Objective: The purpose of this study was to investigate the relationship between care burden and coping strategies in caregivers of hemodialysis patients. Methods: This cross-sectional survey was conducted from September to December 2018 in Kermanshah, Iran. A total of 130 caregivers of patients admitted to the hemodialysis wards of Imam Reza and Imam Khomeini hospitals of Kermanshah, Iran were selected via convenience sampling. Data-collection tools included a demographic information form, caregiver-burden inventory, and coping inventory for stressful situations. Data were analyzed using descriptive and analytical tests. Results: The mean age of the caregivers was 35.8±13.7 years, and 71 (54.6%) were patients' children. The mean caregiver-burden score was 58.5±20.5 out of 96. Mean scores of timedependent, evolutionary, physical, social, and emotion-dependent care burdens were 17.5 ±5. 3, 12.2±6.3, 9.1±4.7, 8.2±4.0, and 11.4±5.1, respectively. Mean scores of problemfocused, emotion-focused, and avoidance-oriented coping strategies were 46.0±80.8, 43.1 ±9.0, and 48.9±9.5, respectively. Among the strategies, only the avoidance-oriented one had a significant positive relationship with total care burden and all its subscales. Conclusion: Caregivers of hemodialysis patients experienced a relatively high care burden. However, they did not use appropriate coping strategies; therefore, they should be trained to select an effective coping strategy.

Background. Nursing and midwifery students have relatively high levels of academic burnout. One of the mechanisms to combat this issue is resilience. The results related to the association between academic burnout and resilience indicate a negative association, but various studies have reported different correlation coefficients. Therefore, the current study was aimed to investigate the association between resilience and academic burnout among nursing and midwifery students. Methods. A total of 240 nursing and midwifery students were recruited in this cross-sectional study using stratified random sampling. Data were collected by a demographic information questionnaire, the Connor–Davidson Resilience Scale (CD-RISC), and the Maslach Burnout Inventory-Student Survey (MBI-SS). Data were analyzed by SPSS-16 using t-test, ANOVA, Spearman’s correlation coefficient, and linear regression analysis. Results. The mean scores of academic burnout for nursing and midwifery students were 41.4 ± 14.8 and 41.2 ± 12.3, respectively, but the difference was not statistically significant ( p  = 0.368). The mean scores of resilience for nursing and midwifery students were 58.1 ± 13.3 and 52.9 ± 13.9, respectively, which showed a statistically significant difference ( p  = 0.004). Resilience was significantly inversely correlated with academic burnout in nursing and midwifery students (r = −0.04, p  < 0.001; r = −0.39, p  < 0.001). Increased resilience in students decreased academic burnout ( p  < 0.001). Conclusion. Academic burnout was moderate in nursing and midwifery students, but resilience was relatively high. Given the negative correlation between resilience and academic burnout, it is necessary to strengthen resilience skills and reduce factors that cause academic burnout.

Aim: Spirituality is a crucial dimension in human health. However, it is often overlooked in patients with heart failure (HF) in Iran. Thus, the purpose of this study was to determine the relationship between spiritual wellbeing, life expectancy and quality-of-life (QOL) in patients with HF. Methods: This cross-sectional study was performed with 150 HF patients, who were enrolled through convenience sampling. Data were collected using a questionnaire comprising four parts: the Minnesota Living with Heart Failure Questionnaire, Schneider’s life expectancy instrument, Ellison’s and Paulotzin’s (1982) Spiritual Well-Being Scale, and a demographic checklist. SPSS software was used for data analysis. Results: In this study, mean and standard deviation of QOL, life expectancy and spiritual wellbeing were 41.82±19.17, 30.20±4.58 and 87.80±5.28 respectively. There was a significant relationship between spiritual wellbeing and quality of life (r=-0.633, P<0.001) and also life expectancy (r=0.544, P<0.001). Quality of life and life expectancy were significantly higher in men than in women. Linear regression tests showed that the existential and religious dimensions of spirituality could influence 44.9% of the QOL variance (F=54.54, P<0.001) and increased values of existential spirituality would improve QOL by an average of 3.45 units. Improving life expectancy also raised QOL by 14.0% (F=21.26, P<0.001). This study also demonstrated that life expectancy is impacted by spiritual health, with a variance of 34.2%, in which the role of existential-spiritual health is of particular significance (t=7.10, P<0.001). Conclusion: The results revealed that spiritual wellbeing, especially the existential type, enhances life expectancy and quality-of-life among HF patients. Therefore, it is recommended that healthcare professionals design a comprehensive and supportive care model for the promotion of spiritual wellbeing in HF patients.