Introduction: The care of patients in vegetative state at home is difficult because they need continuous medical interventions and extensive care. The present study aims to explain the process of home care of patients in vegetative state at home. Methods: This study was a qualitative research with a grounded theory approach. The participants were 22 people (included 17 family caregivers and 5 professional caregivers) who were enrolled in a purposive sampling. Data was gathered through unstructured interviews, observations and field notes. Data collection was continued to saturation. Data analysis was performed through the Strauss and Corbin 1998 approach. The MAXQDA10 software was used to facilitate data analysis. Results: The data analysis led to emerge four main concepts included "erosive care", "erosive expenditures", "seeking solver education" and "lasting hope" as the axes of the study. Participants' experiences showed that the main concern of family caregivers of vegetative patients was "playing an inevitable role in care", in which they did not hesitate to make any effort, and they tolerated all the problems and issues. Therefore, "resilient care" was extracted as the underlying idea of this study. Conclusion: The process of resilient care of vegetative patients at home showed planning by policy makers in health system is very important and underscored the necessity for supporting families and family caregivers of these patients. So some changes in the health system for this goal might include considering home care and supporting them in various aspects, especially information, financial and emotional dimensions.

Aim: Although there has been considerable recent research from around the world on the effect of spiritual wellbeing in a variety of chronic conditions, little research has been conducted specifically on the spiritual wellbeing of patients with a stoma. Therefore, this study aimed to quantify spiritual wellbeing in ostomates and determine whether this had any impact on their quality of life (QoL). Method: This study was conducted in Iran in 2016, and 70 ostomates were enrolled through convenience sampling. The data collection instrument was based on Palutzian and Ellison's Spiritual Wellbeing Scale and the City of Hope Quality of Life-Ostomy Questionnaire. Results: Among the 70 participants, 38 were women (54%). The mean of the total QoL scores was 4.4 (SD=0.7). When separated into physical, psychological, social and spiritual dimensions, the mean QoL scores were 5.7 (SD=0.8), 4.2 (SD=0.7), 3.4 (SD=0.7) and 4.7 (SD=1.1), respectively. The mean score for spiritual wellbeing was 75.1 (SD=7.7). Physical, psychological, social and spiritual dimensions of QoL and total QoL had direct and significant correlations. Conclusion: These results demonstrated that there is a relationship between QoL and spiritual wellbeing levels in ostomates, and this can be used by health-care planners and caregivers to improve the QoL of their patients.

Self-perception is found to be a central predictive factor in experiencing successful aging. The aim of this study was to explore the role of sex, socioeconomic status, and emotional support in elders' aging perception. A cross-sectional design was used with 300 older aged participants recruited from 23 clinics and health centers in Qazvin, Iran. Data were collected included questions to elicit demographic information and Barker's aging perception questionnaire. Exploratory multiple linear regression showed that the level of emotional support (β: -12.10; 95% CI: [-20.72, -3.48]), socioeconomic status (β: 2.84; 95% CI: [0.25, 5.43]), and women (β: -4.34; 95% CI: [-6.91, -1.77]) were associated with aging perception among elders. Educational level and marital status did not significantly contribute to the variance of AP. Findings revealed that aging perception was related to individual differences as well as social and emotional factors. Researchers, health-care professionals, and elders may benefit from thinking about old age as an inevitable life stage.

Background: A great number of people who have survived after stressful events experience positive psychological changes. These positive changes are recognized as posttraumatic growth. Objectives: The purpose of the current study was to examine the relationship between posttraumatic growth and meaning in life in patients with myocardial infarction. Methods: This is a descriptive correlational study conducted on 191 patients referring to the largest cardiology center (Bu-Ali Sina) in Qazvin, Iran. The sample was selected through a convenience sampling method based on the inclusion criteria. The data were collected using a demographic questionnaire, the posttraumatic growth inventory, and the meaning in life questionnaire. Data were analyzed with descriptive analysis. Inferential statistics (Pearson's test) were used to evaluate the relationship between posttraumatic growth and meaning in life. Results: The sample included 49 (25.7%) women and 142 (74.3%) men with the mean age of 59.6 ± 1.2 years. The mean total score of posttraumatic growth was 64.6 ± 11.5 and the mean total score of meaning in life was 49 ± 6.04. Based on the results, there was a significant positive correlation between posttraumatic growth and meaning in life (r = 0.71, P < 0.001). Conclusions: The occurrence of myocardial infarction can lead to some positive psychological changes called posttraumatic growth. Nurses, informal caregivers, and policymakers can use these findings to help patients cope with challenging conditions after myocardial infarction.

Background: Healthcare providers should be able to provide good quality end of life care. A tool to evaluate the positive and negative consequences of caring for dying patients is warranted. Aim:The aim of this study was to evaluate the psychometric properties of the Persian version of the End-of-life Caregiving Experience Appraisal Scale (EOLCAS). Methods: This research was conducted in two phases. Phase I: The World Health Organization Protocol of forward-backward translation and an expert panel in order to determine face and content validity. Phase II: Survey development with 310 nurses who worked in critical care units, construct validity (construct, convergent and divergent validity), internal consistency (Average inter-item correlation, Cronbach's alpha and Omega McDonald's) and construct reliability were evaluated. Results:The exploratory factor analysis showed that the present scale has four factors:Negative Physical-emotional and social consequences, transcendental communication, information deficits, and future rumination which explained 83.92% of the overall extracted variance. Convergent and divergent validity was confirmed for all factors. The internal consistency and construct reliability were acceptable. Conclusion:The scale has a multidimensional concept that is sufficiently reliable and the use of the scale would be helpful in measuring consequences of caring for dying patients.Relevance to clinical practice: This scale makes a significant contribution in that it helps in the recognition of positive and negative consequences for critical care nurses' caring for dying patients.

Background: Evidence-based nursing care guidelines are important tools for increasing the quality of nurses’ clinical work. Objective: The aim of this study was to investigate the effect of implementing evidence-based nursing care guidelines on the quality of care of patients admitted to the Neurosurgical Intensive Care Units (NICUs). Methods: This is a quasi-experimental study on 54 nurses in NICUs of hospitals affiliated to Qazvin University of Medical Sciences selected using a convenience sampling technique and divided into two groups of intervention and control. The intervention included the teaching of evidence-based nursing guidelines and their implementation by the nurses. Before and two months after the intervention, the demographic characteristics and the quality of nurses’ patient care in both groups was evaluated by using a demographic form and a standard checklist with 37 items designed based on the standards of practice for All Registered Nurses (ANA). Data were analyzed in SPSS software using descriptive statistics (Mean±SD), and paired t-test, independent t-test and chi-square test. Findings: The mean score of nursing care quality in the two groups was not significantly different before intervention (P>0.05). After intervention, the mean score was 25.11±6.2 in the intervention group and 20.29±5.3 in the control group, and the difference was statistically significant (P<0.05). Conclusion: Implementation of evidence-based nursing care guidelines can improve the quality of nursing care. Therefore, it is recommended that the teaching of evidence-based nursing care guidelines should be on the agenda of the hospitals’ education unit and related departments.

Introduction: Patients undergoing hemodialysis (HD) are more vulnerable to mental, physical and spiritual disorders. These disorders may have a significant impact on their treatment process and quality of life (QoL). Given the importance of some experiences in these individuals, such as daily spiritual experiences and life expectancy, evaluating their predictive role seems necessary. Objectives: This study was conducted to determine the role of daily spiritual experiences and some demographic variables in predicting the level of hope among HD patients. Patients and Methods: In this cross-sectional study, the predictive role of daily spiritual experiences and some demographic variables in the level of hope in 262 HD patients were evaluated. The demographic variables checklist, the Daily Spiritual Experiences Scale (DSES), and the Adult Hope Scale were employed for data collection. Results: Analysis with multiple linear regression showed that the variables of gender, level of education, duration of diagnosis of renal failure, number of HD per week and daily spiritual experiences predicted 31% of the level of hope changes in HD patients. Conclusion: Nurses and provincial health care providers can help HD patients to promote their spiritual wellbeing and hope. This can be achieved by applying a holistic care approach as well as emphasizing the spiritual aspect of care and its predictive demographic variables.

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