Health related quality of life in family caregivers of patients suffering from mental disorders

Introduction: In the light of the advances in treatment measures and early discharge of patients with mental disorders from psychiatric hospitals, families play important role in caring for such patients. Aim: The aim of this study is to determine the Quality of Life (QoL) of the family caregivers of patients with mental disorders. Materials and Methods: This cross-sectional study was conducted in teaching health care centers affiliated with medical universities in Tehran, Iran. Sampling was conducted by convenience random technique. Participants were 238 family caregivers of mental disorder patients and the Short-Form Health Survey Questionnaire was used to gather data. The data were analyzed by Spearman’s correlation, t-test and ANOVA in SPSS 18.0. Results: The women’s mean QoL was lower than the men’s. Regarding family relationship with the patients, the lowest QoL was observed among the mothers. There was a significant relationship between the caregivers QoL and economic status, the caregivers gender, family relationship with the patients and the patients’ gender (p<0.05). Conclusion: The caregivers of mental disorder patients have lower QoL compared with general population. Appropriately developed plans should be implemented to improve QoL among the family caregivers of these patients

Self Esteem and its Associated Factors in Patients with Multiple Sclerosis

Background & Aim: Multiple Sclerosis (MS) as a progressive disorder can deteriorate body image and the feeling of attractiveness and influence patients’ self-esteem through changing their cognitive experiences and attitude towards their body. Accordingly this study was conducted with aim of assessing self esteem and its related factors in patients with MS. Material & Methods: It was a descriptive, cross-sectional study. The subjects (n= 395) were recruited by convenience sampling from Multiple Sclerosis Society in Tehran. Rosenberg Self-Esteem Inventory was used as data collection tool. Data was analyzed by independent t-test, ANOVA, Pearson correlation, Spearman correlation coefficient, chi-square test and post hoc Scheffe test using SPSS-PC (version 16). Results: The mean score of self-esteem was 17/5 ± 53/20. Most patients had moderate self-esteem, and only a small percentage of them (16.2%) had high self esteem. There were significant relationship between the patients’ self-esteem and their age, educational level, marital status, employment status and the duration of disease (P<0.05). Conclusions: Nurses are able to consider the patients’ esteem needs by recognition of high risk groups and provide appropriate interventions to improve the quality of life of these patients and their families

Experienced stressors and coping strategies among Iranian nursing students

<p>Abstract</p> <p>Background</p> <p>College students are prone to stress due to the transitional nature of college life. High levels of stress are believed to affect students' health and academic functions. If the stress is not dealt with effectively, feelings of loneliness, nervousness, sleeplessness and worrying may result. Effective coping strategies facilitate the return to a balanced state, reducing the negative effects of stress.</p> <p>Methods</p> <p>This descriptive cross-sectional study was performed to determine sources of stress and coping strategies in nursing students studying at the Iran Faculty of Nursing & Midwifery. All undergraduate nursing students enrolled in years 1-4 during academic year 2004-2005 were included in this study, with a total of 366 questionnaires fully completed by the students. The Student Stress Survey and the Adolescent Coping Orientation for Problem Experiences Inventory (ACOPE) were used for data collection.</p> <p>Results</p> <p>Most students reported "finding new friends" (76.2%), "working with people they did not know" (63.4%) as interpersonal sources of stress, "new responsibilities" (72.1%), "started college" (65.8%) as intrapersonal sources of stress more than others. The most frequent academic source of stress was "increased class workload" (66.9%) and the most frequent environmental sources of stress were being "placed in unfamiliar situations" (64.2%) and "waiting in long lines" (60.4%). Interpersonal and environmental sources of stress were reported more frequently than intrapersonal and academic sources. Mean interpersonal (P=0.04) and environmental (P=0.04) sources of stress were significantly greater in first year than in fourth year students. Among coping strategies in 12 areas, the family problem solving strategies, "trying to reason with parents and compromise" (73%) and "going along with family rules" (68%) were used "often or always" by most students. To cope with engaging in demanding activity, students often or always used "trying to figure out how to deal with problems" (66.4%) and "trying to improve themselves" (64.5%). The self-reliance strategy, "trying to make their own decisions" (62%); the social support strategies, "apologizing to people" (59.6%), "trying to help other people solve their problems" (56.3%), and "trying to keep up friendships or make new friends" (54.4%); the spiritual strategy, "praying" (65.8%); the seeking diversions strategy, "listening to music" (57.7%), the relaxing strategy "day dreaming" (52.5%), and the effort to "be close with someone cares about you" (50.5%) were each used "often or always" by a majority of students. Most students reported that the avoiding strategies "smoking" (93.7%) and "drinking beer or wine" (92.9%), the ventilating strategies "saying mean things to people" and "swearing" (85.8%), the professional support strategies "getting professional counseling" (74.6%) and "talking to a teacher or counselor" (67.2%) and the humorous strategy "joking and keeping a sense of humor" (51.9%) were used "seldom or never".</p> <p>Conclusion</p> <p>First year nursing students are exposed to a variety of stressors. Establishing a student support system during the first year and improving it throughout nursing school is necessary to equip nursing students with effective coping skills. Efforts should include counseling helpers and their teachers, strategies that can be called upon in these students' future nursing careers.</p

Concept Analysis of Transition from Nursing Studentship to Working Life: a Hybrid Model

Background & Aim: Transition from studentship to working life is a stressful and challenging event. The concept of transition is important in nursing education, management, and practice issues. However, despite its supreme importance, there are certain ambiguities about the concept of transition in nursing. The aim of this study was to analyze the concept of transition in the context of nursing in Iran.   Methods & Materials: We used the three-phase hybrid concept analysis model including the theoretical phase, the fieldwork phase, and the final analytic phase in this study. In the theoretical phase, we conducted an online literature search to find relevant articles published prior to 2012. In the fieldwork phase, five novice nurses, two experienced nurses, and one head-nurse were interviewed. Interviews were transcribed verbatim and analyzed using thematic analysis approach. During the final analytic phase, we compared the findings of the first two phases to provide a clear and comprehensive definition of the concept of transition .   Results: The findings of the theoretical phase revealed that transition was a process phenomenon having defined attributes such as detachment, individual perception, awareness, and human response patterns. According to the findings of the fieldwork phase, transition was an interactive, evolutionary, and time-bound phenomenon that embodies attributes such as socialization, unavoidability, and competence and ability development. In the final analytic phase, a comprehensive definition was provided for the concept of transition in the context of nursing in Iran .   Conclusion: This study provided a comprehensive understanding of the concept of transition from nursing studentship to working life in Iran. The findings of this study can be used to develop theories, instruments, and criteria for evaluation of novice nurses’ transition to experienced nurses

A model of patient participation with chronic disease in nursing care

Introduction: Chronic diseases are one of the greatest challenges that health systems facing with them today. Recently, patient participation is considered as a key element in chronic care models. However, there are few studies about participation of patients with chronic disease in caring activities. The aim of this study was to identify the factors, which are relevant to patient participation and the nature of participation in caring activities. Material and Methods: A qualitative approach with a basic theory method was used in this study. 22 persons including 9 patients, 8 nurses, and 5 family members were recruited using purposeful and theoretical sampling in three hospitals affiliated with Iran University of Medical Sciences. Data were collected with semi-structured interview and participant observation. Constant comparison was used for data analysis. Results: Findings of this study indicated that participation of patients with chronic disease in nursing care is a dynamic and interactive concept that occurs between nurse, patient and family member in a care-servicing system. The core theme of this study was "convergence of caring agents" that included four categories: adhering, involving, sharing and true participation. Conclusion: This study suggests a pyramid model for explaining patient participation. Participation occurs in different levels, which depends on the factors related to caring agents

Hindrances to the implementation of family-centered care approach: a grounded theory study

Introduction: Family centered care is one of the caring approaches which support patient and family members and reduce their stress level caused by illness. This study aims to explain the challenges of family centered care approach implementations in Iranian health care settings. Methods: This article is a part of grounded theory study. Participants were selected through purposeful sampling method; the data was collected conducting an in-depth semi-structured interview with each participant. Participants were family members, nurses, clinical supervisors and physicians of educational hospitals affiliated to Khuzestan University of Medical Sciences. Data analysis was conducted using constant comparative analysis method. Results: Five challenges to implementation of family centered care were extracted in the process of data analysis including: healthcare resources limitations, health professional patient dependency, time constraints for providing care, nature of chronic diseases and medical paternalism. Conclusions: Implementing this approach is facing with some issues. It needs to develop a partnership between patients&rsquo; family members and healthcare providers. Health care system can achieve a range of potential benefits with the implementation of family centered care

Relationship between Perceived Stress with Resilience among Undergraduate Nursing Students

Background & Aim: The effect of perceived stress on students’ health depends on their coping abilities. Resilience is a coping strategy for dealing with the stress. The aim of this study was to determine the relationship between the perceived stress with resilience in undergraduate nursing students .   Methods & Materials: In this cross-sectional study, 309 undergraduate nursing students of Tehran University of Medical Sciences were selected during the first semester of 2012-2013 using the stratified sampling method. Data were collected using the Perceived stress scale and the Connor-Davidson Resilience Scale (CD-RISC). The data were analyzed using descriptive and inferential statistics in the SPSS-14 .   Results: Findings revealed that most of the students (99.3%) had a moderate or high perceived stress. There was a statistically significant relationship between the perceived stress with the resilience (P £ 0.001, r=-0.38) .   Conclusion: The school of nursing should provide facilities and opportunities for students in their 4-year educational program to learn stress management strategies including increasing resilience ability

Effect of Coping Skills Training on Quality of Life among Parents of Children with Leukemia

Background & Aim: Cancer is the most common childhood chronic medical illnesses that can affect quality of life of the children and their families. The aim of this study was to determine the effect of coping skills training on quality of life among parents of children with leukemia.   Methods & Materials: This non-randomized clinical trial was conducted from March to June 2013. Ninety eight parents of children with leukemia who were referred to two selected hospitals affiliated to Tehran University of Medical Sciences were enrolled to study using convenience sampling method. The participants were allocated to two experimental (n=48) and control (n=50) groups. Data were collected through two questionnaires including demographic characteristics of the parents and children, and the Persian version of the Caregivers Quality Of Life index Cancer. Coping skills training including social communication skills was performed through small group discussion (5-8 members) in four 2-hours sessions for the experimental group. The questionnaires were completed four weeks after the intervention by the parents. Data were analyzed using the independent t-test, paired t-test, Fisher's exact test and Chi-squared test in the SPSS-16.   Results: The results showed significant increase in the overall quality of life after the intervention (P<0.001). The quality of life of parents in the experimental group was improved significantly in comparison with the control group (P=0.045). Mental/emotional burden (P<0.001) and lifestyle disruption (P<0.001) decreased significantly after the intervention.   Conclusion: The coping skills training affected the quality of life among parents of children with leukemia . Effective educational interventions may help to increase the quality of life of parents who have children with Leukemia

Effectiveness of Informational Support on Anxiety among Family Carers of Patients Undergone Open Heart Surgery

Background &amp;amp; Objective: Hospitalization of patients in the intensive care unit of open heart surgery (ICUOH) is often stressful for patients&apos; family carers. This study aimed to investigate the effectiveness of the informational support on anxiety among families of patients undergone open heart surgery. Methods &amp;amp; Materials: In this double-group randomized clinical trial, 64 family carers of patients undergone open heart surgery were selected using convenience sampling method and were randomly allocated into two intervention or control groups. The informational support consistedof&amp;nbsp; holding the ICU orientation tours and educational sessions, and providing educational pamphlets and booklets. The members of the control group received routin information. The anxiety of the family carers was measured using the trait Spielberger anxiety questionnaire before surgery and in the day of discharge from the ICU. Independent and paired t-tests were used to analyze the data. Results: According to the findings, there were no significant difference between the two groups regarding demographic charachteristics. At the baseline, the mean of anxiety scores were 47.9&amp;plusmn;11.5 and 49.2&amp;plusmn;11.5 in the control and intervetion groups, respectively. The anxiety scores diminished in both groups after the surgery, however, the difference was not statistically significant between the two groups (P=0.18). Conclusion: For effective control of anxiety among family members of patients, both informational support and other supportive techniques such as psychological support and meeting other family needs should be considered. &amp;nbsp

The Relationship Between Circadian Rhythm and Temperament/Character of Nurses

Background & Aims One of the areas that need attention in the nursing profession, which can affect various fields of work, professional, care, etc., are temperament and character. Various factors can affect the temperament and character. One of these factors is the circadian rhythms in which most nurses experience disturbances. Considering the importance of examining and evaluating temperament and character in nurses and the effects of circadian rhythm disturbances on them, and given that less attention has been paid to it, this study aims to determine the relationship between circadian rhythm and temperament/character of nurses working in selected teaching hospitals in Tehran, Iran. Materials & Methods This is a descriptive-correlational study with a cross-sectional design. The study population consists of all nurses working in teaching hospitals affiliated to Iran University of Medical Sciences. The study samples were 200 eligible nurses who were selected randomly (by lottery method) from different departments of four hospitals. A demographic form, the morningness-eveningness questionnaire (MEQ), and Cloninger’s temperament and character inventory (TCI) were used to collect data. Data analysis was conducted in SPSS software, version 16. Results Most of the participants (64%) were neither-type nurses in terms of circadian rhythm. The circadian rhythm in overall had a negative significant correlation with persistence (P=0.039) and self-transcendence (P=0.047). Also, circadian rhythm had a significant relationship with age (P<0.001), sex (P=0.044), employment status (P=0.003), and work experience P<0.001). The dimensions of TCI, including novelty seeking, reward dependence, persistence, self-directedness, cooperativeness, and self-transcendence, had a statistically significant relationship with the demographic characteristics of nurses. Conclusion The circadian rhythm of nurses has a significant negative correlation with some components of TCI. Considering the impact of circadian rhythm on the quality of nursing care, the officials and hospital managers should gain sufficient knowledge of circadian rhythms, identify evening-type nurses, provide training, facilities, and special privileges to nurses, and determine their work shifts according to their circadian rhythms, so that they can improve the quality of patient care and increase patient satisfaction