Objectives This study aimed to identify coping strategies used by family caregivers of patients with schizophrenia and their determinants. Methods This was a descriptive correlational study. Participants were 225 family caregivers of patients with schizophrenia who were referred to the psychiatric clinic at one large teaching referral hospital in Iran. They were selected through purposive sampling method. Data collection tools were demographic and clinical data form, the Zarit Burden Interview (ZBI) and the Family Coping Questionnaire (FCQ). Results The score of caregiver burden was 65.14 ± 9.17. Of 225 family caregivers, 23.11% used an avoiding coping strategy. There was a significant relationship between caregiver burden and coping strategies ( P < 0.001). The regression model showed that adaptive coping strategies were significantly associated with some demographic characteristics including age, education level, gender, employment status, losing the job because of caregiving responsibilities, perceived income adequacy, duration of illness, duration of caregiving and caregiver burden ( P < 0.05). Conclusion Family caregivers of patients with schizophrenia experience a high level of burden, which can put them at risk of using maladaptive coping strategies. Mental health professionals should plan programs that support both family caregivers and patients in clinical and community settings.

The broad spectrum of problems caused by caring for a patient with mental illness imposes a high burden on family caregivers. This can affect how they cope with their mentally ill family members. Identifying caregivers' experiences of barriers to coping is necessary to develop a program to help them overcome these challenges. This qualitative content analysis study explored barriers impeding family caregivers' ability to cope with their relatives diagnosed with severe mental illness (defined here as schizophrenia, schizoaffective disorders, and bipolar affective disorders). Sixteen family caregivers were recruited using purposive sampling and interviewed using a semi-structured in-depth interview method. Data were analyzed by a conventional content analytic approach. Findings consisted of four major categories: the patient's isolation from everyday life, incomplete recovery, lack of support by the mental health care system, and stigmatization. Findings highlight the necessity of providing support for caregivers by the mental health care delivery service system.

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Introduction: Medication nonadherence is highly prevalent in patients with bipolar disorders and often results in worsening disease prognosis. The purpose of this study was to investigate the effect of group psychoeducation on medication adherence in female patients with bipolar mood disorder type I. Methods: This randomized controlled trial was conducted on 76 patients with bipolar mood disorder admitted in female psychiatric wards of Razi teaching hospital, Tabriz, Iran. The participants were selected by convenience sampling method and were randomly assigned to experimental and control groups. Patients in experimental group received 10 continuous 90 minutes sessions of psychoeducation, two times a week. Medication adherence was measured using the medicine check list and medication adherence rating scale (MARS) before and after intervention. Data analysis was performed with SPSS ver.13. Results: There was no significant difference between two groups regarding medication adherence before the intervention. After the study intervention, the mean scores of medication adherence check list and medication adherence rating scale in the experimental group were significantly higher than the control group. Conclusion: Since group psychoeducation was effective in improving patients' medication adherence, it could be recommended for psychiatric nurses to apply this intervention in the clinical setting.

It is necessary to pay close attention to the spousal caregivers' own mental health problems while they care for their mentally ill husbands. Mental health professionals should adopt a new approach to the prioritisation and planning of policies that support both family caregivers and patients.

Background The challenging working conditions during the Covid-19 pandemic created a perfect storm that can seriously impact nurses' physical and psychological well-being. Our study aimed to investigate complicated grief and its related factors among nursing staff during the Covid-19 pandemic. Methods This is a cross-sectional study. The participants comprised 375 nurses selected by the convenience sampling method from designated wards for patients with Covid-19 in 3 hospitals in Tabriz, Iran. Participants completed a survey containing demographic and clinical questions, the Inventory of Complicated Grief, and the Multidimensional Scale of Perceived Social Support. Multiple regression analysis was used to identify the associates of nurses' grief. The STROBE guidelines were followed in reporting the study's findings. Results A significant proportion of participants (57.6%) were found to be suffering from complicated grief. Gender, educational background, type of ward, type of nursing role, type of working shift, years of nursing work experience, and experience working in the Covid-19 settings remained the significant associates of nurses' grief in the regression analysis. Conclusion Due to frequent exposure to patients' deaths, healthcare providers are at increased risk of suffering from complicated grief during the Covid-19 and post-pandemic. If it remains unresolved, complicated grief can result in significant health problems and the experience of burnout among nurses. Governments, health authorities, and nursing managers should support nurses who work in Covid-19 settings to reduce the adverse impact of the pandemic on nurses' health and well-being.

Aims and objectives:To investigate the impact of domestic violence-related factors on suicide attempt in married women.Background: Suicide is a global public health concern that poses significant burden on individuals, families and communities. There is limited research on factors predicting suicide attempt in women. Design:A retrospective case-control design was adopted.Methods: Using a convenience sampling method, 610 participants, admitted to a teaching referral hospital in Northwest of Iran, were recruited to the study and assigned to case or control groups based on whether or not they had attempted suicide.The participants in two groups were matched in the terms of important demographic characteristics. Domestic violence-related factors were considered as independent variables and suicide attempt as dependent variable. Descriptive statistics, and simple and multivariate logistic regression analysis were used to analyse the data. Odds ratios (OR) of domestic violence-related factors were compared between the groups.We used STROBE checklist as an EQUATOR in this study. Results:The mean age of participants in the case and control groups was 28.4 and 29.45 years, respectively. The infidelity was the strongest predictor of suicide attempt in women (OR 44.57, 95%CI 6.08-326. 63, p < 0.001), followed by being threatened to physical assault by husband (OR 37.01, 95%CI 11.54-118.67, p < 0.001), jealousy of husband (OR 23.46,, p < 0.001), and previous attempts to divorce (OR 16.55,.31, p < 0.001). Suicide attempt was significantly lower in women who reported a sense of peace in life or lived with their mother or father-in-law (p < 0.001). Conclusions:To reduce the risk of suicide in women, violence against women should be condemned and appropriate prevention measures be taken by health professionals. Relevance to clinical practice: Recognising risk, assessment and referral of victims of domestic violence should be an integral part of healthcare systems. K E Y W O R D S domestic violence, family, suicide attempt, women | 3253 RAHMANI et Al.

Background Healthcare providers have been found to have limited knowledge and skills in interacting with people living with HIV. These factors can adversely affect providers' practice, jeopardize their safety and compromise the care of the patients. Aims This study aimed to explore the experiences of Iranian nurses who were caring for patients with HIV. Methods A focused ethnography approach was used. Participants consisted of 12 nurses working in teaching hospitals affiliated to Urmia University of Medical Sciences and recruited by purposeful sampling. Semi‐structured interviews, field observations and field notes were used for data collection. Data were analysed employing content analysis. Findings Three main themes emerged from the analysis of the participants' experiences of providing care to patients with HIV: ‘excessive fear of being infected’, ‘concerns about the possible consequences’ and ‘lack of self‐confidence in care provision’. Discussion/Conclusion Nurses have experienced a great deal of fear of self and cross‐contamination when providing care to people living with HIV. Social stigma and discrimination against people living with HIV amplified the nurses' experience of fear. Providing appropriate education and training for nurses can improve their attitudes, emotions and self‐confidence while providing care to such people and increasing the quality of care provided. Implications for Nursing and Health policy Planning more educational programmes focusing on improving their misunderstandings about HIV could result in positive outcomes: for nurses to provide high‐quality care and for people living with HIV who receive this care. The healthcare system should consider the culture of care provided by nurses to these people.