستاران از آزمون همبستگی پیرسون با استفاده از نرم‌افزار SPSS 16 استفاده شد. یافته‌ها: میانگین و انحراف معیار مجموع استانداردهای بیمارستان دوستدار ایمنی بیمار از دیدگاه پرستاران مورد پژوهش برابر با 59/16±35/97 بود. میانگین و انحراف معیار عملکرد ایمنی پرستاران برابر با 37/10±36/59 به دست آمد که هر دو متغیر در سطح متوسط قرار داشتند. علاوه بر این بین استانداردهای بیمارستان دوستدار ایمنی بیمار و کلیه ابعاد آن با عملکرد ایمنی همبستگی مثبت و معنی‌داری وجود داشت (843/0=r، 001/0&gt;P). ملاحظات اخلاقی: این مقاله حاصل پایان‌نامه کارشناسی ارشد پرستاری دانشگاه علوم پزشکی تهران است. در طول فرایند پژوهش اصول اخلاقی در پژوهش‌های دارای آزمودنی انسانی در براساس راهنمای جمهوری اسلامی ایران ، از جمله اخذ رضایت آگاهانه جهت شرکت در پژوهش رعایت شد. نتیجه‌گیری: با توجه به نتایج این مطالعه، به نظر می‌رسد بازبینی راهبردها شامل مدیریت هدفمند و مبتنی بر شواهد منابع سازمانی با‌ رویکرد‌ جامع دربرگیرنده ‌موانع تحقق ‌ابعاد‌ ایمنی، نهادینه‌نمودن ‌فرهنگ ‌ایمنی‌ بیمار و ارتقای جو ایمنی، توجه و تمرکز به شاخص‌های ایمنی بیمار در بیمارستان‌ها ضرورت دارد.Background and Aim: Safe operation of staff, especially nurses and the work environment have a decisive role in the quality and safety of patient care. The outbreak of the corona pandemic has led to a high degree of uncertainty and has filled health systems with a variety of challenges. Therefore, the present study aimed to investigate the relationship between patient safety friendly hospital standards and nurses' safety performance during the corona pandemic in Tehran in 2020. Materials and Methods: The present study is a cross-sectional descriptive-correlational study that was performed on 266 nurses of Imam Khomeini Hospital in Tehran who met the inclusion criteria by stratified random sampling. The data collection tool was a questionnaire consisting of three parts including nurses' demographic information, patient safety friendly standards of Parvizi et al. And Parviz et al. Frequency distribution tables, central indices (mean and median) and dispersion indices (variance and standard deviation) were used to describe the data. Pearson correlation test was used to evaluate the correlation between patient safety friendly standards and nurses' safety performance using SPSS 16 software. Findings: The mean and standard deviation of all patient safety friendly hospital standards from the perspective of the nurses was 97.35±16.59. The mean and standard deviation of nurses' safety performance was 59.36±10.37. Both variables were in the middle level. In addition, there was a positive and significant correlation between patient safety friendly hospital standards and all its dimensions with safety performance (r=0.843, P&lt;0.001). Ethical Considerations: This article is the result of a master of sciences nursing dissertation at Tehran University of Medical Sciences. During the research process, the ethical principles in research with human subjects were observed based on the guidelines of the Islamic Republic of Iran/ including obtaining informed consent to participate in the research. Conclusion: Therefore, according to the results of this study, it seems that the review of strategies including purposeful and evidence-based management of organizational resources with a comprehensive approach including barriers to achieving safety dimensions, institutionalizing patient culture, safety and promoting safety atmosphere, focus on the index Patient safety measures are needed in hospitals. &nbsp; Cite this article as: Hajibabaee F, Esmaeili M, Ashrafizadeh H, Farahani M, Haghani SH, Ariyamloo P. The Relationship between Patient Safety Friendly Hospital Standards and Nurses' Safety Performance during Corona Pandemic. Med Ethics J 2021; 15(46): e1

Comparison of Moral Intelligence of Student’s Basic Sciences and Medical Internship in Tehran University of Medical Sciences in 2018

زمینه و هدف: هوش اخلاقی به عنوان اولین مؤلفه انطباق اخلاقی، پایه و اساس عمل اخلاقی است. دانشجویان پزشکی که در محیط‌های بالینی آموزش می‌بینند، علاوه بر شایستگی‌های فنی، بایستی از ارزش‌های اخلاقی مطلوب برخوردار باشند. این مطالعه با هدف مقایسه وضعیت هوش اخلاقی دانشجویان مقطع علوم پایه و کارورزی پزشکی دانشگاه علوم پزشکی تهران در سال 1397 انجام شده است. مواد و روش‌ها: این مطالعه مقطعی از نوع توصیفی ـ مقایسه‌ای بر روی 400 نفر از دانشجویان پزشکی در دو مقطع علوم پایه و کارورزی که به صورت تصادفی ساده انتخاب شده بودند و معیارهای ورود به مطالعه را داشتند، انجام شده است. برای جمع‌آوری داده‌ها از پرسشنامه 40 گویه‌ای هوش اخلاقی Keil و Lennick استفاده شد که دربرگیرنده چهار بعد و ده شاخص بود. برای تجزیه و تحلیل داده‌ها از نرم‌افزار SPSS 25 و آزمون‌های T-test، Chi-Square استفاده شد. یافته‌ها: میانگین نمره کل هوش اخلاقی در گروه کارورزی 78/7±13/72 و میانگین نمره کل هوش اخلاقی در گروه علوم پایه 28/8±11/72 بود. میانگین نمره کل هوش اخلاقی بیشتر کارورزان (7/62 درصد) و دانشجویان علوم پایه (7/60 درصد) در طبقه خوب به بالا بدست آمد. حدود 3/37 درصد از کارورزان و 3/39 درصد از علوم پایه دارای هوش اخلاقی ضعیف بودند. میانگین نمره کلی هوش اخلاقی در دانشجویان مقطع کارورزی نسبت به علوم پایه بالاتر بود، اما این اختلاف معنی‌دار نبود (026/0=P-Value). ملاحظات اخلاقی: این مقاله حاصل پایان‌نامه دکتری حرفه‌ای دانشگاه علوم پزشکی تهران است. در طول فرایند پژوهش سیاست‌های اخلاقی دانشگاه مطابق با اصول بیانیه هلسینکی، از جمله اخذ رضایت آگاهانه جهت شرکت در پژوهش رعایت شد. نتیجه‌گیری: شاخص‌های هوش اخلاقی در کارورزان نسبت به دانشجویان علوم پایه بیشتر نبوده است و این یافته‌ها نشانگر عدم موفقیت برنامه‌های آموزشی عمومی و اختصاصی در زمینه توسعه مهارت‌های اخلاقی در دانشجویان پزشکی است. بنابرین بازنگری کوریکولوم آموزش پزشکی با در نظرگرفتن مفاهیم اخلاقی پیشنهاد می‌شود.Background and Aim: Moral intelligence as the first component of moral compliance is the basis of moral action. Medical students trained in clinical settings, in addition to technical competencies, must have desirable moral values. The aim of this study was to compare the moral intelligence status of students of basic sciences and medical internships in Tehran University of Medical Sciences in 2018. Materials and Methods: This descriptive-comparative cross-sectional study was performed on 400 medical students in both basic sciences and internships who were randomly selected and met the inclusion criteria. A 40-item Moral Intelligence and Keil Lennick Questionnaire was used to collect data, which included four dimensions and ten indicators. SPSS 25 software and Chi-square t-test were used to analyze the data. Findings: The average total score of moral intelligence in the internship group was 72.13±7.78 and the mean total score of moral intelligence in the basic sciences group was 72.11±8.28.The average total score of moral intelligence of most interns (62.7%) and basic science students (60.7%) was obtained in a good category. About 37.3% of interns and 39.3% of basic sciences had poor moral intelligence. The mean total score of moral intelligence in internship students was higher than basic sciences, but this difference was not significant (P=0.026). Ethical Considerations: This article is the result of a professional doctoral dissertation at Tehran University of Medical Sciences. During the research process, the university's ethical policies were observed in accordance with the principles of the Helsinki Declaration, including obtaining informed consent to participate in the research. Conclusion: Indicators of moral intelligence in interns were not higher than students of basic sciences and these findings indicate the failure of general and specific educational programs in the field of developing moral skills in medical students. Therefore, it is recommended to revise the medical education curriculum by considering ethical concepts. &nbsp; Cite this article as: Hajibabaee F, Yazdani Moghaddam M, Namazi HR, Yaseri M, Ashrafizadeh H, Shojaee AA. Comparison of Moral Intelligence of Student’s Basic Sciences and Medical Internship in Tehran University of Medical Sciences in 2018. Med Ethics J 2020; 14(45): e22