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

Provision of Spiritual Care in the Neonatal Intensive Care Unit in Iran from Healthcare Providers? Perspective: A Qualitative Study

Background: The provision of spiritual care along with holistic and comprehensive care is an important need for families with children hospitalized in an intensive care unit. This study aimed to explore the perceptions of healthcare providers regarding the spiritual care of parents with a newborn in a neonatal intensive care unit (NICU) Methods: This study was conducted using conventional qualitative content analysis, which adopts open coding, classification, and abstraction. A total of eight nurses and one doctor participated to be interviewed. Results: Based on data analysis, three categories of nursing support needed for spiritual care as well as the necessity of changes in structural conditions were identified in this study. Conclusion: Hospital administrators must undertake measures to change circumstances in NICUs. In addition, nurse managers should plan training courses on the importance of providing spiritual care to patients and their families

Promotion of Neonatal Pain Management in Neonatal Intensive Care Unit: A participatory Action Research

Abstract Introduction: Pain management is especially important for infants who are not able to verbally express their pain. The objective of this study was to promote pain management in Neonatal Intensive Care Unit (NICU). Methods: The present study was conducted using an action research based on Kemmis and McTaggart’s action research cycle on 35 participants including nurses, physicians, and center managers involved in the care of neonates. Four qualitative methods including interviews, focus group discussions, strategic meetings, and field notes were used for data collection. The content analysis approach was also used to analyze the data. Two action cycles were designed, with four stages of “identification, planning, implementation, and observation and reflection”. Results: Based on the results of this study, the source of the challenges was categorized into four areas of human resources management, pain control policy, workplace conditions, and management factors. The steps for the follow-up and implementation of the proposed solutions and strategies included training workshops, preparation of pain control policy, provision of facilities and equipment, and participation of senior managers in the implementation of neonatal pain management. The results of data analysis in the final evaluation revealed two themes of “comfort” and “improvement” in pain management in the NICU. Conclusion: The results of this study showed positive experiences of the participants on implementation of pain management in the NICU. The results also demonstrated that pain management problems in NICU can be reduced, without imposing high costs, by forming multidisciplinary teams and engaging various disciplines in the process of neonatal pain managemen

Pain Management Perceptions of the Neonatal Nurses in NICUs and Neonatal Units in Ardebil, Iran

Background: This study aimed to determine neonatal nurses’ perceptions of knowledge and practice in pain management in NICUs & neonatal units. Methods: A cross-sectional descriptive study design was used. A total of 120 neonatal nurses who working in NICUs & neonatal units in Ardebil province, Iran were selected using the convenience sampling technique. A questionnaire of Nurses’ Perceptions of Neonatal Pain (Cong, 2013), including 36 questions with Likert scale and 2 open ended questions, was used. Data collected were analyzed with descriptive statistics of frequencies and percentages.Results: Nurses had Appropriate knowledge of neonatal pain management , but less than 50% felt that they received adequate training and continuing education on pain. Participants reported that they don’t use of pain assessment tools (65%). Less than half felt that the pain tool used in their unit was an accurate measure (44.2%). Fewer than half reported that pain was well managed (28.3%) , that their pain protocols were research evidence based (34.2%) and more than half reported that parents should be involve with the care and comfort of their infant during painful procedures (71.6%). Barriers to effective pain management emerged as high workload, shortage of personnel, lack of knowledge, absence of pain protocols, lack of time, and lack of trust in the pain assessment tools.Conclusions: proper pain management was significantly correlated with adequate training, use of proper and accurate pain tools, and clear and research-based protocols and parental involvement. It can be improved by developing guidelines and support of nurses, develop of clinically feasible pain tools, adequate training and proper supervision

Post SARS-CoV-2 infection reactive arthritis: a brief report of two pediatric cases

Abstract Background Although, preliminary reports of Severe Acute Respiratory Syndrome (SARS)-CoV-2 infection suggest that the infection causes a less severe illness in children, there is now growing evidence of other rare or even serious complications of disease. Case presentation During the recent COVID-19 pandemic in Kerman, Iran, two children (an 8 year-old boy and a 6 year-old girl) were referred to outpatient Clinic of Pediatric Rheumatology with complaints of limping. Both children had experienced fever and mild respiratory tract infection. At the beginning of the second week of infection, they developed joint effusion. They both tested positive for coronavirus infection and were therefore diagnosed with post Coronavirus reactive arthritis. Both children were treated successfully with rest and Non-Steroidal Anti-Inflammatory Drugs (NSAID). They did not have any medical problems in the two months fallow up. Conclusions These two cases suggest that COVID-19 may be rheumatogenic. Highlighting the need for awareness of physicians, especially pediatricians, regarding the pathogenesis margins of this virus, as late presentations are of great importance