BACKGROUND፡ Spiritual health is one of the important dimensions of the elderly’s health, which plays an important role in other dimensions of their health. This study aimed to explain the process of spiritual health of the elderly living in nursing homes.METHODS: This grounded theory study was conducted in 4 nursing homes in the city of Arak Iran between October 2019 and September 2020. The participants were 24 elderly people living in nursing homes, two health care providers, one nurse and one family member, first selected through purposive sampling andthen, through theoretical sampling. The data were collected through semi-structured interviews and field notes. All the interviews were transcribed verbatim and analyzed based on Strauss and Corbin approach (2008).RESULTS: Six main categories were identified, including helplessness, inefficient supportive environment, spiritual distress, seeking support, relative improvement of spiritual health and factors affecting spiritual health, each of which explains a part of the whole process of spiritual health of the elderly living in nursing homes.CONCLUSION: Supporting the elderly living in nursing homes is necessary in order to meet their spiritual needs and preserve and promote their spiritual health.

Purpose: Despite its efficacy and safety, electroconvulsive therapy (ECT) is underutilized, in part, due to the stigma associated with the treatment. This study aimed to evaluate the effect of counseling on stigma in patients with psychiatric disorders receiving ECT. Patients and methods: A total of 114 patients with psychiatric disorders undergoing ECT were randomly divided into two groups. Both the groups received routine care and treatment, but the intervention group (n=57) received four counseling sessions. At the beginning and end of the study (6 weeks, post-treatment), patients completed the Internalized Stigma of Mental Illness scale. The data were analyzed using independent and paired sample t-tests. Results: There was no significant difference in the mean stigma scores of participants in the control and intervention groups before counseling (P>0.08). However, post-intervention, there was a significant difference in the mean stigma scores between both the groups (P<0.001). Conclusion: The findings demonstrate that the counseling intervention is effective in decreasing stigma in patients undergoing ECT. Therefore, it is recommended to use this therapeutic method in such patients.

Stigma is one of the most destructive features of mental illnesses that may affect the family caregivers. This study aimed to analyze the effect of training interventions of stigma on family caregivers of the mental illness patients. This quasi-experimental pre- and post-test study was performed on a single group of 43 family caregivers of mental illness patients in Hamadan Psychiatric Hospital, Iran, in 2015. The samples were taken through convenience sampling method and the data collection tool was a stigma questionnaire made by the researchers. The questionnaires were filled by the participants within pre-intervention and 1-month post-intervention. All the data were analyzed by SPSS version 16, and the mean and standard deviation by paired t test and Wilcoxon test. Findings of this study demonstrated that women included 60% of the family caregivers. The average age of caregivers and the duration of caregiving were 41.67 ± 11.62 years and 66.28 ± 7.99 months, respectively. The mean and standard deviation for pre-intervention stigma score were 82.47 ± 12.23 indicating that the family caregivers suffered from some problems arisen from living with mental patients. They include not getting married, unable to find a job, embarrassment, humiliation by others, disgrace, and shame. Our results revealed that the mean and standard deviation of stigma score decreased to 29.28 ± 7.52 after training, and this difference was statistically significant (P < 0.001). According to the results of present study, training interventions reduce the issues caused by stigma and help the family members of mental patients to face and cope with the problem.

Introduction: Previous research has indicated that community‐based mental health services in Iran are restricted, leading to overcrowding in psychiatric wards. This overcrowding has been linked to a range of problems, such as violence, suicide and medical errors. Despite the abundance of research on patient safety, there is still a lack of understanding regarding how mental health nurses (MHNs) create a secure environment within these wards.Aim: This study focused on exploring a safe environment provided by MHNs in inpatient psychiatric wards at Farshchian (Sina) Hospital, Hamadan, Iran.Method: An explanatory mixed‐methods study was conducted. Initially, the Safe Environment Scale was distributed to all MHNs (n = 48) working in three wards at Farshchian (Sina) Hospital to evaluate the current status. The scale measured two dimensions, and descriptive statistics were used to analyse the collected data. Subsequently, 20 MHNs were selected for semi‐structured interviews using purposeful sampling at the same hospital to interpret and fill gaps in the quantitative findings. The data collected from the interviews were analysed using conventional content analysis.Results: The perception and engagement of MHNs in creating a safe environment in the inpatient psychiatric wards were found to be at a medium level, according to the Safe Environment Scale (mean ± SD, 14.67 ± 4.18 and 85.27 ± 17.57, respectively). The qualitative study identified several categories in the results, including ‘Hyper‐vigilance to safety and security environment’, ‘Therapeutic communication gap’, ‘Nurse burnout’, ‘Staff safety and security need’ and ‘Environmental safety hazards’.Discussion: MHNs employ a hyper‐vigilant strategy to guarantee a secure atmosphere within psychiatric wards. However, this approach may inadvertently impede the establishment of a safe environment and even diminish MHNs' perception and involvement in its maintenance.Implications for mental health nursing: According to our research, it appears that MHNs need to improve their education and training in order to successfully implement the vigilance strategy for establishing a secure environment. Additionally, it is essential for them to prioritize therapeutic communication with patients, as this plays a vital role in promoting a safe environment within inpatient psychiatric wards.

Background: The most common psychological problem in hemodialysis patients is low hope. Hope is an important source of adaptation for the survival of the patients with a chronic disease. Objective: This study aimed to evaluate the effect of spiritual care on hope in patients undergoing hemodialysis. Methods: In this randomized controlled trial conducted in Iran in 2017, 60 hemodialysis patients with ending-stage of renal disease under hemodialysis treatment were randomly assigned into two experimental (n=30) and control (n=30) groups. The spiritual care program consisting of protectionist care, supporting the patient's rituals and using support systems was administered in four sessions of 60 minutes individually, twice a week, morning or evening in hemodialysis ward. Snyder’s Hope Questionnaire was completed before and after the intervention in both groups. Data were analyzed in SPSS software version 16. Results: Prior to the intervention, there was no significant difference between the experimental and control groups (p=0.262); however, following the intervention, the difference was statistically significant with regard to the mean scores of hope in the experimental (36.43 ± 3.37) and control (35.20 ± 7.00) groups (p=0.04). Conclusion: According to the findings of the present study, spiritual care promotes hope in Muslim patients undergoing hemodialysis; therefore, nurses can adopt the spiritual care to this end.