Despite increasing interest in the attentional biases of pain patients towards pain-related stimuli, there have been no investigations of whether the main caregivers of chronic pain patients also selectively attend to pain-related information. We compared the attentional biases to painful or happy faces of 120 chronic pain patients, 118 caregivers, and 50 controls. Analyses found that both patients and caregivers demonstrated biases towards painful faces that were not observed in control participants or to happy faces. Those patients and caregivers who were high in fear of pain demonstrated greater biases than those low in fear of pain, and the biases of the high-in-fear-of-pain group differed significantly from zero. When sub-groups of caregivers were compared, it was found that biases towards painful faces were not observed for those caregivers who accurately identified the level of pain the patient currently reported. In contrast, those caregivers who overestimated or underestimated the patients' pain demonstrated biases that were significantly greater than zero. These results add to the growing weight of evidence suggesting that biases towards pain-related stimuli are observed in chronic pain patients, but that the nature of the stimuli is important. In addition, the results suggest that caregivers, particularly those who either under- or overestimate the level of pain that the patient reports, also demonstrate similar biases. Future research should investigate the links between caregivers' biases and the way in which caregivers respond to pain.

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The findings suggest that perceived injustice plays an important role in the well-being of family caregivers and caregivers' well-being may be improved by changing their perceptions about their caregiving tasks and their condition.

Background and Aim: The present study was carried out aiming to determine the relationship between moral distress and moral sensitivity among nurses. Materials and Methods: This descriptive analytical study was conducted on 257 nurses employed in teaching hospitals affiliated to Birjand University of Medical Sciences (South Khorasan) in 2015. Available sampling was done among the nurses working in intensive care units (ICU, CCU, NICU and dialysis) in the whole province meeting the inclusion criteria. The data collection tool was a three-part questionnaire consisting of the demographic information questionnaire, Corly moral distress questionnaire, and the Korean version of the Hun moral sensitivity questionnaire. The collected data were analyzed running SPSS statistical software version 16. Ethical Considerations: Written consent was obtained from all participants. Additionally, all of them were assured of anonymity of the questionnaires and confidentiality of the information. Findings: There was no significant relationship between moral distress and the nurses' moral sensitivity (P=0.2). The mean scores (out of 5) were 3.5±0.66 for the total moral distress, 3.5±0.75 for the intensity of moral distress, and 3.54±0.66 for the frequency of moral distress, respectively. The mean for moral sensitivity (out of 4) was 3.1±0.45. There was a statistically significant relationship between moral sensitivity and moral distress with age and years of work experience, and also between moral distress and the type of the ward (P<0.05). Conclusion:The findings indicates that nurses who do not have sufficient executive power for moral performance will experience moral distress, despite their high and low levels of moral sensitivity. Thus, it is necessary hospital administrators to take some specific measures to carry out periodic evaluation of this phenomenon, and hold some codified trainings in this regard.

Background:The long-term complications of hemodialysis deteriorate patients' quality of life and lead to physical and mental discomfort. Physiologically, sports activities can play an important role in reducing these side effects including muscle cramps. Objectives: The aim of this study was, to determine the impact of isotonic exercise on the frequency of muscle cramps. Methods: This clinical trial was carried out on 60 hemodialysis patients admitted to the dialysis units of Shahrekord and Borujen hospitals in 2014. The intervention included an isotonic exercise program that was implemented during 10 sessions of constant cycling (each lasting 10 minutes) immediately before dialysis. The outcome variable was the number of muscle cramps in patients during the hemodialysis session. The data were analyzed in SPSS-16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential tests (independent and paired t-tests). Results: The mean frequency of leg cramps before the intervention was not significantly different between the two groups (P = 0.10). However, it was significantly different between the groups after the intervention (P = 0.001). Moreover, the number of muscle cramps in the experimental group was significantly lower after the intervention than before implementing the program (P = 0.03). Conclusions:The isotonic exercise of constant cycling has a considerable effect on decreasing the number of muscle cramps in hemodialysis patients. Hence, it is suggested that dialysis units provide facilities for constant walking and cycling to accelerate patients' treatment.

The findings are in line with the idea that family caregivers' solicitous and distracting responses convey to patients that their condition is serious, which may reinforce patients' pain and pain behaviours, especially in those who catastrophise.

Background The COVID-19 pandemic has led to wide-scale changes in societal organization. This has dramatically altered people’s daily activities, especially among families with young children, those living with disabilities such as spinal cord injury (SCI), those who have experienced a stroke, and older adults. Objective We aim to (1) investigate how COVID-19 restrictions influence daily activities, (2) track the psychosocial effects of these restrictions over time, and (3) identify strategies to mitigate the potential negative effects of these restrictions. Methods This is a longitudinal, concurrent, mixed methods study being conducted in British Columbia (BC), Canada. Data collection occurred at four time points, between April 2020 and February 2021. The first three data collection time points occurred within phases 1 to 3 of the Province of BC’s Restart Plan. The final data collection coincided with the initial distribution of the COVID-19 vaccines. At each time point, data regarding participants’ sociodemographics, depressive and anxiety symptoms, resilience, boredom, social support, instrumental activities of daily living, and social media and technology use were collected in an online survey. These data supplemented qualitative videoconference interviews exploring participants’ COVID-19–related experiences. Participants were also asked to upload photos representing their experience during the restriction period, which facilitated discussion during the final interview. Five groups of participants were recruited: (1) families with children under the age of 18 years, (2) adults with an SCI, (3) adults who experienced a stroke, (4) adults with other types of disabilities, and (5) older adults (>64 years of age) with no self-reported disability. The number of participants we could recruit from each group was limited, which may impact the validity of some subgroup analyses. Results This study was approved by the University of British Columbia Behavioural Research Ethics Board (Approval No. H20-01109) on April 17, 2020. A total of 81 participants were enrolled in this study and data are being analyzed. Data analyses are expected to be completed in fall 2021; submission of multiple papers for publication is expected by winter 2021. Conclusions Findings from our study will inform the development and recommendations of a new resource guide for the post–COVID-19 period and for future public health emergencies. International Registered Report Identifier (IRRID) DERR1-10.2196/28337

Background and Aim: Phenomenon of moral distress in critical care environments, have different effects on the quality of care and good communication between members of caring team, especially Physician and nurses could to be effective in prevention of moral distress in nurses through creating desirable ethical atmosphere. This study aimed to determine the relationship between moral distresses with the Physiciannurses relationship in ICUs of the South Khorasan province. Materials and Methods: 215 nurses were recruited to the study by convenience method. Corly moral distress questionnaire and Shortell questionnaire of communication assessment between physician and nurses in ICUs were used for data collection. Data were analyzed by SPSS 16 software and using descriptive and inferential statistics. Ethical Considerations: Participants verbal consent was obtained and anonymously and confidentiality of the completing questionnaires was assured to them. Findings: The mean scores of moral distress severity, moral distress frequency and Physician-nurses relationship were 3±0/59, 3/66±0/5 and 3/2±1/1, respectively. There was significant direct correlation between mean score of communication between physician and nurses with moral distress frequency (r=-0/34, P<0/05). But there was not any correlation between Physician-nurses relationship moral distress severity. Conclusion: regarding undeniable role of good communication between physician and nurses in reducing the frequency of moral distress, it is necessary to determine the effective factors on this relationship and also provide strategies to promote desirable ethical atmosphere, in order to diminish of this phenomenon.