Abstract
One of the important issues regarding caring for patients with mental disorders is the high prevalence of stress, anxiety, and depression in their caregivers. This study aimed to investigate the effect of a spirituality-based program on stress, anxiety, and depression of caregivers of patients with mental disorders. This clinical-trial study involved 60 family caregivers of patients with mental disorders who were referred to the clinic of Shahid Ayatollah Modarres Psychiatric Hospital in Isfahan, Iran, during 2019–2020. Accordingly, the samples were selected using convenient sampling method and then divided into two groups of experimental and control by simple random allocation. Next, the spirituality-based intervention was performed for the intervention group, and the needed data were collected in both intervention and control groups before, immediately after, and one month after the intervention. The data collection tool used in this study was DASS-21 questionnaire. No significant differences were observed between the two groups in terms of the mean scores of stress, anxiety, and depression (p > 0.05) before the intervention. However, some significant differences were found in terms of the stress, anxiety, and depression scores between the two groups immediately (p < 0.001) and one month after the intervention (p < 0.001). The spirituality-based program seemed to affect stress, anxiety, and depression of caregivers of patients with mental disorders positively. So, it is suggested to perform this intervention as an inexpensive and available supportive method for family caregivers of patients with mental disorders.
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References
Abbasi, M., & Akrami, F. (2012). The relationship between dynamic-traditional religiosity and the event of myocardial Infarction. Medical Ethics Journal, 10(37), 17–25.
Acharya, B., Maru, D., Schwarz, R., Citrin, D., Tenpa, J., Hirachan, S., Basnet, M., Thapa, P., Swar, S., & Halliday, S. (2017). Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal. Globalization and health, 13(1), 2. https://doi.org/10.1186/s12992-016-0226-0
Ahangar, T. (1993). Prayers and their effects on mental health. University Unified Islam, Roudehen.
Ahmadvand, A., Sepehrmanesh, Z., Ghoreishi, F. S., & Afshinmajd, S. (2012). Prevalence of psychiatric disorders in the general population of Kashan, Iran. Archives of Iranian Medicine, 15(1029–2977), 205–209. http://www.aimjournal.ir/Article/273
Akbari, B. (2009). The Relationship between prayer and anxiety according to demographic variables in students of Islamic Azad University, Anzali Branch (Publication Number 2009)
Amusoltani, H., Pahlavanzadeh, S., & Maghsudi ganjeh, J. (2017). Vest gating knowledge and attitudes of caregivers of patients affected by mental disorders towards complementary medicine treatments in health centers affiliated to Isfahan University of Medical Sciences in 2014. Journal of Islamic and Iranian Traditional Medicine, 8(1), 117–123.
Asadi, P., Fereidooni-Moghadam, M., Dashtbozorgi, B., Masoudi, R. (2018). Relationship between care burden and religious beliefs among family caregivers of mentally ill patients. Journal of Religion and Health, 58(4), 1125–1134. https://doi.org/10.1007/s10943-018-0660-9
Bolhari, J., Naziri, G., & Zamanian, S. (2012). Effectiveness of spiritual group therapy in reducing depression, anxiety, and stress of women with breast cancer. Quarterly Journal of Women and Society, 3(9), 87–117. https://www.sid.ir/en/journal/ViewPaper.aspx?id=301976
Farzi, S., Farzi, S., Moladoost, A., Ehsani, M., Shahriari, M., & Moinei, M. (2012). Caring burden and quality of life of family caregivers in patients undergoing hemodialysis: A descriptive-analytic study. International Journal of Community Based Nursing and Midwifery, 7(2), 88–96. https://doi.org/10.30476/ijcbnm.2019.44888
Friedman, M. M., Bowden, V. R., & Jones, E. (2003). Family nursing: Research, theory & practice. In Audiobook on CD: CD audio: English (5th ed.) Recording for the Blind & Dyslexic, Prentice Hall.
Gall, T. L. (2003). The role of religious resources for older adults coping with illness. Journal of Pastoral Care and Counseling, 57(2), 211−224.
Ghanei, M., Chilosi, M., Mohammad Hosseini Akbari, H., Motiei-Langroudi, R., Harandi, A. A., Shamsaei, H., Bahadori, M., & Tazelaar, H. D. (2011). Use of immunohistochemistry techniques in patients exposed to sulphur mustard gas. Pathology research international, 2011, 7. https://doi.org/10.4061/2011/659603
Gibson, L. M. (2003). Inter-relationships among sense of coherence, hope, and spiritual perspective (inner resources) of African-American and European-American breast cancer survivors. Applied Nursing Research, 16(4), 236–244.
Goodarzi, N. M. S., Farahnaz, R., & Abolfazl B. A.(2018). Prediction of Depression, Anxiety and Stress in Familial Observers of Patients with Dementia Based on Family Performance. Iranian Journal of Rehabilitation Research in Nursing (IJRN), 4(2), 44–52. https://doi.org/10.21859/ijrn-04027
Gutitrrez, M., Jose, CU., & Alejandra. (2007). Effectiveness of a psycho-educational intervention for reducing burden in Latin American families of patients with schizophrenia. Quality of Life Research, 16(5), 739–747. https://doi.org/10.1007/s11136-007-9173-9
Heidari, A., Kachooie, A., Moghise, M., & Irani, A. (2009). The relationship between depression and religious attitudes in students of Qom University of Medical Sciences. Qom University of Medical Sciences Journal, 3(3), 51–55.
Heydari, A., Meshkinyazd, A., & Soodmand, P. (2014). Mental illness stigma: A concept analysis. Modern Care Journal, 11(3). http://sid.bums.ac.ir/dspace/handle/bums/4916
Kamari, S., & Foladchang, M. (2016). Effectiveness of spirituality therapy training based on positivity on life expectancy and life satisfaction in adolescents. Clinical Psychology and Counseling Research (Educational and Psychological Studies), 6(1). https://www.sid.ir/fa/journal/ViewPaper.aspx?id=305912
Karimirad, M. R., Seyedfatemi, N., Noghani, F., Amini, E., & Kamali, R. (2017). Resilience of family caregivers of people with mental disorders in Tehran, Iran. Iranian Journal of Nursing Research (IJNR), 13(1), 56–62. https://doi.org/10.21859/ijnr-13018
Khayatan Mostafavi, S., Aghaei, A., & Golparvar, M. (2018). The effectiveness of stress management based on iranian-islamic spiritual therapy on stress, anxiety and depression in women with fibromyalgia. Journal of Health Psychology, 7(27), 62–80. https://www.sid.ir/en/journal/ViewPaper.aspx?id=745503
Kiani, J., Hajiuni, A., Gholizadeh, F., & Abbasi, F. (2016). Efficacy of cognitive-behavioral therapy and hope therapy on quality of life, life expectancy and resiliency in patients with thalassemia [Original article]. The Journal of Shahid Sadoughi University of Medical Sciences, 27(4), 1482–1495. https://doi.org/10.18502/ssu.v27i4.1357
Koenig, H. G. (2010). Spirituality and mental health. International Journal of Applied Psychoanalytic Studies, 7(2), 116–122.
Kristjanson, L. J., & Aoun, S. (2004). Palliative care for families: Remembering the hidden patients. The Canadian Journal of Psychiatry, 49(6), 359–365.
Larson, C. A. D. (2004). Spiritual, psychosocial, and physical correlates of well-being across the breast cancer experience cancer experience. The University of Arizona.
Lotfi Kashani, F., Mofid, B., & SarafrazMehr, S. (2013). Effectiveness of spirituality therapy in decreasing anxiety, depression and distress of women suffering from breast cancer. Thought and Behavior in Clinical Psychology, 2 (27), 27–42. https://jtbcp.riau.ac.ir/article_12.html
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335–343.
McCullough, M. E., Emmons, R. A., & Tsang, J.-A., (2002). The grateful disposition: A conceptual and empirical topography. Journal of Personality and Social Psychology, 82(1), 112–127. https://doi.org/10.1037/0022-3514.82.1.112
Meraviglia, M. G. (2002). Prayer in people with cancer. Cancer Nursing, 25(4), 326–331.
Nakau, M., Imanishi, J., Imanishi, J., Watanabe, S., Imanishi, A., Baba, T., Hirai, K., Ito, T., Chiba, W., & Morimoto, Y. (2013). Spiritual care of cancer patients by integrated medicine in urban green space: A pilot study. Explore, 9(2), 87–90. https://doi.org/10.1016/j.explore.2012.12.002
Noorbala, A., Damari, B., & Riazi Isfahani, S. (2014). Evaluation of mental disorders incidence trend in Iran. Daneshvar Medicine, 21, 112. https://www.sid.ir/en/journal/ViewPaper.aspx?id=444366
Omidvari, S. (2009). Spiritual health; concepts and challenges. Quranic Interdisciplinary Studies Journal, 1(1), 17–58. https://www.sid.ir/fa/journal/ViewPaper.aspx?id=99443
Omranifard, V., Kheirabadi, G. H. R., Abtahi, S. M. M., & Kamali, M. (2007). Obsessive compulsive disorder among outpatient referrals to dermatologic clinics of Isfahan. The Horizon of Medical Sciences, 13(2), 52–56. http://hms.gmu.ac.ir/article-1-166-en.html
Pahlavanzadeh, S., Heidari, F. G., Maghsudi, J., Ghazavi, Z., & Samandari, S. (2010). The effects of family education program on the caregiver burden of families of elderly with dementia disorders Iranian. Journal of Nursing and Midwifery Research, 15(3), 102–108.
Poordad, S., & Momeni, K. (2019). Death anxiety and its relationship with social support and gratitude in older adults Iranian. Journal of Ageing, 14(1), 26–39. https://doi.org/10.32598/sija.13.10.320
Potter, P. A., & Perry, A. G. (2008). Critical thinking in nursing practice (C. T. Jackie Crisp, Ed. illustrated ed., Vol. Ed 7th Edn.). Elsevier , 2008.
Rahmanian, M., Moein Samadani, M., & Oraki, M. (2017). Effect of group spirituality therapy on hope of life and life style improvement of breath cancer patients. Biannual Journal of AppliedCounseling, 7(1), 101–114. https://doi.org/10.22055/jac.2017.22221.1471
Salehi, I., & Mosalman, M. (2015). Evaluation of the relationship between religious attitude and depression, anxiety and stress in students of Guilan University.Religion and Health, 3(1), 57–64.
Salsman, J. M., Brown, T. L., Brechting, E. H., & Carlson, C. R. (2005). The link between religion and spirituality and psychological adjustment: The mediating role of optimism and social support. Personality and Social Psychology Bulletin, 31(4), 522–535.
Samani, S., & Joukar, B. (2007). A study on the reliability and validity of the short form of the depression anxiety stress scale (DASS-21). Journal of Social Sciences and Humanities, Shiraz University, 26(52), 66–75.
Sargolzaee, M. R. (2000). The impact of religious activities on depression, anxiety, and substance abuse. Paper presented at the International conference on the impact of religion on mental health.
Seligman, M. E., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60(5), 410.
Sharif Ghaziani, Z., Ebadollahi Chanzanegh, H., Fallahi Kheshtmasjedi, M., Baghaie, M. (2015). Quality of life and its associated factors among mental patients families. Journal of Health Care, 17(2), 166–177.
Simoni, J. M., Martone, M. G., & Kerwin J. F. (2002). Spirituality and psychological adaptation among women with HIV/AIDS: Implications for counseling. Journal of Counseling Psychology, 49(2), 139.
Tarakeshwa, N., Pearce, M. J., & Sikkema, K. J. (2005). Development and implementation of a spiritual coping group intervention for adults living with HIV/AIDS: A pilot study. Mental Health, Religion and Culture, 8(3), 179–190.
Vaillant, G., Templeton, J., Ardelt, M., & Meyer , S. E. (2008). The natural history of male mental health: Health and religious involvement. Social Science and Medicine, 66(2), 221–231.
Veltman, A., Cameron , J. I., & Stewart, D. E. (2002). The experience of providing care to relatives with chronic mental illness. The Journal of Nervous and Mental Disease, 190(2), 108–114.
Watkins, P. C., Woodward, K., Stone, T., & Kolts, R. L. (2003). Gratitude and happiness: Development of a measure of gratitude, and relationships with subjective well-being. Social Behavior and Personality: An International Journal, 31(5), 431–451.
Watson, R., Modeste, N. N., Catolico, O., & Crouch, M. (1998). The relationship between caregiver burden and self care deficits in former rehabilitation patients. Rehabilitation Nursing, 23(5), 258–262.
West, W. (2000). Psychotherapy & spirituality: Crossing the line between therapy and religion (S. S. Translated by: Sh. Shahidi, 2008. Tehran: Roshd., Trans.; Vol. first). Sage.
Wood, A. M., Maltby, J., Gillett, R., Linley, P. A., & Joseph, S. (2008). The role of gratitude in the development of social support, stress, and depression: Two longitudinal studies. Journal of Research in Personality, 42(4), 854–871.
Yaghubi, H., Karimi, M., Omidi, A., Mesbah, N., & Kahani Sh, A.-Q.-Q. M. (2014). Prevalence of mental disorders and demographic factors that influence the freshmen students of Tehran City Universities of Medical Sciences. Journal of Clinical Psychology, 6(2), 95–104. https://www.researchgate.net/publication/312331831
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Hereby, the researchers show their gratitude to the research vice-chancellor of Isfahan University of Medical Sciences for the financial support, as well as to those who participated in this study.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by FK, MF-M, TM and RM. The first draft of the manuscript was written by MF-M and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Isfahan University of Medical Sciences 015, 2019 (No. 015, 2019).
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Khosravi, F., Fereidooni-Moghadam, M., Mehrabi, T. et al. The Effect of a Spirituality-Based Program on Stress, Anxiety, and Depression of Caregivers of Patients with Mental Disorders in Iran. J Relig Health 61, 93–108 (2022). https://doi.org/10.1007/s10943-021-01372-w
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DOI: https://doi.org/10.1007/s10943-021-01372-w