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This is a retrospective descriptive - analytical study on determination of the relationship between breast cancer and first class familial background in women suffered from breast cancer in hospitals of Tehran university of medical sciences in 1997.The investigated units consisted of 659 women suffered from breast cancer. The samples were randomly assigned into 2 groups, 320 women suffering from breast cancer in case group and 339 healthy women ranging in age from 25 to 64 in control group. The following criteria in two groups were considered: age, pregnancy before 35 years of age, the nonexistence of late menopause and pubertas praecox, and not using contraceptive pills.The background of the first class familial of the samples were compared. Furthermore, the background of breast cancer in mother, sister, mother and sister, two sisters (unilaterally or bilaterally) before and after menopause was compared.To collect data, a questionare was used.The results indicated that there was a significant statistically relationship between breast cancer and first class familial background (P=0.0002). Besides, the background of breast cancer in mother, sister, mother and sister unilaterally and before menopause was significantly related to suffering the patients from breast cancer (PO.05). However, there was no significant relationship between the background of breast cancer in two sisters unilaterally before and after menopause and suffering the patients from breast cancer.

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The present study is a descriptive one made for the purpose of quality assessment of family planning counseling in health and treatment centers affiliated to Tehran University of Medical Sciences in year 2000. 410 client of the Family Planning Social Services who had attended 25 health and treatment centers affiliated to Tehran University of Medical Sciences were participated in this research study. A checklist was completed through the observation of family planning counseling sessions. The finding and results of this study showed that personnel&aposs behaviour and the quality of family planning counseling for the majority of samples in the first section have been suitable. In the section of the history taking from clients helping them to select suitable method and to determine next appointment, data for the majority of samples in this study have been in an average level. In the section of need understanding of clients introductory methods providing information the audiovisual training equipments used during family planning counseling, explanation of way of utilizing the selected method, and finally the environment for family planning counseling have not been suitable for majority of the samples. The findings of this study can be beneficial for public health planning in order to improve the quality of the family planning services.

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Introduction: Self-burning is a cruel method of suicide and prevention is the most effective way to decrease its morbidity and mortality.

Material and Methods: This investigation is a descriptive prospective study performed at Shahid Motahari Burn Center, Tehran, Iran from December 2001 to December 2002. Inclusion criteria included being female, married, having no history of medical and mental disorders and admission of self-burning. Data were collected by a questionnaire and interviews and were analyzed with descriptive statistics methods and chi-square test.            

Results: A total of 35 cases entered our study. The mean age of patients was 24.573.94 years and 48.6% of cases were in the 21-25 year age group, 80% had primary school education, 97.1% were housekeeper and 68.8% had low economical status. There were statistically significant differences in all of these variables. In 42.9% self-burning had happened at 12-18 hour period and in 45.7% it had occurred at yard. Kerosene had been used by 91.4% of the women as the burning agent 94.3% of the women had experienced husband’s violence (verbal and physical), 60% of the women stated that their husbands were guilty in their action and 91.4% of the women didn’t know any supportive sources in the society. The mortality rate was 100%.

Conclusion: This research showed that family violence and marital problems are the most important causes of self-burning in the married women. Because of close relationship to families, community health nurses can prevent self-burning in married women by detecting and eliminating these risk factors.

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Introduction: Attention to psychological abuse of old women as a vulnerable group and its complications are important issues. We performed this study to determine the effect of family counseling program on prevention of psychological abuse of elderly women.

Methods and Materials: This is a semi-experimental study. We selected 30 old women referring to clinics of an educational hospital in Tehran by simple randomization. Data collecting instruments included demographic sheets about old person and family members and a questionnaire about psychological abuse, which were completed by interview. An observational checklist about behavioral symptoms was completed at 3 interview sessions by family and old person at home. Then 6 counseling sessions were established. Duration of every session was 1:30 up to 2 hours. After two months and in the last three sessions, final evaluation was conducted by again completing data collecting instruments.

Results: study results showed that 90% of abusers were woman and family dysfunction was the reason of abuse in 43.3% of cases. Mean score of psychological abuse showed a significant decrease after counseling, using dependent t-test and Wilcoxon test (p<0.001). Also, mean score of behavioral symptoms of abuse showed a statistically significant decrease after counseling, using dependent t-test and Wilcoxon (p<0.001). Pearson correlation coefficient (r=0.90) showed that there was a significant correlation between psychological abuse and behavioral symptoms.

Conclusion: Regarding positive effect of family counselling programs on reduction of psychological abuse of old women, it is suggested that effect of family counseling programs in reduction of other types of abuse be determined.

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Background & Aim: Family history of one member suffering from hepatitis B of family is one of the most important ways of illness transmission in Iran. Thus attention to quality of self care of patients of hepatitis B family has vital role in prevention and control in family and society.

Methods & Materials: This research is descriptive study. Samples of this research included 250 patients which 160 persons belonged to simplex hepatitis B families and 90 persons belonged to multiplex hepatitis B families. Patients refer to the center of blood transfusion organization from all of area of Gillan province. In this study data has collected by patens’ questionnaire include: demographic qualifications that were designed in two parts 1- individual qualifications and illness qualifications and questions were about quality self care of drug regimen meal regimen, addictions, precautions standard, fallow up disease and diagnostic quality self care in these groups has been analyzed in SPSS statistical soft ware by statistical tests such as 2 test and fisher test. (p<0.005).

Results: Our results show that (%64) patients of simplex family and (85.6%) patients of family multiplex have not suitable quality self care. In response to hypothesises (there is relationship between quality of self care of patiens members in family and increasing of HBSAg cases) findings show that exists meaningful relation between self care about hepatitis B and increasing cases HBSAg in families (p<0.05).

Discussion: Regarding to dimensions of quality selfcare about hepatitis B disease has important role in preventing from increasing cases HBSAg in families. Particularly regarding to results of research which indicate unsuitable quality self care of patients about drug regime “diet or therapy” “addictions” follow up disease. Therefore in order to control the hepatitis B in family according to the results of this study it is suggested further efforts should be down. The results of this study can be used for other patients infectious such as hepatitis c and Aids.

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Background & Aim: Due to the fact that family centered care have a crucial role in pediatric nursing, it seems compatibility of nurses&apos and parents&apos perception about parents&apos needs can lead to deliver higher quality care. The aim of this study was to compare parents&apos and nurses&apos perceptions about needs of hospitalized children&aposs parents.

Methods & Materials: This is a cross-sectional survey. One hundred and fifty parents and 80 nurses were selected using convenient sampling method. Data was gathered using Kristjánsdóttir&aposs "parental needs of hospitalized children" questionnaire. Data were analyzed using descriptive and analytical (Chi-squared & Mann-Whitney U tests) methods.

Results: Research findings showed that there was significant difference between both parents&apos and nurses&apos perceptions about parents&apos needs (P=0.012). Both groups believed that parents&apos needs are met partially in hospitals. There was not meaningful difference between the parents&apos and nurses&apos perceptions concerning meeting parental needs (P=0.666). Based on their perceptions, understanding of parents&apos needs help them to meet their requirements in health care facilities. There was a significant difference between parents&apos and nurses&apos perceptions regarding parents&apos need (P=0.018).

Conclusion: Parents and nurses recognized all of the parents&apos needs to be important there were also deficits in meeting these needs. Therefore, parents&apos cooperation with health care team is necessary to facilitate the recovery of sick children as well as meeting parents&apos needs.

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Background & Aim: Healthy behaviors of teenagers are effective on the community development. This study was carried out in order to compare healthy behaviors of female teenagers living with their families and in orphanage centers in Tehran.

Methods & Materials: This was a cross-sectional study. The subjects were consisted of 110 female teenagers that 55 of them dwelled in the orphanage centers and the remaining lived with their families. Both groups were studying at the same schools. Samples were selected using stratified random sampling method. Questionnaire was used to gather data. The data were analyzed by descriptive and analytical statistical methods in SPSS software.

Results: There were statistically significant differences between two groups in nutrition (P<0.0003), sleep & rest (P<0.001), physical exercise (P<0.0013), and individual health (P<0.001). Total score of health behaviors were 112.3, and 87.8 in family group and orphanage group respectively (P<0.001).

Conclusion: The average score of health behaviors in girls that reside in orphanage centers was lower than the score of them who lived with their families. This shows the necessity of planning educational and managerial tools to improve their healthy behaviors.

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Background & Objective: Due to physical and mental complications, stroke causes disability in self-care and adherence to rehabilitation in patients. The purpose of this study was to assess the adherence to rehabilitation regimen in family caregivers of patients with stroke.

Methods & Materials: In this cross-sectional study, 180 family caregivers of patients with stroke were recruited to the study using convenience sampling method. The participants were asked to complete demographic sheet and the Adherence-of-Therapeutic-Regime Questionnaires during two months of stroke. Data were statistically analyzed using descriptive and inferential tests in the SPSS-16.

Results: Findings indicated that only about 10% of caregivers were in good levels of adherence to the rehabilitation regimen and about 25% of them were weak. The weaknesses of the adherence were related to rehabilitation of motion, cognitive and emotional deficiencies, and also prevention of respiratory and skin disorders.

Conclusion: According to the study, a small number of family caregivers were in appropriate level for adherence to the rehabilitation regimen. The nurses should be able to empower the family caregivers to decrease physical and psychological disorders related to stroke in patients.

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Background & 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 & 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  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±11.5 and 49.2±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.

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Background & Aim: Stress is a main problem among nurses which affects their professional performance and personal life resulting in conflict between work and life. The aim of this study was to determine the effect of stress management on work-family conflicts.

Methods & Materials: In a quasi-experimental two-group study, 64 medical nurses were selected randomly to the study from Shahid lavasani hospital in Tehran. Data were gathered using a questionnaire including demographic characteristics, work-family conflict items, and nursing stress scale. Then, the experimental group participated in a 2-day stress management course. The questionnaire was completed by the participants one month later. Data were analyzed in the SPSS v.18.

Results: The mean work-family conflict score was 3.97 in the experimental group at baseline. It declined after the intervention to 3.357 (P<0.001). There was statistically significant difference between the two groups on work-family conflict after the intervention (P=0.007). There was a significant decrease in the job stress from baseline (46.52) to the post-intervention measurement (35.61) in the experimental group (P<0.001). There was a statistically significant difference between the two groups in the mean of job stress after the intervention (P=0.014).

Conclusion: Stress management education declined work-family conflict and job stress among nurses. This education should be used in nursing clinical and educational training programs.

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  Background & Aim: Family caregivers play major role in caring for the patients with dementia. Meanwhile, they are at risks of various diseases. Caring for a person with Alzheimer’s disease carries a significant physical, socioeconomic and psychological burden. This study described the impact of cognitive-behavioral management on burden and problems borne by family caregivers of patients with Alzheimer's disease .

  Methods & Materials: This non-randomized controlled clinical trial was conducted on 70 family caregivers of patients with Alzheimer’s disease. The participants were subjected to experimental and control groups. The Zarit Burden Interview was used to assess the burden experienced by family caregivers of the patients. Data were then analyzed using inferential and descriptive statistical parameters (mean and SD) and paired sample t-test on the difference between the scores of pre-test and post-test . 

  Results: The mean level of caregivers’ burden as measured by ZBI was 44.56± 6.77 and 42.57±5.98, in experimental and control groups before intervention respectively. Caregivers’ burden score was 39.54±5.88 and 44.86±5.87, in experimental and control groups after intervention respectively. Results showed a significant decrease in the training group’s score (P<0.001) .

  Conclusion: Given the obtained results indicating the effectiveness of cognitive- behavioral management in reduction of caregivers’ burden, the present study can be helpful in achieving an effective solution to decrease stress among family caregivers of patients who suffer from Alzheimer's disease .

  

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Background & Aim: Studies have shown that family caregivers’ attitude toward mental illness affects their caring to mental patients and may reduce the quality of caring to them. This study aimed to determine the effect of group psychoeducation on attitude toward mental illness in the family caregivers of patients with bipolar disorder.

Methods & Materials: In this randomized clinical trial study conducted in 2015, 74 family caregivers of the patients with bipolar disorder who had been hospitalized in the psychiatric wards of Razi hospital in Tabriz were selected by random sampling method. Then, they were randomly assigned into the experimental and control groups. The families of experimental group participated in 8 continuous 90-minute 2 times a week psychoeducational sessions. Family caregivers’ attitude toward mental illness was measured using the questionnaire of Opinion about Mental Illnesses (OMI) before and after intervention. Data analysis was conducted using descriptive statistics, Chi-square test, independent t-test, paired t-test and ANCOVA on SPSS software version 13.

Results: The results revealed that there was no significant difference in mean score of attitude toward mental illness between the experimental group and the control group before intervention (92.54±8.51 vs. 90.52±9.43, P>0.05). But the mean score of family caregivers' posttest in the experimental group significantly increased compared to the control group (105.43±14.72 vs. 90.52±7.50, P<0.05).

Conclusion: The study results demonstrate that psychoeducational program improves family caregivers’ attitude toward mental illness. Training methods such as group psychoeducation can be effective in promoting positive attitude in the families of patients with psychiatric disorder.

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Background & Aim: Family-centered care is a concept for describing the approach to caring for children and their families in health services and its main element is the involvement of parents in child care. This study aimed to compare the perception of family-centered care from the perspectives of nursing staff and mothers of hospitalized children in children’s wards.
Methods & Materials: This study was a cross-sectional study conducted on 82 mothers of hospitalized children and 60 nurses working in children’s wards of Afzalipour hospital in Kerman in 2017. In this study, a questionnaire on the family-centered care perception from the perspectives of nurses and mothers was used for data collection. Data were analyzed through SPSS software version 20 using t test, analysis of variance and Pearson correlation coefficient.
Results: Average scores for the perception of family-centered care from the perspective of nurses (3.17±0.79) and of the mothers (2.47±0.85) had significant differences between the two groups (P<0.001). In two groups, the highest average was related to the area of cooperation and the lowest average was related to the support area.
Conclusion: Findings showed nurses’ and mothers’ perceptions of family-centered care were positive but nurses have significantly more positive perception than mothers. This can be promising and nursing staff are required to be diligent about mothers’ participation in care so that the child receives better care.
 

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Background & Aim: Anxiety is one of the most common psychiatric disorders in the family of patients with traumatic brain injury. This study aimed to determine the effect of providing information about the patient’s condition on the anxiety level of the family members of hospitalized patients with traumatic brain injury.
Methods & Materials: This quasi-experimental study was conducted on 90 family members of traumatic brain injury patients admitted to Shahid Bahonar hospital in Kerman in 2016. The participants were selected by the consecutive sampling method and were assigned to intervention and control groups. In the intervention, the participants were informed by the nurse about changes in the patient’s condition during the first three days of admission to intensive care unit. During this period, the control received routine care. Data collection tool was the Spielberger anxiety inventory. Independent and paired t-test were used to compare the mean scores of anxiety using the SPSS software version 16.
Results: There was no statistically significant difference in the mean scores of overt, covert and general anxiety between the two groups before the intervention (P>0.05). However, after the intervention in the experimental group, the mean scores of overt anxiety (45.51±7.26), covert anxiety (45.42±6.51) and general anxiety (90.93±12.72) decreased (P<0.05) compared to the mean scores of overt anxiety (49.22±9.42), covert anxiety (49.02±9.15) and general anxiety (98.24±17.67) in the control group.
Conclusion: Providing planned information on changes in the condition of hospitalized patients with traumatic brain injury can reduce the anxiety of family members of these patients.
Clinical trial registry: IRCT20180206038642N2
 

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Background & Aim: Empowerment is a dynamic, positive, interactive and social process, leading to the improvement of quality of life (QOL) in patients with chronic disease. The purpose of this systematic review and meta-analysis was to determine the effect of family-centered empowerment model (FCEM) on QOL in adults with chronic diseases.
Methods & Materials: By searching FCEM in Persian databases including SID, MagIran, IranMedex, IranDoc, and googlescholar, Scopus, Pubmed, Web-of-science, Proquest, and Sciencedirect, all relevant studies were extracted. The methodological quality of the papers was examined using Cochrane-risk-of-bias. Data analysis was carried out through the random effects model and heterogeneity by I² index. The data were analyzed using the STATA software version 11.0.
Results: Of the 647 initial studies, only 8 studies examined the effect of FCEM on the QOL in adult patients using SF-36. The pooled standardized mean difference of the 8-dimensions of QOL included: social-functioning (1.781), Physical role limitation (1.416), bodily pain (0.987), general health (1.352), social functioning (1.010), general health (1.122), emotional role limitation (0.656), and vitality (1.361).
Conclusion: The implementation of FCEM had a significant effect on the 8-dimensions of QOL based on the SF-36 questionnaire. The implementation of FCEM is recommended in order to improve the QOL of adult patients with chronic disease.
 

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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: Substance use as a crisis and a long-term chronic disorder can lead to psychological burden and reduce the quality of life of family caregivers. The aim of this study was to determine the effect of the quality of life therapy intervention on the burden of the family caregivers of addicts.
Methods & Materials: This is a clinical trial. The research population included all the family caregivers of the recovering addicts, admitted to Baharan psychiatric hospital in Zahedan in 2018. The samples were 80 people who were randomly divided into either intervention or control group. Caregivers in the intervention group received eight sessions of group counseling based on the quality of life therapy and on the basis of the determined content, every other day. Before the intervention and eight weeks after the intervention, the data were collected using the Zarit burden questionnaire and were analyzed by statistical tests through the SPSS software version 21.
Results: Before the intervention, there was no significant difference in the mean score of burden between the two groups (P=0.25). After the intervention, the mean score of family caregiver burden in the intervention group (40.10±12.92) was significantly lower than in the control group (46.80±13.58) (P<0.01).
Conclusion: The quality of life therapy intervention in this study had a positive and significant effect on reducing the burden of family caregivers of addicts. Therefore, it is recommended that healthcare providers use this counseling approach along with addiction treatment programs to improve the psychological well-being of family caregivers.
Clinical trial registry: IRCT20160924029954N11
 

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Background & Aim: Caring for children with chronic illness is associated with the care burden of families and affects their self-efficacy. In addition, family-centered care can have positive outcomes. The aim of this study was to determine the relationship of the perception of family-centered care, burden of care and self-efficacy in the mothers of children with chronic illness.
Methods & Materials: This descriptive-analytical study was conducted in 2019 on 220 mothers of children with chronic illness, admitted to pediatric hospitals in Tehran and were selected using the convenience sampling method. Data were collected using the Perception of Family-Centered Care-Parent, Perceived Maternal Parenting Self-Efficacy, and the Impact-on-Family Scale. Data were analyzed by SPSS software version18 using descriptive and inferential statistics such as Pearson correlation and regression tests at the significance level of 0.05.
Results: Results showed that perception of family-centered care is directly associated with self-efficacy and inversely associated with the burden of care (respectively P<0.001 and P=0.022), so that for each 1-unit increase in the score of perception of family-centered care, self-efficacy of mothers increased by 0.25 and the burden of care decreased by 0.23. No significant association was found between self-efficacy and the burden of care (P=0.962).
Conclusion: Given that family-centered care can lead to an increase in self-efficacy and a reduction in the burden of care, nurses can improve mothers’ self-efficacy and reduce their burden of care by improving family-centered care.
 

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Background & Aim: Addiction as a crisis and a chronic long-term disorder can lead to mental health symptoms in the users and their family members, the most common of which are stress, anxiety and depression. The aim of the study was to determine the effect of a quality of life intervention on the psychological reactions in family caregivers of addicts.
Methods & Materials: This study is a clinical trial. The research population included the family caregivers of addicts admitted to Baharan psychiatric hospital in 2018. The sample consisted of 80 subjects who were randomly divided into intervention and control groups. The caregivers in the intervention group received eight sessions of group counseling based on quality of life therapy and based on specified content, every other day. Eight weeks after the intervention, the data were collected using the DASS-21, and were analyzed by the SPSS software version 21 using paired t test, independent t test, Chi-square and Covariance.
Results: After the quality of life intervention, the mean scores of stress, anxiety and depression in family caregivers in the intervention group (11.50±4.36, 11.05±3.49, 10.57±4.67) were significantly lower than those of in the control group (14.67±4.93, 14.02±4.33, 13.40±4.77) (P<0.01). There were no significant differences in these variables between the two groups before the intervention.
Conclusion: Counseling based on quality of life therapy in this study had a positive and significant effect on reducing the severity of psychological reactions in family caregivers of addicts. Therefore, health care providers are recommended to use this counseling approach along with addiction treatment programs to increase the welfare and psychological well-being of family caregivers.
Clinical trial registry: IRCT20160924029954N11
 
 

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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.