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Background & Aim: Tokophobia was introduced as a psychiatric disorder for the first time in 2000. The purpose of this study is to answer four questions: What is tokophobia and how does it occur? What is the global prevalence of tokophobia? What are the symptoms of tokophobia? and what are the strategies for the control and treatment of tokophobia?
Methods & Materials: This systematic review was conducted by searching articles in English and Persian published between January 2000 and January 2018 on international databases; PubMed, Scopus, Web of Science, Google Scholar, Science Direct, and domestic databases; Magiran and SID, along with a manual search in resources.
Results: After reviewing 151 articles, finally 16 were included in the study. The results indicate that tokophobia is a severe and pathological fear of childbirth. In the categorization of psychiatric disorders, it is classified as a specific phobia based on the Diagnostic and Statistical Manual of Mental Disorders, 4^th edition (DSM-IV). The etiology of tokophobia is multifactorial, and its prevalence in pregnant women was reported around 14 percent among 18 countries. The signs and symptoms of the disorder are insomnia, crying, restlessness, depression, anxiety and severe worry about childbirth. Psychological strategies, cognitive behavior therapy and medication have been proposed to reduce the fear of childbirth in women in different studies.
Conclusion: As a guide, these results can assist the healthcare team members to recognize and screen at-risk women as well as to perform nursing interventions and psychotherapy in the prenatal and delivery stages.
 

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Background & Aim: Some studies across different disciplines have investigated students’ learning styles (LS) separately. However, few studies have investigated the LS of students of various educational disciplines in Medical Sciences. We aimed to determine the LS of students of Semnan University of Medical Sciences.
Methods & Materials: In this descriptive-cross-sectional study, 228 students of Semnan University of Medical Sciences were selected by cluster sampling in 2017. Data collection tool was the latest version of Kolb's learning style inventory. Finally, the data were analyzed by descriptive and analytical (Chi square) tests using the SPSS software version 18.
Results: In this study, 54.8% of students were female and 89.5% were single. 63.2% had the average scores higher than 16 and 52.2% were at second semester. The LS of students were assimilation (40.4%), divergent (21.9%), accommodation (19.3%), and convergent (18.4%). There was a significant relationship between the type of LS with the field of study (P=0.014) and average score (P=0.006), but there were no correlations between the type of LS with gender, age, marital status and academic semesters (P>0.05).
Conclusion: Considering that the assimilation LS was predominant within the students and given the fact that medical profession is a communicative, people-centered, and practical work, the faculty needs to emphasize the LS of students, and use various teaching strategies to strengthen and enhance the capabilities which are necessary for this group in educational and clinical settings.
 

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Background & Aim: Self-control is the capacity to organize cognitive and emotional responses in order to provide continuous and adaptive behavior with ideal standards for long-term goals. Due to the high levels of care burden of patients with chronic disease, this study aims to explain the concept of self-control in the family caregivers of patients with chronic disease based on the family-centered empowerment model.
Methods & Materials: Data were collected through in-depth, semi-structured interviews with 26 participants (19 caregivers, four nurses and three patients with chronic disease) from June 2016 to August 2017 in southwestern of Iran. Data were analyzed using the directed content analysis approach. The documents recording, accurate description of details, member checking, peer checking, and maximum variation of participants, were considered for ensuring the trustworthiness of the data.
Results: “Transcendental self-control” of family caregiver was explained by four conceptual categories: “caregiver insight", "value prioritization in care", "acceptance of care responsibilities" and "committed care". By predicting the potential risks of playing the care role and deeply understanding the conditions of care while paying attention to the value prioritization outcome-centered and virtue-based care, the family caregiver accepts the care burden through positive thinking and expediency and modestly offers "committed care" while having competent care experiences.
Conclusion: The explanation of self-control concept based on family-centered empowerment model in the real field creates a clear understanding of this concept and leads to "commitment care" by family caregivers of patients with chronic diseases and in turn provides a basis for reducing workload in the clinical setting.
 

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Background & Aim: Self-care plays an important role in the management of care for patients with chronic renal failure. In order to provide effective education, it is necessary to identify problems, concerns and challenges in this group of patients. The aim of this study was to explore the challenges of self-care in the patients undergoing hemodialysis.
Methods & Materials: This study is part of a research project on adherence to treatment regimen in hemodialysis patients referred to hospitals affiliated to Tehran University of Medical Sciences in 2019. Patients with the highest and lowest mean (SD) scores of self-care were selected by the purposeful sampling method and finally, 22 in-depth semi-structured interviews were performed with 18 interviewees. All data were recorded, transcribed and analyzed using the conventional content analysis approach proposed by Graneheim and Lundman.
Results: Findings from the data analysis included four categories: "the mismatch between the view of patient and the view of nurse", "missing loop training", "culture: a double sword ", and "dual role of religious beliefs".
Conclusion: The results of the present study showed that patients undergoing hemodialysis faced many challenges in self-care. They had difficulty in understanding the meaning of self-care and its implications. There is a need to plan for educating these patients and also changing their religious and cultural beliefs.
 

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Background & Aim: Patients with heart failure experience some outcomes such as poor self-management, poor adherence to treatment and low quality of life. The aim of the current study was to evaluate the effect of self-management based discharge planning on treatment adherence in patients with heart failure.
Methods & Materials: In this quasi-experimental research, 80 patients with heart failure hospitalized in teaching hospitals in Zahedan in 2019-2020, were selected by convenience sampling and were randomly allocated into either intervention or control groups. The self-management-based discharge plan consisted of four educational sessions in hospital for the intervention group. In order to follow up, the first call was made 2-3 days after discharge. Then, the patients or their family caregivers were contacted weekly in the first month and twice a month in the second and third month. Data were collected by the treatment adherence questionnaire and were analyzed using independent sample t-test, Fisher exact test, Chi-square and repeated measures ANOVA by the SPSS software version 16.
Results: The two-way repeated measures analysis of variance showed a significant difference in the mean scores of treatment adherence over time (P<0.001) and in the intervention and control groups (P<0.001).
Conclusion: According to the findings, it is recommended that self-management-based discharge plan be employed in an integrated manner for patients with heart failure in medical wards.
 

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Background & Aim: Considering the importance of communication skills in nursing, we aimed to study the impact of online support and e-content on communication skills of nurses with patients.
Methods & Materials: In this quasi-experimental study with pre- and post-design, 100 nurses employed in the orthopedic wards of Chamran hospital affiliated to Shiraz University of Medical Sciences in 2018 were selected randomly and assigned into two groups of 50. Both groups received the electronic content of communication skills. In the intervention group, in addition to receiving educational content, online support was provided through social media for four weeks with the presence of a psychologist, so that by asking real questions and problems or simulated scenarios, appropriate behavior in that situation was discussed. Before and eight weeks after the intervention, communication skills in the both groups were assessed by the Burton Jay's Communication Skills questionnaire, and data was compared using independent t-test and analysis of covariance.
Results: The results showed that there was no significant difference between the two groups in the communication skills score before the intervention, but eight weeks after receiving the e-content, the participants' scores increased in the both groups. This increase was greater in the online support group (P<0.001). In fact, online support caused a difference (0.637) in the communication skills score between the two groups.
Conclusion: The results of this study showed the provision of e-content along with online support has led to the improvement of communication skills. It is recommended that in addition to education through e-content, social media be used in the empowerment programs of the treatment team including communication skills improvement, due to their advantages such as ease of use, availability and relatively low cost.
Clinical trial registry: IRCT20090127001599N27
 

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Background & Aim: The inadequate level of pharmaceutical knowledge of nursing students carries the risk of medication errors, and this is one of the main concerns of clinical educators. Therefore, the aim of the study was to determine the effect of targeted and game-based pharmacology education on pharmacology scores of nursing students.
Methods & Materials: This quasi-experimental interventional study was conducted through the census method on third-semester nursing students of Abadan University of Medical Sciences in 2018-2019. The intervention included teaching clinical pharmacology in the form of game during an internship course (including 10 sessions). The first to third sessions included holding the pharmacology theoretical class, the fourth to ninth sessions included playing game, theoretical classes, and clinical practice, and the tenth session included a station review program and a competitive pharmaceutical data pool program. The pharmacology exam was given before and after the intervention. The data was analyzed by paired t-test using the SPSS software version 18.
Results: There were 77 students until the end of the study, of whom 42 were female and 35 were male. Their mean age was 21±2 years, the total average of students was 15.57±3.81 with a mean pharmacology score of 14.74±3.42. According to the test results, the pre-test mean score was 26.06±5.83 and the post-test mean score was 31.58±4.02, which indicated a significant difference between before and after the intervention (P<0.001).
Conclusion: This purposeful educational program increased the level of pharmacology scores of nursing students and can be used as a suitable method to improve students' knowledge and understanding of pharmacology.
 

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Background & Aim: Self-care education is one of the effective ways to improve the quality of life and health in patients with heart failure. The purpose of this study was to determine the effect of applying the specific situation theory on the quality of life in patients with heart failure.
Methods & Materials: In a clinical trial study, 80 patients with class 2 or 3 heart failure, referred to 12 Farvardin hospital in Kahnooj in 2018 were included. Data collection tool included a three-part questionnaire: demographic variables, Left Ventricular Dysfunction Scale to assess patients' quality of life, and Self-care Heart Failure Index. The questionnaires were completed at the first visit and three months after follow-up. Data was analyzed using independent and paired t-test, ANOVA, Pearson correlation through the SPSS software version 20.
Results: Before the intervention, there was no significant difference in the scores of quality of life and self-care between the two groups. After the intervention, the mean score of quality of life and self-care dimensions increased (P<0.001). Regarding self-care after the intervention, the highest score was related to self-care confidence with mean and standard deviation of 21.43 and 3.30 respectively, and the lowest score was related to self-care management with mean and standard deviation of 17.45 and 5.5 (P<0.001).
Conclusion: Paying attention to the dimensions of self-care based on a specific situation theory can lead to a better understanding of these patients’ problems and appropriate planning, and in turn improvement of the quality of life. Since in this study, most of the participants were illiterate, using visual teaching aids, adjusting the schedule according to the patient's conditions and readiness, and if necessary, family involvement can have positive results. It appears necessary to consider the underlying factors in the implementation of self-care programs, especially in people with lower levels of education and income.
Clinical trial registry: IRCT20141109019862N6
 

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Background & Aim: Structured description of pediatric medical emergencies requires the assessment and classification of underlying factors. The aim of study was to investigate frequency of predisposing factors for the entry of foreign bodies (FB) in the ear, ingestion and aspiration in children under five years in Tabriz.
Methods & Materials: This is a descriptive, cross-sectional study conducted through convenience sampling (n=245) in the ENT and emergency departments and the clinic of children's hospital in Tabriz, from March 2019 to June 2019. A researcher-made tool including the demographic characteristics form and questionnaire on predisposing factors was used to collect the data. Data was analyzed using the SPSS software version 21 through descriptive statistics.
Results: There were 137 (55.9%) cases of  FB aspiration into the airways (upper and lower), and the highest was related to nose. FB in ear was 19.6% and in stomach was 19.2%. Clinical manifestations were pain (50.2%), no clinical signs (29.4%), and the rest were bleeding with pain, cough, shortness of breath, suffocation, wheezing, nausea, and vomiting. The place of event was at home (in living room) and in the evening and night time. FB types included objects, food stuff/snacks/nuts, beans and fruit cores, and toy pieces, and it is most likely to be seed, toy pieces, nuts, shirt buttons, and rosary beads.
Conclusion: Parental, child-related, and environmental predisposing factors were reported. Therefore, future studies are suggested to evaluate the contribution of each of three factors and to implement necessary educational, notification, and interventional measures.
 

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Background & Aim: Caring for children with congenital heart disease is very challenging for their parents, and the mothers of these children have a low quality of life. The aim of this study was to evaluate the effect of discharge planning on quality of life among mothers of children with congenital heart disease undergoing surgery.
Methods & Materials: In this quasi-experimental study, 72 mothers of children with congenital heart disease referred to Shahid Rajaie Cardiovascular center in Tehran in 2019 were included in the study using the continuous sampling method and non-randomly allocated to experimental or control groups (36 in each group). Data collection tool included demographic questions and the SF-36 questionnaire, which was completed before and two months after the intervention. The intervention was performed in six thirty-minute training sessions at the time of admission, during hospitalization and discharge. The training follow-up continued for two months after discharge. Data was analyzed by the SPSS software version 20 using Chi-Square test, independent t-test and Fisher's exact test.
Results: The mean score of quality of life before the intervention was 58.93±19.35 in the experimental group and 64.93±16.78 in the control group, and there was no significant difference between groups (P=0.165). Two months after the intervention, the mean score of quality of life was 73.44±17.81 in the experimental group and 73.67±16.49 in the control group, and there was no statistically significant difference between groups (P=0.956).
Conclusion: The discharge planning did not improve the mothers’ quality of life. It is suggested that in addition to educating about proper care of the child, psychological support be provided for mothers while implementing discharge planning.
Clinical trial registry: IRCT20180501039489N3
 

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Background & Aim: Performing daily activities is a major element of quality of life in heart failure patients. The Duke Activity Status Index (DASI) is a tool to measure factional capacity. We aimed to examine the psychometric properties of the DASI in patients with heart failure.
Methods & Materials: In this methodological study using convenience sampling, we included 120 patients with heart failure referred to the heart clinic of Afshar hospital, Yazd in 2018.  We first translated the original DASI to Farsi using forward and backward translation method. Then, we evaluated its face validity, content validity, criterion-related validity, construct validity (Exploratory Factor Analysis), and reliability (internal consistency).
Results: In quantitative content validity, the content validity index and content validity ratio were confirmed. The criterion-related validity was confirmed using the Spearman correlation coefficient between the New York Heart Association functional classification scores and the DASI score (r=-0.77, P<0.001) with a significant correlation. To assess construct validity, exploratory factor analysis revealed two factors, explaining 52.61% of the total variance. Factor 1 included items with high MET values and factor 2 included those with low MET values. The reliability of the DASI was determined using the Cronbach’s alpha coefficient that was 0.81.
Conclusion: The DASI is of good validity and reliability and due to its appropriate psychometric properties, this tool can be used to evaluate the functional status of patients with heart failure.

 

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Background & Aim: Child marriage is a violation of human rights and children's rights. Since most of these marriages take place without the informed consent of children, and parents are the final decision makers. Therefore, the mothers’ attitude towards the marriage of girls can have an undeniable effect on the early marriage of their daughters. The aim of the present study was to determine the knowledge and attitude of mothers with teenage daughters towards early marriage, its causes and consequences.
Methods & Materials: This descriptive-analytical, cross-sectional study was conducted on 270 mothers with teenage daughters in Tabriz in 2020-2021. Data were collected using a researcher-made questionnaire, and were analyzed using descriptive statistics, one-way analysis of variance, Chi-square test and Fisher's exact test through the SPSS software version 21.
Results: More than half (55.2%) of the mothers had a good level of knowledge about early marriage. The majority of mothers (87.0%) were against marriage before the age of 18. There was a statistically significant relationship between mothers' knowledge and attitude towards early marriage (P<0.001). The emotional, social, intellectual and economic maturity of girls were the most important reasons for the decrease in early marriage, and one of the most important reasons for the increase in early marriage was not reaching intellectual-psychological maturity. The most important consequence of early marriage from the mothers' points of view was the high possibility of family involvement in married life and decision-making.
Conclusion: Despite the negative attitude of mothers towards early marriage, nearly half of them had poor and moderate levels of knowledge regarding early marriage. Therefore, raising the level of knowledge of mothers with teenage daughters about the consequences of early marriage, creating a culture to correct social misconceptions, passing appropriate laws to prevent child marriage, can reduce the severity of this harm.

 

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Background & Aim: Accreditation of hospitals plays an important role in promoting the quality, safety and effectiveness of medical services, and increasing the efficiency of hospitals. The effectiveness of the accreditation system depends on the quality of the accreditation standards, the comprehensiveness of the accreditation method, and the quantity and quality of the accreditation appraiser. There is a need for appropriate metrics to review and evaluate the implementation of the charter of patients’ rights in the accreditation of hospitals. The aim of this study was to explain the challenges of patients’ rights in the Iranian hospitals accreditation system.
Methods & Materials: This qualitative study was conducted using a conventional content analysis approach with the participation of 13 key informants. In parallel with the interviews, with the aim of assessing the comprehensiveness, the coverage of the patients’ rights components was assessed by accreditation metrics in four sessions. Data analysis was conducted using the Graneheim and Lundman method.
Results: The challenges of the accreditation system were explained by two categories "Content deficiencies of hospitals accreditation standards", "Managerial challenges of accreditation system".
Conclusion: Accreditation has an effective and serious role in the improvement of hospital services and can be a good monitor for observing the rights of service recipients and the charter of patients’ rights. This study provides useful information on the content deficiencies of the country's accreditation standards in terms of service recipients’ rights and its implementation challenges that can be used by policy makers.

 

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Background & Aim: Fear of childbirth is one of the reasons for choosing cesarean section. Given the consequences of repeated cesarean section, interventions that control the fear of childbirth are important in mother's decision for the mode of birth. The aim of the study is to assess the effect of individual counseling based on the Fogg model on the motivation and the fear of natural childbirth in women with previous cesarean section.
Methods & Materials: In this clinical trial, 62 pregnant women with a previous cesarean section, referred to Mashhad Comprehensive Health Centers in 2020, were randomly assigned into intervention or control groups. In the intervention group, individual counseling based on the Fogg model was provided in two face-to-face 45-60 minute sessions biweekly and one non-face-to-face session on the Telegram channel at 28-30 weeks of pregnancy. Data was collected by a demographic form, the motivation questionnaire, and the Wijma expectation/ experience questionnaire at the beginning and two weeks after the intervention. Data analysis was performed using statistical tests by the SPSS software version 25 at a significance level of 0.05.
Results: The mean difference of the fear of childbirth score before and after the intervention was 15.84±20.07 for the intervention group and 6.06±23.28 for the control group. Counseling with the fog approach has significantly changed the fear of childbirth score in the intervention group compared to the control group (P<0.001), but the changes in motivation were not statistically significant.
Conclusion: Counseling with the Fogg approach reduced the fear of childbirth score. It is recommended to use this counseling method to reduce the fear of childbirth, and to use strategies to increase the motivation for natural childbirth after cesarean section.
Clinical trial registry: IRCT20200105046014N1

 

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Background & Aim: Cancer is a disease that affects the quality of life of the patient, and palliative care is a solution that can improve it. However, home palliative care program has not developed in most countries of the world. The aim of this study is to improve a home palliative care program for cancer patients.
Methods & Materials: This research is an action research study that was conducted through quantitative and qualitative approaches in Tabriz over 2018-2020. Eighteen home care nurses were selected for interviews using purposive sampling in order to identify the care needs of cancer patients and the barriers to palliative care at home. In addition, a questionnaire to determine the attitude and knowledge was distributed among 60 home care nurses before and after the action stage. The qualitative data were analyzed using conventional content analysis method, and the SPSS software version 14 was used to analyze the quantitative data.
Results: The care needs of cancer patients were determined in five categories and barriers to palliative care in three categories. Cancer patients have physical, psychological, educational, financial and spiritual needs, and barriers to palliative care include poor instruction, families' desperation, and unprofessional caregivers. In the quantitative phase, nurses had average knowledge and negative attitude towards palliative care. Training through virtual space improved the knowledge and attitude of nurses, and the paired t-test showed that the mean score of nurses' knowledge after the action stage was significant.
Conclusion: according to the findings, to improve palliative care at home, the physical, psychological, educational, financial and spiritual needs of cancer patients should be considered. Removing barriers to palliative care including developing guidelines, supporting the families of cancer patients and training special nurses for palliative care at home can improve care in these patients.

 

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Background & Aim: Various factors play a significant role in shaping the professional identity of nursing students, and among these factors, the impact of the hidden curriculum holds utmost importance. However, this process remains still unknown.  The aim of the study is to explore the role of hidden curriculum in the formation of professional identity among undergraduate nursing students.
Methods & Materials: This is a qualitative research using the grounded theory approach. The participants in this study included 35 undergraduate nursing students from Tehran University of Medical Sciences during the 2020-2021 academic year who participated in semi-structured interviews. The interviews lasting between 30 and 60 minutes were conducted with each participant. Subsequently, the interviews were transcribed and analyzed following the framework proposed by Strauss and Corbin in 2008.
Results: After analyzing the data, three main categories and 12 subcategories have emerged. The theory developed in this research was formed through the core category of “identity instability within the nursing profession”. The main categories that emerged were “ambiguity and lack of motivation in professionalization”. The study identified "the governance of a discriminatory culture" as the underlying process, while “the promotion of demotivation resulting from inefficient patterns” served as the basis of this study.
Conclusion: Based on the study's findings, the process of developing a professional identity can be metaphorically likened to a river. In this analogy, discrimination serves as the clouds hovering over this river, casting a shadow on the identity development process. While inefficient patterns can be likened to lightning bolts that further complicate the process. Furthermore, the rocky bed of the river, symbolizing the lack of motivation among learners towards professionalism, makes it even more challenging to build a strong professional identity.
 

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Background & Aim: Eating disorders manifest numerous psychological and social consequences for both individuals and society. The present study was conducted to investigate the effectiveness of cognitive-behavioral therapy in alleviating COVID-19-related anxiety, fear of negative evaluation, and depression among women diagnosed with Anorexia Nervosa.
Methods & Materials: This study employed a quasi-experimental pre-test-post-test design with a control group. The research population consisted of women diagnosed with anorexia nervosa in Tehran in 2022. Thirty participants were selected through convenience sampling from psychological clinics in the 6th and 8th districts of Tehran, and were randomly assigned to either the intervention group (n=15) or the control group (n=15). Questionnaires assessing eating attitudes, COVID-19-related anxiety, fear of negative evaluation, and depression were administered to both groups. The intervention group received a total of eight 90-minute sessions of cognitive-behavioral therapy, while the control group did not receive any intervention. The collected data were subsequently analyzed using multivariate analysis of covariance through the SPSS software version 24.
Results: The results of the study showed that cognitive-behavioral therapy led to a significant reduction in mental anxiety related to COVID-19 (P<0.001, F=36.41), physical anxiety related to COVID-19 (P<0.001, F=39.15), fear of negative evaluation (P<0.001, F=41.92), and depression (P<0.001, F=47.48) in women diagnosed with anorexia nervosa (P<0.001).
Conclusion: Cognitive-behavioral therapy demonstrated efficacy in alleviating psychological disorders among women diagnosed with anorexia nervosa. Given the potentially severe impairment of mental health experienced by numerous individuals with anorexia nervosa, it is imperative to implement measures for identifying and providing psychological interventions to vulnerable groups.

 

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Background & Aim: In recent years, significant changes have occurred in the dynamics of childbearing within familial context. Notably, Iranian families have witnessed a noticeable decline in the desire for childbearing and having additional children. The aim of this study was to explore the determinants of childbearing decision-making among women and men of reproductive age.
Methods & Materials: This study adopts a qualitative research design using the conventional content analysis approach in 2023. The participants comprised 19 married women and men of reproductive age living in Zanjan, who were purposively selected to ensure maximum variation. After obtaining informed consent, the participants were invited to participate in individual, semi-structured interviews. Data collection continued until data saturation was reached, with concurrent analysis conducted throughout the process. The textual data were managed using MAXQDA software, version 2020.
Results: Throughout the inductive data analysis process, seven main categories emerged as determinants of decision-making about childbearing. These categories included social role modeling, reflection within family structure, social and economic requirements, contemporary concerns in parenting, avoidance of responsibility and comfort-seeking, unpleasant past experiences and age-related challenges. Among these categories, social and economic requirements emerged as the most prevalent concept across all interviews, with a total of 505 open codes associated with this category.
Conclusion: The normalization of reduced childbearing rates within the society, accompanied by shifting values and attitudes towards the significance of children, as well as economic and social problems have contributed to an increasing preference for smaller families. Furthermore, the desire for fewer children can be viewed as a response to the individualistic tendencies of women and men, as well as a means of avoiding parenting concerns.

 

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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: Post-treatment follow-up care for breast cancer is crucial in reducing mortality rates, minimizing treatment costs, and enhancing patients' quality of life. This study aims to identify the psychosocial factors affecting post-treatment follow-up care in breast cancer patients.
Methods & Materials: This descriptive-analytical study involved 180 breast cancer patients from Babol and other cities of western Mazandaran province. Participants were selected using a simple random sampling method between 2021 and 2022. Data were collected through personal information questionnaires, the Zigmond Hospital Anxiety and Depression Scale, the Psychological Distress Thermometer, the Fear of Cancer Recurrence Scale, and a post-treatment breast cancer follow-up care checklist. Data analysis was conducted using SPSS version 18, employing descriptive and inferential statistical methods.
Results: The average age of the participants was 51.49 years (SD=12.01). The mean and standard deviation scores for depression, anxiety, and psychological distress were 6.16±2.71, 10.70±4.13, and 5.98±2.54, respectively. The results showed that individuals with higher levels of anxiety, depression, psychological distress, and fear of recurrence are less likely to engage in follow-up care (P<0.05).
Conclusion: The results suggest that health policymakers should address the psychological challenges faced by breast cancer patients. Specifically, providing insurance coverage for the screening and treatment of mental health problems may improve mental well-being, encourage self-care behaviors, and promote overall health.