Background:Despite the growing importance of spiritual care, the delivery of spiritual care is still an area of disagreement among healthcare providers.Objective:To develop a grounded theory about spiritual care delivery based on Iranian nurses’ perceptions and experiences.A grounded theory approach:A qualitative study using the grounded theory approach.Participants and research context:Data were collected through holding 27 interviews with 25 participants. The study setting was the Imam Khomeini Hospital Complex. Sampling was started purposively and continued theoretically. Data analysis was performed by the method (...) proposed by Strauss and Corbin.Ethical consideration:The study was approved by the Ethics Committee of Tarbiat Modares University and the agreement of the administrators of the study setting was got before starting the study.Results:The core category of the study was “Trust building” which reflected the nature of spiritual care delivery by nurses. Trust building was the result of eight main categories or strategies including creating a positive mentality at hospital admission, understanding patients in care circumstances, having a caring presence, adhering to care ethics, developing meaningful relationships, promoting positive thinking and energy, establishing effective communication with patients, and attempting to create a safe therapeutic environment. Poor interprofessional coordination negatively affected this process while living toward developing greater cognizance of divinity and adhering to the principles of professional ethics facilitated it. The outcome of the process was to gain a sense of partial psychological security.Conclusion:The “Trust building” theory can be used as a guide for describing and expanding nurses’ roles in spiritual care delivery, developing care documentation systems and clinical guidelines, and planning educational programs for nursing students and staff nurses. (shrink)

Scientometrics has found many applications in describing, explaining and predicting the scientific status of researchers, educational and research groups, universities, organizations and countries in various national and international arenas. By studying the scientific products of different countries, their status in the production of science can be evaluated. Present study was conducted using a scientometrics approach and using co-word analysis and social network analysis (SNA) to investigate relationships in the field of know­ledge organization. In this regard, research indexed in web of (...) science on the topic of “know­ledge organization” has been analyzed using software including VOSviewer, Gephi, Publish or Perish. The findings of the study show that the most frequently used topics and words are know­ledge organization and classification. Also, the most valuable subject areas were identified based on the maps drawn using the closeness and centrality of indexes, taxonomy, ontology and know­ledge organization systems. Co-authorship analysis revealed that the co-authorship network is discrete and has low-density, with a total of 12,491 citations in all articles. Also, the most prolific author is Hjorland, followed by Smiraglia and Dahlberg. using the co-word map of know­ledge organization, policymakers can plan appropriately through the know­ledge of the research and thematic status of know­ledge organization. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

ObjectivesThe breast cancer stigma affects Health-related quality of life, while general resilience resources, namely, sense of coherence, social support, and coping skills, are thought to alleviate this effect. The study aimed to explore the mediating/moderation role of GRRs in the relationship between stigma and HRQoL and its dimensions in Iranian patients with breast cancer.MethodsIn this cross-sectional study, Stigma Scale for Chronic Illness 8-item version, SOC-13, Medical Outcome Survey- Social Support Scale, Brief COPE, and Functional Assessment of Cancer Therapy-Breast were investigated (...) in a convenience sample of Iranian women with confirmed non-metastatic breast cancer. Following the establishment of correlations using Pearson’s correlation, single and parallel mediation analysis and moderation analysis were conducted to determine the extent to which each GRR might be impacted by stigma or decrease the adverse impact of stigma on HRQoL.ResultsAn analysis of 221 women with the mean age of 47.14 showed that stigma was negatively correlated to all HRQoL’s dimensions, SOC, social support, and the bulk of coping skills. In the single mediation analysis, stigma affected all facets of SOC, all subscales of social support, and positive reframing, which partially reduced breast cancer HRQoL. Stigma affects general HRQoL through damaging meaningfulness, social support, and positive reframing. Meaningfulness was marked as the most impacted GRR in terms of all domains of HRQoL. In parallel mediation, reduced meaningfulness, total social support, and positive reframing were highlighted as the pathways of diminished breast cancer HRQoL. Moderation analysis indicated the higher levels of humor, behavioral disengagement, and use of instrumental support behaviors to be functional in protecting different dimensions of HRQoL, while the results were mixed for venting, especially in patients with mastectomy surgery.ConclusionWhile GRRs may be impacted by stigma, they exert a relatively small protective effect against the impact of stigma on HRQoL. This study provides some novel findings, but longitudinal studies are needed to further verify these before any causal conclusion or recommendations for health policy can be drawn. (shrink)