Background More than 50,000 deaths in terms of cancer occur annually in Iranian hospitals. Determining the preferred place of end-of-life care and death for cancer patients in Iran is a quality marker for good end-of-life care and good death. The purpose of this study was to determine the preferred place of end-of-life care and death in cancer patients. Method In 2021, the current descriptive cross-sectional investigation was carried out. Using the convenience sample approach, patients were chosen from three Tehran referral hospitals (the capital of Iran). A researcher-made questionnaire with three parts for demographic data, clinical features, and two questions on the choice of the desired location for end-of-life care and the death of cancer patients served as the data collecting instrument. Data were analyzed using SPSS software version 18. The relationship between the two variables preferred place for end-of-life care and death and other variables was investigated using chi-square, Fisher exact test, and multiple logistic regression. Result The mean age of patients participating in the study was 50.21 ± 13.91. Three hundred ninety (69.6%) of the patients chose home, and 170 (30.4%) patients chose the hospital as the preferred place of end-of-life care. Choosing the home as a preferred place for end-of-life care had a significant relationship with type of care (OR = .613 [95% CI: 0.383–0.982], P = .042), level of education (OR = 2.61 [95% CI: 1.29–5.24], P = 0.007), type of cancer (OR = 1.70 [1.01–2.89], P = .049), and income level (Mediate: (OR: 3.27 (1.49, 7.14), P = .003) and Low: (OR: 3.38 (1.52–7.52), P = .003). Also, 415 (75.2%) patients chose home and 137 (24.8%) patients chose hospital as their preferred place of death. Choosing the home as a preferred place of death had a significant relationship with marriage (OR = 1.62 [95% CI: 1.02–2.57], P = .039) and time to diagnostic disease less than 6 months (OR = 1.62 [95% CI: 0.265–0.765], P = .002). Conclusion The findings of the current research indicate that the majority of cancer patients selected their homes as the preferred location for end-of-life care and final disposition. Researchers advise paying more attention to patients’ wishes near the end of life in light of the findings of the current study. This will be achieved by strengthening the home care system using creating appropriate infrastructure, insurance coverage, designing executive instructions, and integration of palliative care in home care services.

/pdf/preferred-place-of-death-and-end-of-life-care-for-adult-1as1zblq.pdf

Preferred place of death and end-of-life care for adult cancer patients in Iran: A cross-sectional study

Abstract Aim This study aimed to investigate procrastination in nursing care providing. Design This descriptive cross-sectional study was carried out on 125 nurses in ICUs, PICUs, NICUs, and surgery wards, who were selected by census sampling in Iran. Methods The data were collected using the Procrastination Scale, which consisted of 25 items relating to 3 factors. Data were analyzed using statistics, Chi-square, Friedman test, analysis of variance, and Kolmogorov–Smirnov tests. Results Overall, 37% of the participants showed very high or high procrastination. Most of the procrastination was observed in the “Task aversion” (44.2%). ANOVA indicated that the mean total procrastination score had a significant relationship with age ( p = 0.013), work experience ( p = 0.006), and marital status ( p = 0.02). Nurses with permanent employment ( p = 0.014) and lower education ( p = 0.009) and women ( p = 0.023) were much more likely to procrastinate the provision of care. Conclusion It is recommended to adopt appropriate management strategies and take adequate measures to reduce procrastination, considering the existence of procrastination among nurses and its adverse impact on the quality of care. 

/pdf/assessment-of-procrastination-in-providing-nursing-care-1xkpjuyb.pdf

Assessment of procrastination in providing nursing care among Iranian nursing staff

In the health care setting, and especially in cancer patients nearing the end of life, administrators, medical staff, patients, and families face challenges of a social, legal, religious, and cultural nature in the process of care. The present study aimed to perform a metasynthesis of qualitative studies conducted on providing end-of-life care for cancer patients. The present metasynthesis was conducted using Sandelowski and Barroso's method. A literature search was performed in PubMed, Scopus, Web of Science, and Embase databases, from the inception to date, and a total of 21 articles were identified as eligible for inclusion in the study. Critical Appraisal Skills Programme (CASP) criteria were used for assessing the articles, and data were analyzed by the subject review. Six themes were extracted for end-of-life care including psychological support, palliative support, educational-counseling support, spiritual support, preferential support, and supportive interactions, each comprising a number of categories. The most frequently mentioned categories were high-value care (67%) and adaptive acceptance (57%). The findings of this metasynthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The present study showed that providing high-value care and facilitating adaptive acceptance are important constituents of a holistic strategy for providing end-of-life care to cancer patients.

End-of-Life Care Provided for Cancer Patients: A Metasynthesis Study.

Interpretation of palliative care concept, its barriers and facilitators using meta-synthesis

Although providing spiritual care is an important part of holistic nursing care for psychiatric patients, factors associated with spiritual care competency in mental health nurses remain unclear. The aim of our study was to explore a possible association of personal and external factors with spiritual care competency in mental health nurses.This prospective questionnaire-based cross-sectional study was conducted by inviting mental health nurses from mental health hospitals and tertiary referral centers. Personality traits and spiritual care competency were assessed by using [1] "big-five Mini-Markers" questionnaire, and [2] spiritual care competency scale, respectively. From the 250 mental health nurses being invited, 239 valid questionnaires were valid for final analysis. Statistical analyses including descriptive statistics, ANOVAs, t-tests, and hierarchical multiple regression models were used to investigate the associations between personal/external factors and their spiritual care competency in mental health nurses.The mean age of the 239 participants was 35.96 ± 8.11 and the mean years of working experience was 9.41 ± 7.06. Over 90% of them had no experience of providing spiritual care. There were significant positive correlations of spiritual care competency with the experience of delivering spiritual care (p < 0.001), previous participation in spiritual care education programs (p = 0.045), a longer working experience (p = 0.014), and a higher education level (postgraduate vs. college, p = 0.006), as well as the personality components of "Conscientiousness" (p < 0.001), "Agreeableness" (p < 0.001), "Extraversion" (p = 0.03), and "Openness/Intellect" (p < 0.001).Both personal and external factors may be related to the self-perception of spiritual care competency among mental health nurses. These findings may help mental health nurses understand the possible positive and negative associations of their personality components with their spiritual care abilities. Moreover, our identification of the positive impacts of educational programs and previous experience of spiritual care on spiritual care competency may underscore the importance of tailoring appropriate training programs to cater for the individual needs of mental health nurses. 

/pdf/factors-affecting-spiritual-care-competency-of-mental-health-2xpo1tyv.pdf

Factors affecting spiritual care competency of mental health nurses: a questionnaire-based cross-sectional study

Palliative care is a human need, which is essential for patients with chronic disorders such as cancer, and aims to prevent and relieve pain and improve the quality of life (QoL) of patients and their families. Since culture is an important factor in predicting health behavior, it can be effective in providing these services. Thus, this review study has been conducted to assess the cultural aspects of palliative care in Iran. The findings were classified and provided based on the definition of palliative care on three major topics including early diagnosis, during treatment and disease period, and finally death and later. In the beginning of diagnosis, the most important element of palliative care is informing the disease to the patient and family. Disclosure of the disease in Iran is not culturally possible. The most important cultural barrier is cancer stigma in Iran, which affects the related measures such as screening diagnosis. The most important challenge in the treatment is pain management, which overshadowed factors such as cultural beliefs. Despite the challenges in the diagnosis and treatment of patients, which make the care difficult, the religious and spiritual context of Iranian people in the death and bereavement, as well as the strong family connections, are considered as a strong point that is helpful in the process of passing from the stage. According to the statement of the Union for International Cancer Control in 2008 based on “a better attitude toward cancer by 2020 and removing misconceptions about the disease”, the available cultural opportunities in the country can be considered as areas in need of strengthening. The negative attitudes and beliefs can be reformed by adopting strategies such as increasing the awareness of the community as the first strategy in changing the culture.

https://openventio.org/Special-Edition-1/Cultural-Aspects-of-Palliative-Cancer-Care-in-Iran-PMHCOJ-SE-1-110.pdf

Cultural Aspects of Palliative Cancer Care in Iran

Background: Due to the growing prevalence of cancer globally, the disease is considered one of the most important sources of stress, disability, and reduced life satisfaction. Although life satisfaction is supposed to be a relatively stable psychological construct, it may change in response to life events. Life-satisfaction is the assessment of the quality of life according to one’s chosen criteria. Objectives: The purpose of this research is the psychometric evaluation of the Persian version of “Brief Multidimensional Life Satisfaction Scale” (BMLSS) in Iranian patients with cancer. Methods: The present study was a methodological research, during which the BMLSS was translated and the Farsi version was validated for patients with cancer. Results: The fit indices of confirmatory factor analysis confirmed the dual dimension of the BMLSS. Regarding the convergent validity of the BMLSS, the total score of the instrument had a positive and significant relationship with age and the sense of religiosity. Cronbach's alpha and Intraclass Correlation were calculated. Conclusions: The findings indicated that this Persian version has good validity and reliability and can be used as a comprehensive instrument in Iran.

The Translation and Psychometric Evaluation of the Persian Version of Brief Multidimensional Life Satisfaction Scale for Iranian Patients with Cancer

Introduction: 
Self-confidence in adolescents gradually diminishes during puberty due to changes in identity and in their responsibilities. It decreases more in adolescents suffering from chronic disease of diabetes, in whom promotion of self-confidence for self-management behaviors, has a significantly positive effect. The purpose of this study was to investigate the effect of
spiritual care on the self-confidence of adolescents with type 1 diabetes.
 Materials and Methods:
This quasi-experimental clinical trial study was performed on 52 adolescents with type 1diabetes,
selected through convenience sampling and randomly assigned in two groups, the intervention
and control (n=26 each). The intervention was implemented daily for 6 sessions in the experimental
group. Data were collected using the demographic and Rosenberg scale and analysis was done by
SPSS-19 software. Descriptive and inferential statistics and repeated measure ANOVA, Mann- Whitney, Fisher, and Chi-square tests were used.
 Results:
 The mean scores of self-confidence in the control group before/after the intervention, and also in the follow up period were 0.46, 1.5, and1.46, respectively. The values in the intervention group were 3.92, 5.69, and 6.38, respectively. Results of analysis of variance showed the significant effects of intervention (p<0.001).
Conclusion: 
The results indicate the effect of spiritual care on the self-confidence of adolescents with type 1 diabetes, emphasizing that nurses, as part of the health care system, must pay attention to spiritual care and its continuity in the care of these patients.

The Effect of Spiritual Care on Self Confidence of Adolescents with Type 1 Diabetes

Background: Diabetes is a stressful condition, which affects identity and psychosocial dimensions in adolescent then they need to be adapted. This study was conducted to investigate the effect of spiritual care on adolescents' adjustment with Type 1 diabetes. Materials and Methods: This randomized controlled clinical trial study was performed on 52 adolescents with Type 1 diabetes mellitus members of Sanandaj Diabetes Association (Sannadaj city, Kurdistan province, Iran), who were selected through convenience sampling and randomly divided into two groups (26 in each group). Spiritual care in the intervention group was performed in group form and daily for 6 sessions. Data were collected using "Baseline Characteristics Questionnaire", and "Lazarus and Folkman Coping Strategies Questionnaire" before and after the intervention and three weeks later. Data were analyzed using SPSS software version 19.0. Results: Chi-square test indicated the difference between the groups according to the level of education (p=0.048). Therefore, the effect of this variable was moderated. The mean of overall adjustment score in control group before and after providing intervention in the intervention group and during the follow-up period was 94.92±13.04, 90.12±10.96, and 92.08±13.34, respectively. The mean of overall adjustment scores in the intervention group before and after intervention and during the follow-up period were 104.08±23.35, 112.46±17.09, and 117.35±16.05, respectively; also t-test result showed a significant effect of intervention type (p<0.001). Conclusion The results indicate the positive effect of spiritual care on adolescents' adjustment with Type 1 diabetes after the intervention and three weeks later in intervention group, but the increase of adjustment was not rational reasonable in control group.

https://ijp.mums.ac.ir/article_11708_382c6f3618b5be7f726062a722bfa0b0.pdf

The Effect of Spiritual Care on Adjustment of Adolescents with Type 1 Diabetes

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Papers

Cultural Aspects of Palliative Cancer Care in Iran

The Translation and Psychometric Evaluation of the Persian Version of Brief Multidimensional Life Satisfaction Scale for Iranian Patients with Cancer

The Effect of Spiritual Care on Self Confidence of Adolescents with Type 1 Diabetes

The Effect of Spiritual Care on Adjustment of Adolescents with Type 1 Diabetes