Background The COVID-19 pandemic has put heavy pressure on nurses. Psychiatric nurses are also exposed to moral distress due to the special conditions of psychiatric patients and patient’s lack of cooperation in observing health protocols. This study has been conducted to explore and describe factors that caused moral distress in Iranian psychiatric nurses during the COVID-19 pandemic. Method This qualitative study with a conventional content analysis approach involved 12 nurses at the Shiraz University of Medical Sciences in Iran. This study was conducted in the winter of 2021. Data collection was performed by semi-structured interviews, data analysis was performed based on the five steps of Graneheim and Lundman. Results By continuous comparison and integration of data, 17 subcategories, 8 subcategories, and 3 categories were extracted from 252 initial codes. The causes of moral distress in psychiatric nurses during the COVID-19 pandemic were identified as emotional responses (Fear and Doubt), relational factors (Nurses’ Relationship with Each Other, Nurse-physician Relationship, and Relationship whit Patients), and Institutional factors (Lack of Attention to Health Instructions, Failure to complete the treatment process for patients and Institutional Policies). Conclusion New dimensions of the causes of moral distress associated with the COVID- 19 pandemic are discovered in this study. Managers and planners should equip psychiatric hospitals with isolation facilities and Personal Protection Equipment for patients and nurses. Strengthening the ethical climate by improving communication skills and individual nursing empowerment to prevent moral distress is recommended.

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Background The birth of premature newborns and their separation from family due to their hospitalization in the Neonatal Intensive Care Unit (NICU) cause stress in the parents, especially mothers. We conducted this study aimed to evaluate whether training the fathers to support their wives impacts premature newborn mothers’ stress and self-efficacy or not? Methods A quasi-experimental (before-after study) including one experimental and control group was used. Data were collected from Seventy-five parents with newborns hospitalized in NICU (n = 30) in the intervention and (n = 45) in usual care groups. Settings were the NICUs of the two international, educational, specialty, and subspecialty Nemazee and Hafez hospitals of the Shiraz University of Medical Science. Fathers in the intervention group learned how to support their wives and provide care for their premature newborns. The control group received the usual care. Mother’s stress and self-efficacy were measured using validated questionnaires. Results Data analysis showed that the mean scores of mothers’ stress and self-efficacy from pre-intervention to post-intervention were significantly decreased and increased respectively in the intervention group (p <0.001). At the same time, there was no significant difference in the control group. Conclusion When fathers are trained to support their wives and do so, it relieves the stress and improves the mothers’ self-efficacy, and has a direct effect on providing care to their premature newborns. Therefore, it is recommended that measures should be taken so that the fathers be present, participate in providing care, and support their wives and newborns in NICU. Trial registration IRCT20171130037691N1.

Background: Family caregivers of individual with schizophrenia experience various stresses in everyday life which have a negative impact on their well-being. The Caregiver Well-Being Scale(CWBS) is an instrument with psychometrics properties that identifies many important factors associated with caregiving stressors, and provides a picture of overall felt well-being. Since, there is no Persian version of this instrument for investigating schizophrenia caregiver’s well-being, cross cultural adaptation and evaluation of the psychometric properties of the CWBS among Iranian Schizophrenia caregivers is required.Methods: A methodological and cross-sectional study was conducted with 144 Schizophrenia caregivers in psychiatric centers affiliated to Shiraz University of Medical Sciences(SUMS), in the south of Iran. Persian version of the CWBS was generated in two phases: Phase 1 – Cross-cultural adaptation using forward translation and backward translation methods in five stages. Phase 2 – Psychometric properties test involved assessing content validity, construct validity by exploratory factor analysis and convergent and divergent validity, reliability by internal consistency and test –retest.Results: The translation, cross-cultural adaptation and qualitative content validity resulted in some semantic modifications to the original CWBS version. Both subscales of CWBS -(Basic Need(BN) and Activities of Daily living (ADL)- showed a significant strong positive correlation with total CWBS, (BN: r = 0.81 and ADL: r= 0.88), moderate positive correlation with SOC (BN: r = 0.42 and ADL: r = 0.46), and moderate negative correlation with CBI (BN: r = -0.38 and ADL: r= -0.47) (all p<0.001), presenting convergent and divergent validity. Factor analysis and Varimax Rotation provide evidence that the Persian version encompasses three underlying constructs for ADL and BN, as the original scale. The CWBS showed acceptable internal consistency (Cronbach’s alpha: 0. 0.842) and satisfactory test-retest reliability within 2.5 weeks interval (intraclass correlation coefficient was 0.872 (95% confidence interval [CI], 0.827 to 0.906)) for 14 items.Conclusions: The results showed the Persian adapted version of CWBS complies the validity and reliability of the criteria required. The scale can be employed in practice and research to assess well-being in Iranian caregivers of individuals with schizophrenia. Registration number: (registration no.97-01-08-18819).