Background: Since “dignity” is one of the fundamental rights of every patient, consideration for patients’ dignity is essential. Unfortunately, in many cases, especially in cancer patients, dignity is not fully respected. Dignity is an abstract concept, and there are only a few comprehensive studies on the dignity of cancer patients in Iran. Research objective: This study aimed to evaluate the perception of Iranian cancer patients on human dignity. Research design: A qualitative research approach was used as the study design. The data were collected through individual semi-structured interviews and analyzed using the qualitative content analysis method. Participants and research context:  This study was conducted on cancer patients in internal medicine wards in Iran. The data were gathered through semi-structured interviews from May 2017 to February 2018. Ethical considerations: The study protocol was approved by the Research Ethics Committee of medical universities located in Southwest of Iran. The ethical principles were carefully followed throughout the study. Findings: Based on the results of the interviews, 3 main themes and 11 categories were determined. The main themes were identified as the “personal space and privacy,” “respect for human values,” and “moral support.” Discussion: The results of the present study showed the necessity of care for cancer patients in a respectful manner. The key elements in such care were the preservation of their personal space and privacy, respect for their values, and the provision of adequate moral support. These measures will have a positive effect on the perception of such patients on human dignity. Conclusion: Considering the special care required by cancer patients, the Iranian healthcare and hygiene managers should design and implement a care plan that includes the ethical principles related to human dignity.

Background:Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has established, improving communication as a priority for improving patient safety since 2006. Therefore, the present study aimed to evaluate nursing students’ communication abilities to recognize their strengths and weaknesses in communication skills.Method:This cross-sectional study was carried out in 2014. The study participants included all the nursing students who passed two semesters in Fatemeh School of Nursing and Midwifery in Shiraz, Iran. The students’ communication skills were assessed using a self-administered questionnaire. Then, the data were entered into the SPSS statistical software (v. 16) and analyzed using both descriptive (mean and percentage) and inferential statistics (Pearson correlation and ANOVA).Results:Among the 200 students who completed the questionnaires, 58% were female and 42% were male with the mean age of 21.79 years (SD=2.14). The results of Pearson correlation analysis demonstrated a significant correlation between the nursing students’ clinical communication behavior scores and treatment communication ability scores (P<0.001). The findings demonstrated that most nursing students required improvement in their communication skills in both clinical communication behavior and treatment communication ability. Besides, a significant difference was observed among the students of different terms regarding clinical communication behaviors (P≤0.05), but not concerning communication abilities. Nursing students in higher semesters had better communication skills.Conclusions:The results showed that nursing students in this university had a moderate ability in clinical and treatment communication. Thus, paying attention to standard education, curriculum revision, and adding some specific theoretical lessons for improving communication skills are mandatory during the bachelor’s degree.

BackgroundElder abuse is a serious violation of human rights and a worldwide issue. Upon hospital admission, elderly patients become vulnerable and susceptible to abuse. Understanding the issues perceived as abuse by the elderly patients and their family members allows us to identify, manage, and prevent elder abuse; especially in hospital settings. The present study aimed to identify and describe the abuse of hospitalized elders from the perspective of patients and their family members.MethodsThe present exploratory qualitative study was conducted from October 2017 to September 2018 at six different teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The target population was elderly patients in different wards across various hospitals and their family members. Based on the purposive sampling method, 16 hospitalized elderly patients and 11 family members were recruited and interviewed. The data were analyzed using the inductive content analysis method in accordance with the process described by Elo and Kyngas (J Adv Nurs 62:107–15, 2008).ResultsBased on the analysis of the interview data, four main categories were extracted and classified as Micro-level, Meso-level, Exo-level, and Macro-level issues.ConclusionHospitalized elder abuse is a multi-dimensional phenomenon caused by personal and professional factors as well as issues related to the inadequate physical environment and organizational structure. To prevent the occurrence of elderly abuse, it is recommended to train hospital staff, rearrange the physical environment, reform the organizational structure, and better plan and manage the financial, physical, and human resources.

Background:Unwanted pregnancy has affected different aspects of our life. Researchers point out if a child’s birth is unwanted, an increase in maternal issues can be observed. The aim of this study was to describe the women’s viewpoints regarding unwanted pregnancy.Method:This qualitative study using content analysis was employed in Shiraz University in 2013-2014. 20 women with unwanted pregnancy were chosen using purposeful sampling. Data were gathered through semi-structured interviews and trustworthiness of them was evaluated.Results:Findings of this study, according to the participants’ experience, revealed maternal emotions like embarrassment for getting pregnant, mother’s own negative affection, concerns about missing family and other children, and terminating the pregnancy through illegal abortion, the husband’s disagreement about the termination, blaming themselves for thinking about abortion or illegal abortion, and concern about their guilt feeling. Another finding was family problems like husband’s behavior and his negative outlook towards his child and fetus. The next category belonged to anxiety about the future of their child, including economic, social and relational problems, and suppression of the children’s logical expectations. The last finding was the lack of maternal emotional support.Conclusions:Unwanted pregnancy’s effects on the mothers and infants’ health are considerable. A closer observation by family and health care providers for unwanted pregnancies and its results is recommended; therefore, they should be taken care of as high risk pregnancies, requiring family support.

BackgroundAnger and aggression have been developing notably in societies, especially among patients depending on substance abuse. Therefore, this study aimed to investigate the effect of anger management based on group education among patients depending on substances according to Patrick Reilly’s cognitive behavioral approach.MethodsIn a quasi- experimental study, all patients who met the inclusion criteria were evaluated regarding their aggression level. The participants were assigned to 12 educational sessions based on group therapy and Patrick-Reilly’s anger management by focusing on using a combination of cognitive intervention, relaxation, and communication skills. The data were analyzed using the SPSS statistical software, version 16.ResultsThe findings showed a significant difference between the two groups regarding aggression level after the intervention (p = 0.001). No significant relationship was observed between aggression level and demographic variables (p > 0.05).ConclusionThe intervention of this study can be used for establishing self-management and decreasing anger among patients depending on substances. They can also be used as a therapeutic program in addition to pharmacotherapy.Trial registration IRCT2016102030398N1.

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused patients with chronic diseases to face various challenges. The present qualitative study aimed to explore adherence to treatment in patients with coronary artery disease (CAD) during the COVID-19 pandemic. Methods: This qualitative content analysis was conducted from September 2020 to February 2021. Online in-depth interviews were conducted with 15 patients with CAD after discharge from Nemazi and Al-Zahra heart hospitals, Shiraz, Iran. Data management was done via MAXQDA 12 software using conventional content analysis based on the method proposed by Graneheim and Lundman. Results: The results revealed three main categories, nine subcategories, and 431 primary codes. The first category was ‘improved self-care in the shadow of COVID-19‘ (Improving self-care due to fear of COVID-19, ‘utilization of alternative strategies, and reinforcement of self-care beliefs). The second category was ‘redefinition of support systems’ (need for a support system, seeking for alternative support systems, and changes in social interactions). The last category was ‘barriers to treatment adherence’ (shortage of financial resources, need to adjust with working conditions, and mental conflicts). Conclusion: The results indicated that the COVID-19 threats encouraged the patients with CAD to adhere to their care principles. Nonetheless, the restrictions resulting from the pandemic caused problems in adherence to treatment. Thus, redefinition of the support systems in accordance with the present conditions are recommended.

Background Self-handicapping is an effective defense strategy in an individual’s behavior that leads to weak performance in different situations like education. This study aimed to investigate how training problem solving skills affected the rate of self-handicapping among nursing students. Methods This interventional study was done in Jahrom, Fars province, Iran during 2016–2017. Totally, 90 nursing students were selected among those admitted from 2013 to 2016 using stratified sampling. Then, the students were randomly divided into a control and an intervention group each including 45 participants. Teaching problem solving skills to the intervention group was completed over six sessions each lasting for two hours. The students’ rate of self-handicapping was evaluated based on the scores obtained in Jones and Rodwalt’s self-management questionnaire before and after the intervention (immediately and one month later). The data were entered into the SPSS statistical software, version 16 and were analyzed using descriptive and inferential statistics, including t-test, chi-square, and repeated measures ANOVA. The significance level was set at 0.05. Results The findings revealed a significant difference in the intervention group’s self-handicapping scores before and after the intervention ( p < 0.001). However, no significant change was observed in this regard in the control group ( p = 0.575). The results indicated no significant differences between the intervention and control groups concerning the mean score of self-handicapping immediately after the intervention ( p = 0.761). However, a significant difference was detected between the two groups in this regard one month after the intervention ( p = 0.014). Conclusion Teaching problem solving skills influenced the students’ beliefs and performances positively and led to a decrease in their self-handicapping. Thus, teaching cognitive-behavioral approaches is recommended to be considered among the ten life skills used in curricular design for medical students, including nurses. Trial registration IRCT 2017011231895 N.Data registered: October 30, 2016.

BackgroundIrritable bowel syndrome (IBS), as a chronic digestive disorder, impacts extensively on the quality of life, emotional well-being and self-identity. Chronic illness disrupts taken-for-granted notions about self. No qualitative study was found regarding patients’ experience of life with irritable bowel syndrome (IBS) in Iran.ObjectiveTo explore the self-perception of lived experience of IBS patients.MethodsA qualitative study with hermeneutic phenomenological approach was conducted on 12 IBS patients who had been referred to three central clinics (2 governmental and 1 private) affiliated to Shiraz University of Medical Sciences. The data were collected through in-depth semi-structured interviews from July 2015 to September 2016 by purposeful sampling. Thematic analysis was carried out using Van Manen’s six-step methodological framework as a guide. In addition, MAXQDA software was used for data management.ResultsIn this study, two main themes “the threatened self” and “deep self-knowledge”, emerged during the life of patients with IBS, indicating the meaning of self-perception of such patients. The theme of “the threatened self” consisted of two subthemes of “fear from stigmatization” and “bad sense of self”. The subthemes of “body knowledge”, “self-acceptance” and “personal growth” were related to deep self-knowledge.ConclusionThe results of the present study could be applied in designing and implementation effective and holistic care of IBS patients.