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Background & Aim: Cancer as one of the most common illnesses in the world is associated with mental, physical, social and financial problems, which affects not only the patients, but also the family caregivers and creates a burden of care. Some studies have shown that spiritual well-being is effective in reducing the burden of care. Therefore, this research was conducted to determine the correlation between spiritual well-being and burden of care in family caregivers of cancer patients.
Methods & Materials: In this cross-sectional correlational study, 150 family caregivers of cancer patients referred to Taleghani, Shohadaye Tajrish, Masih Daneshvari and Imam Hossein hospitals in Tehran were selected by the convenience sampling method from August to November 2017. The data gathering tool was a questionnaire, and data were analyzed using descriptive statistics, Pearson and Spearman correlation coefficients, independent t-test, analysis of variance and multiple regression analysis at a significance level of 0.05.
Results: The mean and standard deviation of spiritual well-being score and burden of care were 90.36±17.70 and 25.54±11.79, respectively. There was a significant relationship between spiritual well-being (and its components including religious well-being and existential well-being) and burden of care (r=-0.421, P˂0.001). The result of regression test showed that spiritual well-being significantly predicted the burden of care.
Conclusion: The burden of care is experienced by family caregivers during caring for cancer patients, which is related to their spiritual well-being. Therefore, paying attention to the spiritual well-being of these caregivers is emphasized.
 

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Background & Aim: Assessment of sexual health literacy requires an appropriate tool. The purpose of this study was to develop and validate a questionnaire to evaluate the level of sexual health literacy among Iranian adults.
Methods & Materials: This study was designed in two phases in Tehran during 2017-2018. In the first step, the questionnaire was developed by item generation through expert panel and literature review. In the second step, the assessment of psychometric properties of the questionnaire including face, content, and structure validity (exploratory factor analysis) and convergence criterion (using general health literacy questionnaire) were done. Reliability of the questionnaire was assessed by internal consistency (Cronbach’s alpha) and intraclass correlation coefficient (ICC). Data were analyzed using the SPSS software version 21.
Results: The content validity indices (CVI and CVR) for all items were 0.84 and 0.81, respectively. Exploratory factor analysis identified four factors including skills of access, reading and understanding, evaluation and analysis, and application of information that explained %68.1 of the variance. Convergent validity of the questionnaire showed a correlation between the questionnaire’s dimensions and general health literacy questionnaire in the range of 0.31 to 0.70. The SHELA showed a high internal consistency reliability with Cronbach’s alpha, ranging from 0.84 to 0.94 and intraclass correlation coefficient (ICC), ranging from 0.90 to 0.97.
Conclusion: The psychometric assessment of the 40-item questionnaire (SHELA) indicates desirable validity and reliability. This questionnaire is suggested for assessing the level of sexual health literacy of adults in future studies.
 

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Background & Aim: Efforts to improve self-care in patients with heart failure provide better treatment outcomes and longer life expectancy. The purpose of this study was to determine the effect of a caring program based on Pender model on health-promoting self-care behaviors in patients with heart failure.
Methods & Materials: In this single-blind randomized controlled trial, 48 patients with class II or III heart failure, referred to Golestan hospital in Tehran in 2017-2018, were recruited by the purposive sampling method and were randomly assigned to an intervention or a control group. For the intervention group, a caring program based on the Pender Health Promotion Model was conducted in six sessions. Data were collected by the Health Promoting Lifestyle Profile and the Self-Care Heart Failure Index, before and after the intervention. Descriptive and inferential statistical tests were used to analyze the data by the SPSS software version 16.
Results: The mean scores of the dimensions (except self-actualization) and the total score of health-promoting behaviors and self-care in the intervention group were higher than in the control group after the intervention (P<0.05). In addition, after the intervention, the mean scores of the dimensions and the total score of health-promoting behaviors and self-care significantly increased in the intervention group (P<0.05).
Conclusion: Implementing a caring program based on Pender model increases the self-care and health-promoting behaviors of patients with heart failure. Therefore, application of this caring program is recommended for this group of patients.
Clinical trial registry: IRCT20150801023446N17
 

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Background & Aim: Health promoting behaviors have been recognized as an important strategy for maintaining and improving the independence, health and quality of life of people with chronic diseases. The aim of the present study was to compare the health promoting behaviors of patients with MS with those of healthy people.
Methods & Materials: This cross-sectional, comparative study was conducted on MS patients and healthy people in Guilan province in 2018. For this purpose, 120 MS patients (from the MS association of Guilan province and other health centers) and 120 healthy people were selected by the convenience sampling method. The Health-Promoting Lifestyle Profile (HPLP-II) was used to collect the data. The data were analyzed using the SPSS software version 22.
Results: The results showed that health promoting behaviors of MS patients were significantly lower than those of healthy people (t=-3.127, df=238, P<0.001). The results of the components analysis indicated that the mean ranks of self-actualization (U=4948.500, Z=-4.191, P<0.001), interpersonal relationships (U=12874.000, Z=-2.957, P<0.003), stress management (U=5787.000, Z=-2.644, P<0.008) and physical activity (U=5506.500, Z=-3.156, P<0.002) in MS patients were significantly lower than those in healthy people. However, there was no significant difference between MS patients and healthy people in the components of health responsibility and nutrition.
Conclusion: In general, it can be concluded that chronic conditions are associated with a decrease in health promoting behaviors in MS patients, and the patients should be educated in this area using appropriate nursing and psychological interventions.
 

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Background & Aim: The success of the surgical safety checklist in reducing surgical mortality and morbidity largely depends on the degree of compliance with the checklist and correct implementation of its components by the staff. The aim of this review is to determine the challenges of effective implementation of the surgical safety checklist and to provide solutions for its more effective implementation.
Methods & Materials: In the present systematic review, all the relevant qualitative papers published from 2010 to October 2018, were examined. A  literature search was done in databases SID, Iran Medex, Iran doc, Magiran, Science Direct, Medline/PubMed, Web of Science, Scopus, ProQuest, Google Scholar, Cochran Library with keywords patient safety, surgical procedures, operative, checklist, World Health Organization, implementation science, qualitative research and their equivalent terms in Persian. Inclusion criteria were articles written in English or Persian, qualitative studies and relevant to the objectives of the study. Exclusion criteria were review articles, posters, presentations, letters to editor and quantitative studies.
Results: The findings of the review of 14 qualitative studies showed that the most important challenges in effective implementation of the surgical safety checklist were unpredictable priorities, lack of collaboration and coordination of the surgical team members, mismatch between the checklist and hospital setting, lack of patient’s cooperation and lack of a planned approach towards implementing the checklist. The strategies to improve the implementation of the surgical safety checklist included checklist localization, improving the collaboration and coordination of all the team members, training and practicing, patient participation, and active organizational leadership.
Conclusion: The introduction of the surgical safety checklist to the health care setting is a permanent challenge and requires ongoing evaluations and its integration into the workflow in the hospital, active and effective leadership, explanation of why and how to use it by managers and receiving support from the organization. Continuous education, performance evaluation and the participation of all the surgical team members in the implementation of the checklist are key factors for effective implementation of the surgical safety checklist.
 

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Background & Aim: Menstrual health is an important aspect of adolescent health. Most girls do not have proper information about menstrual health, and incorrect information from unreliable sources makes problems for them. Aim of this study was to compare small group-based education with maternal participation and routine education on adolescent girls’ menstrual health behaviors.
Methods & Materials: This randomized clinical trial study was performed on 60 high school students with regular menstruation in the groups of intervention and control. Among high schools in Mashhad in 2018, two schools were assigned to one of two groups by lottery. Menstrual health education was provided to the intervention group in four sessions as the groups of 3-4 people. For mothers in this group, two 2-hour sessions with the same content were held and the students in control group received routine education. Data were collected by a questionnaire on menstrual health behaviors, before the intervention, after the end of the first and second menstrual cycle. Data were analyzed by Mann-Whitney, Chi square and independent samples t-test using the SPSS software version 16.
Results: before the intervention, there was a statistically significant difference in the menstrual health behaviors score (P=0.199). After the intervention, mean score of menstrual health behaviors (the end of the first and second menstrual cycles) significantly increased (P<0.001) for the two groups. Also, mean score of menstrual health behaviors for the intervention group was significantly higher than that of for the control group (P<0.001).
Conclusion: The small group-based education with the participation of mothers in comparison to routine education was more effective in promoting menstrual health behaviors in adolescent girls. This method is recommended to health planners for education of health issues, including menstrual health.
Clinical trial registry: IRCT20180904040952N2
 

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Background & Aim: Physical activity is a health behavior that helps one's mental and general health, improves the health of women during preconception period and reduces pregnancy and birth complications. The aim of this study was to predict physical activity based on the BASNEF model constructs during preconception period among women referred to Uremia health centers.
Methods & Materials: This cross-sectional study was conducted on 230 women during preconception period, who were selected using the multistage sampling method in 2018. The data collection tool was a researcher-made questionnaire containing sociodemographic information, the BASNEF model constructs, and a short form of the international physical activity questionnaire. Data were analyzed using logistic and linear regression and t-test through the SPSS software version 16.
Results: The results showed that 61.3% of women had low levels of physical activity. Knowledge (β=0.2, P<0.003), attitude (β=0.15, P<0.017), and enabling factors (β=0.18, P<0.004) significantly explained their intention to do physical activity. Also, among the predictive variables, knowledge (P<0.001) significantly explained physical activity.
Conclusion: Low rate of women's physical activity during preconception period calls for designing an intervention based on BASNEF model in order to influence knowledge, attitude and enabling factors.
 

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Background & Aim: Cesarean section (CS) rate was 56% in 2012 in Iran, which was considerably higher than the WHO recommended rate (10-15%). Thus, the Normal Delivery Promotion (NDP) program as a part of Iran’s Health Transformation Plan (HTP) was implemented in 2014 to reduce unnecessary cesarean deliveries and promote maternal and neonatal health. The aim of the study was to evaluate the effect of the NDP plan on the CS rates.
Methods & Materials: This quasi-experimental and longitudinal study analyzed the immediate and long- term effects of the NDP program on the CS trend in Iran using an interrupted time series analysis. Monthly CS rates in the hospitals of the country were extracted from April 2013 to September 2018.
Results: Overall CS rate in Iran decreased by 6% immediately after the implementation of the NDP program and then remained at the same level. The NDP program reduced the CS rate in teaching (9.5%), non-teaching (11.7%), private (18.1%), and charity (27.1%) hospitals. But the CS rate increased in social security (7%) and other hospitals (15.7%). The CS rate would have reached 58.5% by September 2018 if the NDP program had not been implemented.
Conclusion: The NDP program was somewhat effective in reducing the CS rate in Iran. Promoting this program by formulating a strategic plan and comprehensive action plans addressing various underlying causes of CS at meta (ministry of health), macro (universities of medical sciences), meso (hospitals) and micro (obstetricians, midwives, and mothers) levels and considering effective solutions in the areas of governance and leadership, financing, human resources, equipment, information and service delivery is critical to achieve the determined national goals.
 

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Background & Aim: Clinical competence is the ability to perform professional tasks and coordinate cognitive, communication and psycho-motion skills in patient care, and empathy is one of the factors influencing clinical competence. Given the role of clinical competence in the quality of midwifery care, this study aimed to determine the effect of empathy skill training on clinical competence in midwifery students.
Methods & Materials: This randomized clinical trial study was conducted on 73 midwifery students and 438 pregnant women in 2015. A clinical competence questionnaire was used to assess the clinical competence of the students, which was completed in two ways by self-assessment and researcher assessment (after reviewing the student's performance for 3 times). Data were analyzed by chi-square test, independent t-test and paired t-test using the SPSS software version 16.
Results: There was no significant difference between the two groups in the mean score of clinical competence in the ways of self-assessment and assessment by the researcher before the intervention (P>0.05). Results from the post-intervention showed that there was significant difference between the two groups. However, the clinical competence score by the researcher assessment in the intervention group was significantly higher than in the control group (P<0.05). Also, the difference in the mean scores of the self-assessment of clinical competence before and after the intervention between the two groups was not significant (P>0.05), but the difference in the mean scores of the researcher assessment of clinical competence before and after the intervention between the two groups was significant (P<0.05).
Conclusion: Empathy skill training is an effective way to increase the clinical competence of students.
Clinical trial registry: IRCT 2016051127855N1
 

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Background & Aim: Osteoporosis is a silent and progressive disease that causes disability in people particularly women, with age and has irreversible consequences in their lives. This study aimed to determine the effect of an educational intervention program based on BASNEF model on prevention of osteoporosis among women referred to health centers in the south of Tehran.
Methods & Materials: This is a quasi-experimental study with two groups of intervention and control, performed on 162 women (81 in the intervention group and 81 in the control group) aged 30-49 years, referred to health centers in the south of Tehran in 2018. The data collection tool included demographic information, a researcher-made questionnaire based on BASNEF model constructs and another part of the questionnaire was Health Promotion Standards Questionnaire (HPLP II). Questionnaires were completed for both the intervention and control groups before and six months after the intervention. Data were analyzed by the SPSS software using chi-square, t-test, and paired t-test at a significance level of 0.05.
Results: The mean of women’s age in this study was 37.79±5.47 years old. There was no significant difference in demographic variables and BASNEF model constructs before the intervention (P>0.05). After the intervention, the mean score of BASNEF model constructs and the dimensions of health promoting behaviors significantly increased in the intervention group (P<0.001).
Conclusion: The study results revealed a positive effect of the BASNEF model-based educational program on health promoting behaviors regarding osteoporosis prevention among women. It is suggested to use this model as a successful model in educational interventions to prevent osteoporosis in women.
Clinical trial registry: IRCT20130213012460N15
 

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Background & Aim: The health of newborns and infants as the future makers of the country is of special importance. Today, the main benefits of breastfeeding for children, mothers and society have widely been recognized. Given the importance of self-efficacy in initiating and continuing breastfeeding, the present study was conducted to determine the effect of breastfeeding counseling with a spiritual approach on breastfeeding self-efficacy in primiparous women.
Methods & Materials: In this randomized controlled trial study, 60 primiparous women referring to the childbirth preparation classes at Alavi Hospital, Azadegan Comprehensive Health Service Centers, Sina and Dr. Hazrati in Ardabil in 2019 were selected through the convenience sampling method and assigned to intervention or control groups using quadruple block method. The control group received routine care and the intervention group received eight sessions of breastfeeding counseling with a spiritual approach. Data was collected using the Dennis Lactation Self-efficacy Questionnaire and analyzed through the SPSS software version 16 using descriptive statistics, chi-square test and independent t-test at 95% confidence level.
Results: The mean scores of breastfeeding self-efficacy for the intervention and control groups were 27.48±5.83 and 28.23±4.44 (P=0.575) before the intervention, 39.83±10.14 and 25.33±3.62 (P<0.001) immediately after the intervention, 42.45±13.00 and 23.43±6.23 (P<0.001) one month after the intervention. There was a significant difference between the two groups after the intervention.
Conclusion: Employing spiritual approach in breastfeeding counseling was effective in improving the breastfeeding self-efficacy of primiparous women. The integration of spiritual content into the package of postpartum services with a focus on breastfeeding appears to be an appropriate measure that can be considered by planners in this area.
Clinical trial registry: IRCT20150731023423N14
 

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Background & Aim: Health promotion nursing activities for the elderly with COPD is different in various health care structures, and research in this area can help to identify the existing knowledge gap. The aim of this study was to determine health promotion nursing activities for the elderly with COPD.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2020. A total of 180 nurses working in teaching hospitals affiliated to Mazandaran University of Medical Sciences were selected using the convenience sampling method. Data collection tools included a demographic questionnaire and a researcher-made questionnaire on health promotion nursing activities for the elderly with COPD. The data was analyzed through the SPSS software version 18 using t-test, ANOVA and multivariate regression.
Results: The mean age of nurses was 34.58±8.05 years, 84.4% were female and 70.6% were married. The mean score of health promotion nursing activities was 197.10±37.90. Among the dimensions related to health promotion activities, “drugs/smoking cessation” (34.4%) and “self-empowerment” (32.8%) had the lowest frequency. There was a significant relationship between health promotion nursing activities with the work place (P=0.034), age (P<0.001), gender (P=0.022) and marital status (P=0.014).
Conclusion: The health promotion nursing activities for the elderly with COPD was above moderate levels. In-service training programs and internal conferences are needed especially in the area of ​​counseling behaviors and smoking cessation in order to improve the professional competency of nurses.
 

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Background & Aim: Cultural competence is one of the main components of health care. Attention to cultural competence is essential to reduce healthcare inequalities and identify potential for improving healthcare delivery. The aim of this study was to investigate cultural competence and its related factors in health care providers working in comprehensive health centers affiliated with Tehran University of Medical Sciences (TUMS).
Methods & Materials: In this descriptive, cross-sectional study, 250 health care providers working in health centers affiliated with TUMS were selected using the convenience sampling method in 2020. The demographic characteristics form and the cultural competence scale for health workers (CCSN) were used to collect the data. Data were analyzed using descriptive and inferential statistical tests (t-test and ANOVA) through the SPSS software version 16 at a significance level of 0.05.
Results: The mean total score of cultural competence in health care providers was 162.66±28.41 (range: 33-231). According to the findings, the mean score of cultural competence for all dimensions was desirable. The mean score of cultural competence had a statistically significant relationship with intra-ethnic marriage (P>0.005) and work experience (P=0.012) while no statistically significant difference was observed with other demographic variables.
Conclusion: The study results showed that cultural competence in health care providers was at the desirable level. These results may be useful for managers and planners in the development and management of human resources and quality assurance of health services delivery.

 

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Background & Aim: The COVID-19 survivors are prone to psychological distress due to their experience of illness and severe conditions. Diseases can also affect patients’ quality of life. The aim of this study was to determine the relationship between mental health and quality of life among the COVID-19 survivors one year after the infection.
Methods & Materials: This is a descriptive, correlational, cross-sectional study that was conducted from February, 2020 to July 2020. A total of 276 patients who survived from COVID-19 were included to the study through the convenience sampling method. Data were collected using a demographic and clinical information form, the 12-item general health questionnaire (GHQ-12) and the 36 item short form survey (SF-36). Data analysis was performed through the SPSS software version 16 using independent t-test, Pearson correlation coefficient, analysis of variance (ANOVA) and linear regression.
Results: The mean score of mental health and total score of quality of life were 6.26±2.75 and 59.2±18.30, respectively. There is a significant relationship between the score of mental health and the score of quality of life (P<0.001), so that with the increase of the mental health score, which indicated the worsening of the mental health status of the participants, their quality of life score decreased.
Conclusion: Paying attention to the mental health and quality of life of the survivors of COVID-19, as well as adopting supportive strategies for them are recommended. Providing psychological and psychiatric services can improve their mental health and quality of life.

 

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Background & Aim: Many factors affect the hypertensive patients’ quality of life. Identifying the factors related to the quality of life can help to promote the quality of life in hypertensive patients. This study aimed to determine the predictive role of illness acceptance and social, individual factors in the hypertensive patients’ quality of life.
Methods & Materials: This correlational, cross-section study was conducted in 2020-2021 on 245 hypertensive patients referred to a hypertension clinic in Lahijan selected by the convenience sampling method. Data were collected by a questionnaire, including demographic information, Acceptance of Illness Scale and the WHO's Quality of Life-Brief questionnaire. Data were analyzed by multiple linear regression at a 95% confidence level using the SPSS software version 23.
Results: The mean score for the quality of life was 65.32±12.18 (0-100) and for the acceptance of illness was 31.83±4.98 (8-40). Age, sex, employment status, marital status, monthly income, family arrangement and the acceptance of illness were identified as the predictors of quality of life in hypertensive patients (P<0.001). According to the coefficient of determination (R²=0.401), the variables of the final regression model explained about 40% of the quality-of-life changes among hypertensive patients.
Conclusion: Given that the acceptance of illness and some social, individual factors can affect the hypertensive patients’ quality of life, focus on the strategies to promote the acceptance of illness and paying attention to social, individual factors can help improve the quality of life among hypertensive patients.

 

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Background & Aim: Infectious diseases represent a significant health concern within human communities. Considering the importance of pregnancy, the present study was conducted with the aim of exploring the health behaviors exhibited by pregnant women during the COVID-19 pandemic.
Methods & Materials: This qualitative study employed the conventional content analysis approach to examine a cohort of 16 pregnant women in 2021. The research was conducted within the health centers of Ilam, employing the purposeful sampling technique and unstructured interviews to collect the data. Simultaneous to the data collection, conventional content analysis was employed to analyze the data. MAXQDA version 10 software was utilized for data management purposes.
Results: The participants had a mean age of 30 years, while the average gestational age was 30.38 weeks. Through analysis, three main themes and eight categories were derived from the collected data. The main themes identified were as follows: 1- self-care practices for disease prevention, 2-  the adverse effects of the pandemic on pregnancy, and 3- changes in the healthcare system.
Conclusion: The results of the present study highlight the emergence of a novel form of self-care among pregnant women as a consequence of the COVID-19 pandemic. The adverse effects of the pandemic, such as quarantine measures, were associated with the development of negative ruminations within pregnant women. Following the quarantine restrictions, significant modifications were observed in the ways through which women sought health-related information and engaged in daily activities. Moreover, alterations were made to care policies. Paying attention to the comprehensive health needs of pregnant women, including both physical and mental health, is imperative within the context of pandemic-related health services.

 

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Background & Aim: Knee osteoarthritis as a common chronic illness leading to disability, imposes numerous challenges on individuals in terms of daily living and self-care. Therefore, the implementation of tele-rehabilitation nursing interventions that foster patients' internal health locus of control and enhance the development of self-care behaviors may be useful. This study aimed to determine the effect of tele-nursing rehabilitation on the health locus of control in patients with knee osteoarthritis.
Methods & Materials: In this randomized clinical trial study, a total of 34 patients with knee osteoarthritis referred to the rehabilitation clinics affiliated with Shiraz University of Medical Sciences in 2022 were enrolled. The intervention group participated in an 8-session tele-rehabilitation nursing program, while the control group received standard routine care. The Multidimensional Health Locus of Control scale was administered to both groups on three separate occasions. The data were subjected to descriptive and inferential statistical analyses using SPSS software version 26.
Results: According to the results from a two-way repeated measures analysis of variance (ANOVA), a statistically significant difference was observed solely in the trend of changes in the mean score of internal belief between the two groups and over the study time period (P<0.001). Specifically, the scores of the intervention group exhibited a significant increase over time, surpassing those of the control group.
Conclusion: The implementation of tele-rehabilitation nursing care, which emphasizes patient responsibility for their internal health locus of control can improve self-care. Therefore, it is recommended that nurses employ this approach in managing additional chronic conditions.
Clinical trial registry: IRCT20220216054038N1

 

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Background & Aim: Parents of children with autism face numerous challenges that hinder their social adjustment. Spiritual health emerges as a relevant components that can potentially enhance their social adjustment. The present study was conducted with the aim of investigating the relationship between spiritual health and social adjustment among parents of children with autism.
Methods & Materials: This is a descriptive correlational study that investigates a sample of 194 parents of children with autism at Hekmat Autism Center in Borujerd and Yekta Autism Center in Khorramabad, during the period of March 2021 to April 2021. To collect data, a demographic information questionnaire, the Paloutzian and Ellison spiritual health questionnaire, and the personal resource questionnaire were employed. Data analysis was conducted using the SPSS software version 26, utilizing the Chi-square test, one-way analysis of variance (ANOVA), and Pearson's correlation coefficient.
Results: There was a statistically significant relationship between the scores of spiritual health (82.03±17.68) and social adjustment (78.52±15.59) among the parents (r=0.572, P=0.0001). The parents with low spiritual health had a mean social adjustment score of 65±0, while those with moderate spiritual health had a mean score of 76.63±15.76, and parents with high spiritual health had a mean score of 89.19±9.45. These results indicate that there was a statistically significant difference in the mean scores of social adjustment across different levels of spiritual health (P<0.001).
Conclusion: There was a significant correlation between spiritual health and social adjustment among parents of children with autism, suggesting that higher levels of spiritual health were associated with increased social adjustment. To enhance the social adjustment of these parents, it is advisable to implement appropriate planning aimed at improving their spiritual health.

 

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Background & Aim: Breast cancer is the most common type of cancer in the world, imposing significant physical problems and psychological burdens on sufferers. Education is one of the ways to reduce the psychological problems of these patients. Therefore, the current study was conducted to compare the efficacy of Acceptance and Commitment Training (ACT) and Positive Psychology (PP) in enhancing the mental health and resilience among women with breast cancer.
Methods & Materials: This study employed a two-group quasi-experimental design with a pretest-posttest design, involving 60 women with breast cancer at Khatamolanbia cancer center in Jahrom during 2020-2021. Participants were selected through convenience sampling and randomly assigned to either the Acceptance and Commitment Training group (focused on accepting uncontrollable factors and committing to enriching life) or the Positive Psychology group (emphasizing individual abilities and positive emotions). Prior to and one week following the sessions, participants completed questionnaires evaluating resilience and mental health. Data analysis was performed using MANCOVA with a significance level set at 0.05.
Results: Based on the MANCOVA findings, there was no statistically significant difference in resilience and mental health scores (F=2.318, P=0.110) between the two intervention groups after adjusting for pretest scores. However, clinically significant improvements were observed in mental health and resilience for 75% and 42% of the ACT group, and 65% and 46% of the Positive Psychology group, respectively.
Conclusion: According to the findings, both group therapies, ACT and Positive Psychology, are effective in enhancing resilience and mental health in breast cancer patients. These findings provide more opportunities for healthcare providers to tailor interventions to the characteristics of caregivers and the personality characteristics of the patients.

 

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Background & Aim: Family caregivers of COVID-19 patients in the Intensive Care Units (ICUs) face numerous challenges that can affect their well-being. Spiritual health represents a crucial component for coping with such stressful conditions. Therefore, this study aims to determine the relationship between spiritual health and attitude towards death in family caregivers of COVID-19 patients post-discharge from the ICUs.
Methods & Materials: This descriptive-correlational study conducted between April and November 2021, focused on family caregivers of COVID-19 patients discharged from the ICUs. The sample comprised 260 family caregivers selected through convenience and purposive sampling methods. Data collection tools included a demographic and clinical questionnaire, Polotzin and Ellison's Spiritual Health Questionnaire, and Wong's Death Attitude Questionnaire. Data were analyzed using SPSS version 24 encompassed chi-square tests, one-way analysis of variance and Spearman correlation coefficient.
Results: The results showed a significant inverse relationship between total spiritual health score and the total score of attitude towards death (rs=-0.101, P<0.05). The attitude towards death findings revealed fear as the highest scoring dimension, with active acceptance scoring the lowest. Moreover, religious health exhibited a significant inverse relationship with avoidance of death (rs=-0.93) and fear of death (rs=-0.64, P<0.05).
Conclusion: The study highlighted an inverse relationship between the level of religious health and negative dimensions of attitude towards death. Individuals with higher religious health scores exhibited lower average scores for negative attitudes towards death, including fear and avoidance of death. This underscores the importance of emphasizing the religious dimension within families, and among patients discharged from the ICU, showcasing the role of religion in mitigating negative attitudes towards death.