Being hopeful and continuing to move ahead: religious coping in Iranian chemical warfare poisoned veterans, a qualitative study

Spiritual Coping of Emergency Department Nurses and Emergency Medical Services Staff During the COVID-19 Pandemic in Iran: An Exploratory Study

Emergency department (ED) nurses and emergency medical services (EMS) staff have been recently exposed to high levels of stress due to the new Coronavirus (COVID-19) pandemic. This increased stress level may influence the physical and mental health of ED nurses and EMS staff and the quality of caregiving to the patients. A spiritual coping approach is one of the most commonly used strategies to help healthcare workers manage stressful events or situations. This study explores the spiritual coping (positive or negative) among ED nurses and EMS staff during the COVID-19 pandemic. A descriptive cross-sectional study was performed on 494 ED/EMS nurses in Ardabil Province in the northwest of Iran, using a convenience sampling method. The spiritual coping questionnaire (SCQ) was used to assess spiritual coping in the subjects. The results of this study showed that ED nurses and EMS staff generally used positive spiritual coping methods to reduce stress during the COVID-19 pandemic. Multiple linear regression indicated that workplace (β = 0.22, p < 0.001), service location (β = 0.16, p < 0.001), and type of employment (β = - 0.13, p = 0.012) were significant predictors of positive spiritual coping, and older age (β = 0.13, p = 0.045), overtime work (β = 0.12, p = 0.01), and marital status (β = - 0.12, p = 0.021) were predictors of negative spiritual coping. Our findings indicated that positive religious behavior was the main spiritual coping strategy used by healthcare workers. The findings could help emergency nurse managers to propose future strategies to minimize stress based on the use of spiritual coping strategies and provide time and facilities to pray.

Spiritual Self-care in Stroke Survivors: A Qualitative Study

Self-care and quality of life challenges significantly affect post-stroke life. Stroke patients look for strategies to improve their performance and cope with their new situation. The aim of this study was to explore spirituality in self-care from the perspective of stroke survivors in the northwest of Iran. Purposive sampling is done on 15 participants through Semi-structured interviews of obtained data through conventional content analysis approach. Two categories of "spiritual self-care" as the main theme included "supplication" comprising subcategories of "worship and prayer", "resort" and "trust" and "religious beliefs" with subcategories of "divine providence" and "divine blessing". Based on results of this study, Spirituality increases motivation for self-care and adaptation, reduces stress and helps patiently manage diseases as realities.

Influences of religiousness/spirituality on mental and physical health in OEF/OIF/OND military veterans varies by sex and race/ethnicity

BACKGROUND

Religiousness/spirituality (R/S) has been associated with greater mental wellbeing in US military veterans, but this work has been conducted primarily with older veterans, cross-sectionally, using a constrained set of R/S and mental health constructs, and lacking consideration of the influence of sex and race/ethnicity. Further, few studies have focused on associations of R/S with veterans' physical health.

METHOD

We investigated the relationship of R/S to mental and physical health in a sample of 410 Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn veterans within five years of military separation and one year later.

RESULTS

In the full sample, R/S coping, R/S organized practices and private prayer minimally related to mental or physical wellbeing, yet R/S struggle related inversely to concurrent and subsequent mental and physical health. For women only, higher baseline organized R/S was associated with lower subsequent stress, anxiety, and insomnia. For men only, baseline R/S coping predicted subsequent poorer physical quality of life and baseline R/S struggle predicted subsequent increased pain. For minority race but not white veterans, higher baseline private prayer predicted increased current pain level at 12 months; for Latinx ethnicity only, higher baseline R/S coping predicted increased quality of life a year later and higher baseline R/S struggle predicted higher subsequent levels of anxiety.

CONCLUSIONS

R/S, broadly conceptualized, may relate to wellbeing in military veterans in different ways depending on sex and race/ethnicity, with implications for the role of R/S and R/S struggle in personalizing mental and physical health services.

A Qualitative Exploration of Occupational Adaptation in Caregivers of People with Multiple Sclerosis

Due to the unpredictable and progressive nature of multiple sclerosis, the burden of care is placed on the primary caregivers. This study aimed to explore occupational adaptation strategies implemented by primary caregivers to adapt to occupational challenges of caregiving. Seventeen primary caregivers of people with MS were interviewed using purposive sampling techniques. Data were analyzed using content analysis method. Two main categories of strategies were determined: (a) Strategies to alleviate intrapersonal challenges of occupational adaptation; and (b) Strategies to alleviate environmental challenges of occupational adaptation. These included various skills and solutions that aided primary caregivers' adaptation toward occupational challenges. Based on the results of this study, occupational adaptation is a means of achieving mastery in alleviating occupational challenges to cope with adverse circumstances. The results of this study can be used to help therapists design appropriate caregiver-focused interventions, ultimately improving caregiver performance.

The Effect of Spiritual Care Based on the Sound Heart Model on the Spiritual Health of Patients with Acute Myocardial Infarction

Meeting the spiritual needs of patients with cardiovascular diseases has a significant effect on their speed of recovery and spiritual health, especially in coronary care units (CCUs). The present study was conducted to investigate the effect of spiritual care based on the sound heart model on the spiritual health of patients with acute myocardial infarction (AMI) admitted to the CCU of Chamran Hospital in Isfahan, Iran, in 2016. This clinical trial was conducted on 92 patients with AMI selected by convenience sampling and randomly assigned to the intervention (n = 46) and control (n = 46) groups. The spiritual care program based on the sound heart model was regularly carried out for the intervention group over 3 days at 5-8 PM during their hospital stay, and continued for 1 month at home after discharge from the hospital, and the control group only received routine nursing interventions. The patients completed Paloutzian and Ellison's Spiritual Well-Being Scale at baseline and a month after the intervention. Data were ultimately analyzed using Fisher's exact test, Mann-Whitney's test, the Chi-square test, and the t test. The spiritual care program was able to improve the mean scores of religious health (7.8), existential health (9.3) and the total score of spiritual health (17.1) in the intervention group, while these scores reduced to 0.9, 3.4 and 4.2 in the control group. A significant difference was found between the intervention and control groups in terms of the spiritual health score (P < 0.001). The present findings confirmed the effect of spiritual care based on the sound heart model on promoting spiritual health in patients with AMI. Its application as a holistic care approach is therefore recommended for improving the signs and dimensions of spiritual health in patients with coronary artery disease, especially MI.

The experiences of Iranian patients with epilepsy from their disease: A content analysis

This qualitative study investigated experiences of patients with epilepsy in Iran regarding stigma. Twenty-two participants were chosen by purposive sampling method. After getting informed consent, we conducted and recorded interviews and then transcribed them verbatim. After that, all the researchers read the texts thoroughly, and the data were analyzed using conventional content analysis method. Seven categories emerged from the analysis including need for support, defense mechanisms, superstitious beliefs, negative feelings, negative reactions of others, imposed deprivations, and spirituality. These results will increase healthcare professionals' knowledge about the problems of Iranian patients with epilepsy and improve the design of healthcare models that can promote successful coping strategies for them.

Identification of Concepts of Spiritual Care in Iranian Peoples with Multiple Sclerosis: A Qualitative Study

Living with multiple sclerosis (MS) often needs attention combined with receiving the holistic care. Attention to spiritual care dimension is one of the most important aspects of care for these patients. This study aims at exploring and explaining dimensions of spiritual care for MS patients in care system of Iran. This study is conducted to explore the concept of spiritual care in care system of Iran during 2015-2016. Purposive sampling is done on 25 participants through unstructured interviews and observation of obtained data through conventional content analysis approach. Four themes of participants' experiences in spiritual care include restoration of identity essence and nature; disease as a factor for nearness to God; giving meaning to life; and disease as a facilitator for self-purification. Clear understanding of spiritual care dimensions and promoting knowledge in MS nurses as the caregivers play important roles in achieving the goals of health among patients in different cultures and religions. Given the results of this study, the themes such as the restoration of identity essence and nature, the disease as a factor for nearness to God, giving meaning to life and the disease as a facilitator for self-purification play important roles in explaining the concept of spiritual care in patients with MS. Therefore, the MS nurses and other health professionals need to effectively and successfully integrate the concept of spiritual care with their professional performance by deep understanding of this concept and try to provide holistic care to respond to MS patients' intertwined needs.

Taking Refuge in Spirituality, a Main Strategy of Parents of Children with Cancer: a Qualitative Study

Background:

Due to the rise in prevalence of childhood cancer the impact on family caregivers is increasing. Spirituality may be an alleviating factor for improving the quality of parent life. There is a lack of organized spiritual care in health care facilities, so that this aspect needs more emphasis. Thus this study aimed to evaluate the spiritual strategy of parents of children with cancer.

Materials:

This qualitative study was conducted with a conventional content analysis approach. Fifteen parents of hospitalized children with cancer at the Oncology and Hematology departments of governmental pediatric hospitals nationwide were purposefully selected. Semi-structured in-depth interviews were conducted for data collection and inductive content analysis.

Results:

Eleven sub-themes were extracted in the data analysis, which resulted in the generation of three themes: “spiritual strategy,” “spiritual escape” and “spiritual growth”.

Conclusion:

The spiritual approach of parents of children with cancer had a significant influence on spiritual care and consequently the acceptance of disease and coping with the associated conditions. Spiritual care clearly should be introduced into the health care system of Iran, particular for the parents of children with cancer.

Dealing with Chronic Illness: Experiences of Iranian Families of Persons with Multiple Sclerosis-A Qualitative Study

Background

Today family members are providing care and support to each other during illness. In particular, in chronic illness, such as multiple sclerosis, the families are more involved in caring for and supporting their patients, so they use several strategies to cope with this situation. The purpose of this study was to explore the coping strategies in family caregivers of persons with multiple sclerosis in Iran.

Methods

This is a qualitative study that was conducted through 18 family caregivers of persons with multiple sclerosis. A purposeful sampling method was used. Data were collected through semistructured and in-depth interviews conducted in Multiple Sclerosis Society and hospitals of Tabriz in Iran. The collected data was analyzed according to qualitative content analysis.

Results

Five main categories were elicited from interviews: “using spirituality,” “living with hope,” “experiencing persistence and stability,” “seeking support,” and “seeking alternative treatments.” Conclusion. The study findings can help to inform the support given to families to help them cope with the effects of caring for someone with multiple sclerosis. Health system managers and professionals by using these results are able to support patients and their families appropriately in order to improve their quality of life and alleviate the complications of disease.

Air Force Chaplains' Perceived Effectiveness on Service Member's Resilience and Satisfaction

This study examined how 3,777 active duty male United States Air Force service members' (SMs) rank and residence location moderated the associations between perceived chaplain effectiveness, SMs' resilience, family coping, marital satisfaction, and satisfaction with the Air Force (AF). A multiple-sample structural equation model was conducted with four subgroups of SMs who had received chaplain support: enlisted members living on base, enlisted members living off base, officers living on base, and officers living off base. Chaplain effectiveness was significantly related, both directly and indirectly, to SM's spirituality, resilience, family coping, marital satisfaction, and AF satisfaction. Resilience was significantly associated with increased AF satisfaction for all SMs, except for those living on base. However, living on base was found to strengthen the protective factor between family coping and relationship satisfaction. Rank was found to moderate the link between resilience and family coping. Family coping was significantly related to increased relationship satisfaction.

Spiritual development in Iranian nurses

BACKGROUND

Spiritual development is one of the most important aspects of socialization that has attracted the attention of researchers. It is needed to train nursing student and novice nurses to provide high-quality care for patients. There is ambiguity in the definition of spiritual development and its relations, especially in the eastern countries.

RESEARCH OBJECTIVES

To explore the concept of spiritual development in Iranian nurses.

RESEARCH DESIGN

Qualitative content analysis approach. Data were gathered from semi-structured interviews. Participants and research context: The participants were 17 Iranian Muslim nurses selected using a purposeful sampling. The place of interviews was on their choice. Ethical considerations: Based on the principles of the Helsinki declaration, the focus was on preserving the participants' autonomy, confidentiality, and anonymity. The participants were told the study purposes and trends, and their rights were emphasized; they were then asked to sign written consent forms. Formal research approval was obtained from Kerman University of Medical Sciences. Ethical approval was granted by the University Ethics Committee before the study was conducted (K/92 etc).

FINDINGS

Three themes for spiritual development were defined: obligation to religion, commitment to ethics, and commitment to law. From the results, factors such as connection to the limitless divine power, personal and society-oriented ethical codes, and commitment to the law are proposed.

DISCUSSION

There are some differences between these findings and previous study, especially in the relation of the spirituality, religion, and law. Some studies, mostly Iranian, support these findings partially.

CONCLUSION

The results suggest that it is better to teach nursing education based on humanistic principles, ethics, and law to the new generation of nurses to improve community health and development. More studies are needed to examine the relation between these themes.

Religion as an Alleviating Factor in Iranian Cancer Patients: a Qualitative Study

After diagnosis of cancer, many patients show more inclination towards religion and religious activities. This qualitative study using semi-structured interviews explored the perspectives and experiences of 17 Iranian cancer patients and their families regarding the role of religion in their adaptation to cancer in one of the hospitals in Tehran and a charity institute. The content analysis identified two themes: "religious beliefs "(illness as God's will, being cured by God's will, belief in God's supportiveness, having faith in God as a relieving factor, and hope in divine healing) and "relationship with God during the illness." In general, relationship with God and religious beliefs had a positive effect on the patients adapting to their condition, without negative consequences such as stopping their treatment process and just waiting to be cured by God. Thus a strengthening of such beliefs, as a coping factor, could be recommended through religious counseling.

Effect of Islam-based religious program on spiritual wellbeing in elderly with hypertension

Background:

Lack of spiritual health in patients with hypertension leads to many mental, social, and physical effects, On the other hand, considering the prevalence of hypertension among the elderly, interventions to enhance their spiritual wellbeing is essential. Therefore, the aim of this study was to examine the effect of religious programs based on Islam on spiritual wellbeing in elderly patients with hypertension who referred to the health centers of Isfahan in 2014.

Materials and Methods:

This study was a randomized clinical trial. The participants (52 elderly patients with hypertension) were randomly divided in to experimental and control groups. Religious program was implemented for the experimental group in eight sessions in two Isfahan health centers. Spirituality wellbeing survey (SWB) questionnaire was completed in three steps, namely, pretest, posttest and follow-up (1 month) in two groups. In the study, Chi-square test, independent t-test, and repeated-measures analysis of variance were performed for analyzing the data.

Results:

Before the intervention, there was no significant difference between the mean scores of spiritual wellbeing, the religious dimension, and the existential aspect of spiritual wellbeing of the two groups. However in the posttest step and follow-up stage, the mean scores of spiritual wellbeing, the religious dimension, and the existential aspect of spiritual wellbeing in the experimental group was significantly higher than in the control group (P < 0.001).

Conclusions:

The religious program based on Islam promoted the SWB of elderly patients with hypertension; further, nurses can use these programs to promote the SWB of elderly patients with hypertension.

Patients' experiences of adapting to multiple sclerosis: a qualitative study

Unpleasant, unpredictable symptoms, difficult treatment regimes, and uncertainty about the future of Multiple Sclerosis require the patients to adapt to new life changes and restrictions. This study aimed to explore patients' experiences of adapting to Multiple Sclerosis. A qualitative content analysis method was used to conduct this study. The study participants were 25 patients with Multiple Sclerosis, chosen through purposeful sampling. Data were analyzed by using content analysis. The analysis resulted in the emergence of seven themes and eighteen subthemes. The main themes were: religiosity, information seeking, seeking support, hope rearing, emotional reactions, concealing the disease, fighting the disease and disability. These themes can represent the perceived characteristics and difficulties of adaptation to Multiple Sclerosis by patients. These findings can help nurses and families to aid patients in increasing their abilities to adapt to the disease and enhance their quality of life.

Assessing cancer patients' quality of life and coping mechanisms in Radiotherapy Department of the University College Hospital, Ibadan

BACKGROUND

Cancer is often associated with a lot of pain and suffering. These suggest that coping with the symptoms, diagnosis and treatment of cancer is a major life stressor that is capable of influencing patients' quality of life (QoL).

PURPOSE

The purpose of the study is to assess the relationship between cancer patients' QoL dimensions and coping strategies in the Radiotherapy Department of the University College Hospital Ibadan, Nigeria.

METHODS

Data were collected on clinic days from all available and consenting cancer patients who were receiving treatment at the radiotherapy department. Participants were informed of their right to decline to fill the questionnaires.

RESULT

In this study, 237 cancer patients participated. They had an age range of 15 to 95 years with a mean age of 49.91 years. There was significant inverse relationship between physical well-being with behavioural disengagement, venting, planning and self-blame (p < 0.05); social/family well-being has significant linear relationship with active coping, emotional support, positive reframing, instrumental support, acceptance and religion (p < 0.05); emotional well-being has significant inverse relationship with behavioural disengagement and self-blame (p < 0.05); functional well-being has significant linear relationship with active coping, instrumental support and acceptance (p < 0.05).

CONCLUSION

It is important to assess cancer patients for the kind of coping strategies they are adopting to use in coping with their cancer burden, thereby guiding against lower QoL due to negative coping strategies. Intervention programmes could be developed to help cancer patients adopt more positive and effective coping strategies to improve patients' QoL.

Spiritual experiences of war veterans who suffer from combat-related post-traumatic stress disorder: a qualitative study

Recognition of the spiritual experiences of patients with post-traumatic stress disorder may be helpful in their rehabilitation. Accordingly, the present study has been carried out to determine the spiritual experiences of Iranian Muslim warriors who suffer from the previously mentioned disorder. In this qualitative study, 22 patients were selected using an objective-based sampling method and underwent an individual, semi-structured thorough interview. The data were analyzed using content analysis. The spiritual experiences of the participants were divided into two main categories as follows: (1) religious attitude consisting of three sub-categories known as "religious beliefs," "religious sentiments," and "religious behaviors" and (2) a national sensibility that includes the two sub-categories of "patriotism" and "proud" of being injured for my homeland. The analysis of the participants' spiritual experiences showed that their specific religious orientation and feelings of nationalism assisted with their improved ability to cope with the consequences of their disorder. Therefore, it is recommended that caregivers use patients' spiritual values to help them cope more efficiently.

The lived experiences of parents of children diagnosed with cancer in Iran

Threatening nature of childhood cancer and the aggressiveness of prescribed treatments place enormous stress on the family of children suffering from cancer. This study was conducted to better understand the lived experiences of parents of children suffering from cancer and to document their account of such experiences. The aim of this research was to describe the lived experiences of parents of children diagnosed with cancer in Iran. This hermeneutic phenomenological study was conducted between June 2008 and May 2009. Data were generated from 15 parents using in-depth interviews to capture their experiences of having children with cancer. Analysis is based on the framework of Diekelmann enabled data interpretation and elaboration of shared themes. One constitutive pattern 'Feeling trapped in the cancer dead end' and four related themes, namely 'Contradiction in reconciliation with situation', 'Doomed to accept', 'Isolation from others' and 'Devastated life', were identified. The results of this study showed that parents feel as if they are trapped by their child's disease. They are affected by several mental, social and familial issues while trying to tolerate their child's illness and conform to the new order of life.