Living with cancer challenges: a qualitative analysis of cancer patients’ perceptions in Iran

Aim Cancer patients are confronted with different challenges. The purpose of current study was to explore Iranian cancer patients’ perceptions of these challenges. Subjects and methods The study took a qualitative approach. Semi-structured interviews were held with 26 cancer patients in four university hospitals in Iran. Transcripts of the interviews underwent conventional content analysis, and categories emerged. Results The findings came under two major categories: psychological challenges and socio-cultural challenges. Psychological challenges had two subcategories: repressed wishes, and negative feelings. Socio-cultural challenges also had two subcategories: deteriorated relationships and work distress. Conclusion Findings of the current study have potential to identify psychosocial challenges of cancer patients. These findings propose that psychological support is essential for them. Our results recommend that healthcare providers should work to remain sensitive to cancer patients’ challenges. There is a need for culture-based caring programs that are responsive to these patients

Perceived factors to providing palliative care for patients with cancer - a qualitative systematic review

Palliative care (PC) is one of the necessary cares given throughout a patient's experience with cancer. The aim of this study was to identify the perceived factors to providing PC for patients with cancer. Our study was a systematic review of qualitative literature. To this end, electronic databases, including CINAHL, PubMed, PsycINFO, Ovid, and Web of Science as well as Persian databases were searched and qualitative studies on the role of PC in patients with cancer published between Jan 2008 and Dec 2017 were selected. Generally, 12 studies were reviewed. A thematic synthesis approach was used to analyze the data. Exploring the selected articles, the findings on the perceived factors to providing PC for patients with cancer were categorized into three themes, including organizational factors, ethical factors, and psychological factors. This qualitative systematic review expands our knowledge about factors influencing the provision of PC for patients with cancer. It is necessary for health system managers and caregivers to pay attention to all aforesaid factors in order to improve PC for cancer patients

Psychosocial Distress as a Factor in Patients With Cancer Seeking Support: A Hermeneutic Study

Cancer is one of the main causes of human death in the world, but its mortality rates have been in continual decline for the past 20 years (Siegel, Miller, & Jemal, 2015). It is a growing problem in Middle Eastern countries (Daher, 2011). In Iran, an ancient country in the Middle East (Borimnejad, Mardani-Hamooleh, Seyedfatemi, & Tahmasebi, 2014), cancer is the third most common cause of death, after heart disease and traffic accidents. The incidence of cancer in Iran is anticipated to be around 48 to 112 and 51 to 144 cases per year per million people for women and men, respectively (Seyedfatemi, Borimnejad, Mardani-Hamooleh, & Tahmasebi, 2014). As the incidence of new cases of cancer increases every year, breaking bad news to patients is very important. Bad news is described as any piece of information that could potentially be directed to negatively change a patient’s expectations, ideas, feelings, or outlook (Salem & Salem, 2013). Breaking bad news to patients with cancer is a delicate and challenging task for most health-care providers (Eng, Yaakup, Shah, Jaffar, & Omar, 2012). Bad news about cancer creates pain for patients (Zebrack, Chesler, & Kaplan, 2010). It is unexpected and often may come as a shock (Yoo, Levine, Aviv, Ewing, & Au, 2010). In this regard, despite efforts by family members to conceal cancer diagnoses from patients, the majority of patients discovered the diagnosis of their own accord (Wang, Guo, Peng, Su, & Chen, 2011). Breaking bad news to patients with cancer is diverse across different cultures (Table 1). Nondisclosure is the norm for Iranian people. However, health-care workers often want to tell patients of their diagnosis but worry that breaking bad news could evoke fear and anxiety for patients. In fact, it is difficult for health-care workers to predict cancer patients’ responses following disclosure. Therefore, a significant percent of cancer patients in many Mediterranean countries, such as Iran, are not made aware of their diagnosis, and many health-care workers prefer to disclose the cancer diagnosis directly to patients’ family members. However, the clinical experiences of the researchers show that family members rarely transfer this information to patients, and frequently prevent the disclosure of the cancer diagnosis

Living with cancer challenges: a qualitative analysis of cancer patients� perceptions in Iran

Aim: Cancer patients are confronted with different challenges. The purpose of current study was to explore Iranian cancer patients� perceptions of these challenges. Subjects and methods: The study took a qualitative approach. Semi-structured interviews were held with 26 cancer patients in four university hospitals in Iran. Transcripts of the interviews underwent conventional content analysis, and categories emerged. Results: The findings came under two major categories: psychological challenges and socio-cultural challenges. Psychological challenges had two subcategories: repressed wishes, and negative feelings. Socio-cultural challenges also had two subcategories: deteriorated relationships and work distress. Conclusion: Findings of the current study have potential to identify psychosocial challenges of cancer patients. These findings propose that psychological support is essential for them. Our results recommend that healthcare providers should work to remain sensitive to cancer patients� challenges. There is a need for culture-based caring programs that are responsive to these patients. © 2017, Springer-Verlag GmbH Germany

Concept analysis of human dignity in patient care: Rodgers� evolutionary approach

Human dignity (HD) in patient care is an important concept in clinical ethics that has various definitions in existing literature. This study aimed at analyzing the concept of HD in patient care. To this end, Rodgers� evolutionary concept analysis was used. For this purpose, scientific databases PubMed, Elsevier, ScienceDirect, Scopus, OVID, Web of Science, CINHAL, IRANDOC, Google Scholar, Magiran, SID and IranMedex were searched fusing the words �human dignity�, �patient care� and �ethics�. The main criterion for inclusion in the final analysis was the literature published in English and Persian from 2006 to 2016 in online scientific journals within the context of health care disciplines. Ultimately, 21 articles were selected for the study. The attributes of the concept under study were identified in two areas of individual HD and social HD. Antecedents included facilitators and threats, and the consequences consisted of both favorable and unfavorable consequences. HD forms the essence of patient care and is a value-based and humanistic concept based on respect for the integrity of human beings and their beliefs. This concept, with its holistic approach to humans, takes into account all stages of disease, old age and the end of life period. HD in patient care is influenced by cultural, social, spiritual and religious factors, and with its justice-based approach emphasizes equality of all patients and extends patient care to all areas of society rather than restricting it to hospital settings. In this study, a clear definition of HD is introduced. © 2018 Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences. All rights reserved

Concept analysis of human dignity in patient care: Rodgers� evolutionary approach

Human dignity (HD) in patient care is an important concept in clinical ethics that has various definitions in existing literature. This study aimed at analyzing the concept of HD in patient care. To this end, Rodgers� evolutionary concept analysis was used. For this purpose, scientific databases PubMed, Elsevier, ScienceDirect, Scopus, OVID, Web of Science, CINHAL, IRANDOC, Google Scholar, Magiran, SID and IranMedex were searched fusing the words �human dignity�, �patient care� and �ethics�. The main criterion for inclusion in the final analysis was the literature published in English and Persian from 2006 to 2016 in online scientific journals within the context of health care disciplines. Ultimately, 21 articles were selected for the study. The attributes of the concept under study were identified in two areas of individual HD and social HD. Antecedents included facilitators and threats, and the consequences consisted of both favorable and unfavorable consequences. HD forms the essence of patient care and is a value-based and humanistic concept based on respect for the integrity of human beings and their beliefs. This concept, with its holistic approach to humans, takes into account all stages of disease, old age and the end of life period. HD in patient care is influenced by cultural, social, spiritual and religious factors, and with its justice-based approach emphasizes equality of all patients and extends patient care to all areas of society rather than restricting it to hospital settings. In this study, a clear definition of HD is introduced. © 2018 Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences. All rights reserved

The Impact of a Stress Management Program on the Stress Response of Nurses in Neonatal Intensive Care Units: A Quasi-Experimental Study

This study was conducted with the aim to determine the effect of a stress management program on the response to stress by nurses working in neonatal intensive care units. This quasi-experimental study was conducted on 70 nurses in Iran. The nurses were assigned to the 2 groups: experimental and control groups, with each group comprising 35 participants. The McNamara education program was used for nurses in the experimental group. The response to stress in both groups was reviewed pre-and postintervention and 8 weeks after the intervention using the Stress Response Inventory. The 2 groups had no significant differences in terms of stress response preintervention (t = 0.668, P =.506). The mean scores in the experimental group were higher preintervention than those obtained postintervention, and the difference between them was significant. These findings indicate that the program has led to stress reduction in the experimental group. © 2019 Wolters Kluwer Health, Inc

Correlation between moral sensitivity and self-esteem in nursing personnel

Nurses are continuously involved with ethical problems in their area of practice and need to possess a satisfactory level of moral sensitivity in order to be able to offer moral care. Additionally, they act as agents for proper management of ethical dilemmas and are therefore required to have high self-esteem. This study aimed to determine the correlation between moral sensitivity and self-esteem in nurses. In this descriptive-correlational research, sample study included 204 nursing personnel working in hospitals affiliated with Iran University of Medical Sciences. Participants were selected by convenience sampling. The data were collected using a demographic form, Lützén�s Moral Sensitivity Questionnaire, and Rosenberg�s Self-Esteem Questionnaire. Then, the data were analyzed using descriptive and analytical statistics. Written informed consent was obtained from each subject who participated in the research. The mean score for moral sensitivity of the samples was 69.15 ± 5.70, and 20.01 ± 4.76 for their self-esteem. Pearson�s correlation coefficient test indicated a meaningful and positive relationship between the two variables under study (r = 0.472 and P = 0.001). There was no correlation between the participants� demographic data and moral sensitivity (P > 0.05), but a significant relationship was found between the participants� level of education and the variable self-esteem (P < 0.05). Since there was a positive and significant relationship between moral sensitivity and self-esteem among the nursing staff, nursing managers should focus on improving the quality of patient care by promoting nurses� moral sensitivity inspired by high self-esteem. © 2017 Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences

Ethical Challenges in Cancer Care: A Qualitative Analysis of Nurses' Perceptions

Cancer is a growing problem in the world, meanwhile, the issue of providing care for cancer patients has been associated with multiple ethical challenges (ECs). This study aimed to investigate and explain the nurses' perceptions of ECs in caring for cancer patients in Iran. In this qualitative study, the participants consisted of 25 nurses working in cancer wards. The typical EC that the nurses are faced with while caring for cancer patients included categories such as "creating moral distresses" and "threat to patient's autonomy." The category of creating moral distress consisted of two subcategories, including "faulty communication process" and "provision of futile care." Also, the category of "threat to patient's autonomy" included subcategories of "individual factors" and "organizational factors." Since disregarding ethical principles in caring for patients with cancer will result in greater ECs in this respect, the healthcare administrators should make more effort to help establish transparent rules, and develop protocols needed to identify and eliminate these ECs. © Copyright 2019 Springer Publishing Company, LLC

Palliative Nursing for Cancer Patients as an Abstract Concept: A Hermeneutic Study

Background: Understanding the outcomes of palliative care (PC) that is provided to patients with cancer is necessary. Purpose: The aim of this study was to explore the lived experiences of Iranian nurses with regard to PC outcomes in cancer patients. Methods: This hermeneutic study interviewed 14 nurses to understand their lived experiences with regard to PC outcomes in cancer patients. A seven-stage process of data analysis was employed. Results: One constitutive pattern "palliative nursing for cancer patients is an abstractive concept" and the two associated themes of "providing excellent PC" and "PC as an alarm" were identified. Providing excellent PC had two subthemes: being a unique nurse and experiencing the humanistic approach to caring. PC as an alarm also had two subthemes: caring-related concerns and challenging issues caused by caring. Conclusions: The findings provide a deeper understanding of the nursing experience with regard to PC outcomes in cancer patients. Copyright © 2018 Taiwan Nurses Association