Can internship programs affect nursing students' critical thinking disposition, caring behaviors, and professional commitment?

BACKGROUND

Nursing students are given opportunities to develop critical thinking disposition, caring behaviors, and professional commitment through clinical training. Therefore, nurse educators should move away from traditional methods toward new ones, such as internship programs in clinical training. This study assessed the effect of nursing internship programs on senior undergraduate nursing students' critical thinking disposition, caring behaviors, and professional commitment.

METHODS

This quasi-experimental study was conducted using a pretest-posttest design but with no control group. The study sample included 46 senior students enrolled in nursing internship programs. A demographic questionnaire, the Critical Thinking Disposition Inventory (CTDI), the Caring Assessment Report Evaluation (Care-Q), and the Nursing Professional Commitment Scale (NPCS) were used to collect data before and five months after the nursing internship programs were implemented.

RESULTS

The study findings revealed that the senior nursing students' caring behaviors improved, but the total scores of critical thinking disposition and professional commitment did not change significantly after the nursing internship programs (p > 0.05).

CONCLUSION

According to the results, nurse educators are recommended to adopt strategies to improve the effectiveness of internship programs on critical thinking disposition and professional commitment among senior undergraduate nursing students.

Innovative cultural care training: the impact of flipped classroom methods on critical cultural competencies in psychiatric nursing: a quasi-experimental study

INTRODUCTION

Healthcare systems are encountering a growing number of diverse and multicultural clients due to globalization and migration. To effectively address the challenges associated with cross-cultural interactions, nurses require a comprehensive framework of critical cultural competencies. One potential approach to enhancing these competencies in mental health care settings is to use innovative methods such as the flipped classroom in cultural care training programs. This study evaluated the effect of using the flipped classroom method in cultural care training on the critical cultural competencies of nurses working in a psychiatric hospital.

METHODS

This quasi-experimental study involved 70 nurses working in a psychiatric hospital affiliated with the Kerman University of Medical Sciences in southeastern Iran. Through random sampling, the nurses were allocated into two groups of intervention (n = 35) and control (n = 35). The intervention group participated in a cultural care training program using the flipped classroom method, which consisted of four sessions conducted over a four-week period. To evaluate the nurses' critical cultural competence, the Almutairi's Critical Cultural Competence Scale was administered before the training and again one month later.

RESULTS

The study findings indicated no significant differences in the scores of critical cultural competencies between the intervention group (4.53 ± 0.64) and the control group (4.73 ± 0.42) during the pre-test stage (t = 1.53, p = 0.13). Both groups had a similar perception of critical cultural competencies, which was not particularly positive. However, in the posttest stage, the intervention group (5.33 ± 0.49) demonstrated a significant increase in critical cultural competencies compared to the control group (4.75 ± 0.44) (t = 5.14, p = 0.001).

CONCLUSION

The study results indicated that the use of the flipped classroom method in the cultural care training program effectively enhanced the critical cultural competencies of nurses. Given the importance of cultural care in both physical and psychiatric care settings for multicultural clients, it is crucial for nurses to receive ongoing in-service education that utilizes innovative and active methods such as the flipped classroom.

Exploring the consequences of nurses' involvement in disaster response: findings from a qualitative content analysis study

BACKGROUND

The presence of nurses during disasters can lead to many consequences. Understanding the nurses' experiences of these consequences can provide valuable insights. Therefore, this study was conducted to explore the experiences of Iranian nurses regarding the consequences they faced when being present during disasters.

METHODS

This qualitative descriptive study employed a content analysis approach to examine the topic at hand. 20 nurses working in the emergency units of Kerman hospitals were selected through purposive sampling. In-depth semi-structured interviews were conducted to collect the data. The data were analyzed using qualitative content analysis proposed by Graneheim and Lundman. MAXQDA 10 was used to manage data.

RESULTS

After analysis of the interviews, two main categories were identified: overlapping of job frustrations and acquiring experience in difficult conditions. The main category of acquiring experience in difficult conditions comprised the following subcategories: improved quality of care, experience and dedication in fulfilling the role, reduced stress, occupational motivation and enthusiasm, increased self-confidence, and improved social status. On the other hand, the category of overlapping of job frustrations also consisted of the subcategories of physical strength deterioration, psychological and emotional distress, discontinued from supports, feelings of hopelessness, increased exposure to violence and aggression, and occurrence of family problems.

CONCLUSION

Being present during disasters and obtaining the necessary competencies can have positive consequences that serve as turning points in the personal and professional growth of nurses. Additionally, favorable outcomes can help nurses cope with adverse circumstances. Managers can utilize the findings of this study to develop strategies aimed at reducing negative outcomes and enhancing positive ones among nurses during disasters.

The effect of polyethylene cover intervention on ocular surface disorder of intensive care unit patients: a systematic review and meta-analysis

BACKGROUND

Polyethylene covers have been proven to be effective in protecting the eyes in patients with decreased or disappeared blink reflexes, but their advantages compared to other conventional methods are still unclear. This systematic review and meta-analysis study aimed to elucidate the impact of polyethylene covers in the prevention of ocular surface disease (OSD) in patients admitted to the intensive care unit (ICU).

METHODS

We searched the Scopus, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify randomized controlled trial studies. This study followed the PRISMA guidelines and used the Cochrane Collaboration tool to assess the risk of bias.

RESULTS

The findings were expressed as risk ratio (RR) with 95% confidence intervals. The incidence of OSD in the polyethylene cover group was lower than that in the eye drops group (RR = 0.27; 95% CI (0.07, 1.09), P = 0.07) and adhesive tape group (RR = 0.11, 95%CI (0.04, 0.31), P < 0:0001) but the polyethylene cover group showed no significant difference compared to the eye gel group (RR = 0.79, 95%CI (0.18, 3.51), P = 0.76) and the eye ointment group (RR = 0.85; 95% CI (0.36, 1.99), P = 0.71).

CONCLUSION

This study showed that polyethylene covers, eye gels, and eye ointments had an equal effect on preventing OSD in ICU patients, and eye drops and adhesive tapes were relatively less effective. However, other intervention methods had not been compared due to the small number of articles. Hence, further studies should assess the available methods to choose the best practical method.

The effect of positive thinking training on anxiety and happiness among older adults: A quasi-experimental study

BACKGROUND

Anxiety and depression are the most prevalent mental disorders associated with aging. Positive thinking training is a way to help older adults cope with anxiety and depression and increase their happiness. This study aimed to determine the effect of positive thinking training on anxiety and happiness among older adults.

MATERIALS AND METHODS

This quasi-experimental study was conducted with 48 older adults referred to two comprehensive health service facilities in the southeastern Iranian province of Kerman. The intervention (n = 24) and control (n = 24) groups were randomly assigned from a convenience sample of older adults. The intervention group attended eight two-hour training sessions on positive thinking. Data were collected before and one month after the positive thinking training using Beck Anxiety Inventory and Oxford Happiness Inventory. All statistical procedures were performed in SPSS software (version 22), with the significance level set to P = 0.05.

RESULTS

Before the positive thinking program was delivered, the mean anxiety scores in the intervention and control groups were 13.98 ± 8.61 and 19.25 ± 11.67, respectively. After the intervention was completed, the mean scores for the intervention and control groups were 4.50 ± 4.07 and 15.54 ± 9.04, indicating a significant reduction in anxiety among intervention group participants (t = -5.45, P < 0.001). The mean baseline happiness scores in the intervention and control groups were 26.58 ± 12.40 and 37.91 ± 5.57, respectively, which changed to 62.91 ± 4.66 and 35.62 ± 10.62 at the post-test. Positive thinking training improved happiness in a significant manner (t = -4.08, P < 0.001).

CONCLUSION

Results revealed that positive thinking training decreased anxiety and enhanced happiness among older adults. Given the growing elderly population, clinical managers, clinical specialists, nurses in health care centers, and those involved in elderly care facilities can benefit from this non-pharmacological treatment program for older adults suffering from anxiety and depression. It is suggested that preventive programs based on positive psychology be developed to aid in the prevention of people's declining happiness and increasing anxiety as they age.

The effect of service-based learning on health education competencies of students in community health nursing internships

AIM

This study investigated the impact of service-based learning on the health education competencies of students in community health nursing internships. community health nursing internship is one of the areas where students acquire health education competencies. Studies have shown that some students have poor health education competencies, and new educational interventions, such as service-based learning, can help improve their competencies.

METHOD

This quasi-experimental study was conducted in 2021-2022. The participants were final-year nursing students affiliated to Kerman University of Medical Sciences. All participants (n = 72) were selected via the census method and randomly divided into intervention and control groups (36 participants in each group). The students in the intervention group attended a service-based learning program for 20 days. The data were collected before and one month after intervention using a 48-item health education qualification questionnaire. The collected data were analyzed using SPSS22 software.

RESULTS

The results showed that the mean health education competencies scores were lower before intervention in the intervention and control group (165.75 ± 23.09) (170.16 ± 28.58)(p > 0.05). There was no significant difference between the two groups in terms of their mean scores on health education competencies(p > 0.05). The health education competencies score increased significantly for the participants in the intervention group (191.58 ± 28.35) compared to the control group (165.97 ± 28.11) after intervention.

CONCLUSION

Nursing administrators and professors need to take effective steps to empower nursing students as much as possible and incorporate service-based learning techniques in clinical education programs for nursing students.

Nursing students' patient safety competencies in the classroom and clinical settings: a cross-sectional study

INTRODUCTION

Patient safety is one of the critical indicators of providing qualified and high-quality health care services. Determining nursing students' patient safety competencies will significantly contribute to the literature. Therefore, this study aimed to investigate Iranian nursing students' patient safety competencies in classroom and clinical settings.

METHODS

In this cross-sectional study data were collected from 215 nursing of a university of medical sciences between February and May 2022, using a general questionnaire form and the Health Professional Education in Patient Safety Survey. Data analysis was done using descriptive and analytical statistics such as percentage, mean and paired-samples t-test.

RESULTS

The mean scores of nursing students' the Health Professional Education in Patient Safety Survey were 3.50 ± 0.55 in the classroom and 3.45 ± 0.57 in the clinical setting. The highest mean scores of nursing students were in subdimension of "clinical safety" in both the clinical (3.91 ± 1.13) and classroom settings (3.91 ± 0.78). In addition, a statistically significant difference was found in patient safety learning confidence in the classroom versus clinical setting in the "culture of safety" subdimension.

CONCLUSION

It appears that current educational programs provide opportunities to improve nursing students' patient safety, but they are not enough. Nurse educators should apply new teaching methods and evaluate clinical strategies to meet educational needs.

Nurses' challenges for disaster response: a qualitative study

BACKGROUND

Healthcare providers, particularly nurses, play a critical role in mitigating the impact of disasters on victims and the healthcare system. However, nurses face unique challenges in disasters that may not experience in their daily practice, which can make it harder for them to deal with disasters efficiently. This study aimed to investigate the challenges faced by nurses for disaster response.

METHODS

A qualitative content analysis approach was used in this study. Purposeful sampling was used to select 24 nurses working in the emergency departments of hospitals in Kerman, southeastern Iran. Data were collected through semi-structured interviews and analyzed using MAXQDA10. The conventional content analysis method proposed by Graneheim and Lundman was used to analyze the data.

RESULTS

The analysis of the findings resulted in one major category, insufficient ability of nurses to respond to disasters, and five subcategories: diverse nursing conditions during disasters, inappropriate interactive platform during disasters, the presence of obstacles to teamwork, lack of platform for nurses to acquire adequate disaster risk management competence, and moral tension in complex disaster situations.

CONCLUSIONS

Determining the challenges that nurses face during disasters is essential for improving disaster response efforts, promoting disaster preparedness, ensuring appropriate care for patients, and reducing emotional fatigue among nurses. Finally, nursing leaders, healthcare policymakers and governments should use these findings to better support the nursing workforce in disasters.

Designing, implementing, and evaluating a mobile app-based cultural care training program to improve the cultural capacity and humility of nursing students

BACKGROUND

Given the growing cultural diversity among healthcare clients, it is crucial for nursing education to have a clear mission: to effectively train future nurses by incorporating cultural care curricula. The goal is to equip them with the necessary cultural capacity and humility. This study focused on designing, developing, and evaluating a mobile app-based cultural care training program, with the aim of enhancing the cultural capacity and humility of nursing students.

METHODS

This experimental study utilized the five steps of the ADDIE instructional model (analysis, design, development, implementation, and evaluation) to design a mobile app-based cultural care training program. The first three steps involved designing and developing the program, drawing upon Purnell's model for cultural competence and Foronda's rainbow model of cultural humility. In the fourth step, the cultural care training program was implemented in 16 modules among 80 internship nursing students. These students were randomly assigned to either the intervention or control groups, with 40 students in each group. Finally, in the fifth step, the effectiveness of the mobile app-based program was evaluated by administering the Cultural Capacity Scale, and the Foronda Cultural Humility Scale before and one month after the cultural care training. The collected data were analyzed using SPSS22, employing techniques such as paired t-test, chi-square test, and independent samples t-test.

RESULTS

A total of 76 students completed the study, with 39 students in the intervention group and 37 students in the control group. Prior to the mobile app-based cultural care training program, there were no significant differences in cultural capacity and humility scores between the two groups (p > 0.05). However, following the completion of the program, the intervention group exhibited higher scores in cultural capacity and humility compared to the control group (p < 0.05).

CONCLUSION

Based on the findings, it can be concluded that the mobile app-based cultural care training program had a positive impact on the cultural capacity and humility of undergraduate nursing students. These results indicate the importance of nurse educators designing comprehensive training programs that incorporate innovative approaches to enhance cultural capacity and humility among nursing students at all academic levels.

The effect of scenario-based training on the Core competencies of nursing students: a semi-experimental study

INTRODUCTION

Competency is defined as the variety of skills and knowledge required to perform a specific task. Due to the specificity of pediatric nursing, students face some challenges in acquiring core competencies. Therefore, the use of new training methods in pediatric nursing is necessary. One of the modern learning methods is learning based on clinical scenarios. Thus, this study aimed to investigate the effect of scenario-based education on the core competencies of nursing students.

METHOD

This quasi-experimental study employed a pre-test and post-test design. All participants (n = 72) were selected via the census method and randomly divided into intervention (N = 33) and control groups (N = 40). The data were collected using a demographic information questionnaire and the Nursing Students' Clinical Competencies Questionnaire. Before the intervention, both groups completed the pre-tests. After one month, the students in both groups completed post-tests.

RESULTS

The average score of core competencies for the students in the intervention group after the training (247.05, SD = 36.48) increased compared to before the intervention (229.05, SD = 36.58) (P > 0.05). The average score of the core competencies for the students in the control group after the training was 240.76 (SD = 35.36) compared to 235.56 (SD = 27.94) before the intervention, with no significant difference (P < 0.05). The independent t-test did not show a significant difference between the control and intervention groups before and after the intervention (P > 0.05).

CONCLUSION

The results indicated the effectiveness of scenario-based training on the core competencies of students in the intervention group. Accordingly, nursing administrators and professors are recommended to incorporate new scenario-based teaching and learning methods in educational programs of universities. It is also necessary to conduct more research into the effectiveness of this method in combination with other training methods like team-based and problem-based training.

Effectiveness of an online training program for improving nurses' competencies in disaster risk management

BACKGROUND

Nurses' incompetency in disaster risk management can have many negative consequences during disasters, so it is important to prepare nurses and improve their competencies in disaster risk management. This study was conducted with the aim of investigating the effectiveness of an online training program to improve competencies in disaster risk management.

METHOD

This interventional study was conducted on nurses working in a specialized trauma hospital affiliated with the Kerman University of Medical Sciences in southeastern Iran in 2023. Eighty-one nurses were randomly assigned into two interventions (n = 42) and control groups (n = 39). The intervention group received an online training program in four sessions, and both groups electronically completed the demographic questionnaire and the nurses' perceptions of disaster core competencies scale (NPDCC) before and one month after the intervention.

RESULTS

The study results showed no significant difference in disaster competency scores between the two groups before the intervention (p < 0.51), but the NPDCC score in the intervention group was statistically significant after the intervention compared to before the intervention (p < 0.02) and no statistically significant difference was observed between the two groups after the intervention (p < 0.16).

CONCLUSION

While the online training program was found to significantly improve the NPDCC score of nurses in the intervention group, this increase was not significant when compared to the control group. Therefore, we suggest continuous practical exercises and maneuvers to improve nurses' perception of the competencies required for effective disaster management.

Experiences of family caregivers of people with intellectual disabilities from rural areas in southeastern Iran: a qualitative study

BACKGROUND

Caring for people with intellectual disabilities can be a challenging task, but it can also bring about positive experiences for family caregivers. The present study aimed to explore these positive experiences and shed light on the ways in which family caregivers of people with intellectual disabilities can find meaning and fulfillment in their roles.

METHODS

This qualitative study used conventional content analysis to explore the positive experiences of family caregivers of people with intellectual disabilities. Sixteen family caregivers from rural areas in southeastern Iran were purposively selected to participate in the study. Semi-structured in-depth interviews were conducted to collect data. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using the method proposed by Graneheim and Lundman.

RESULTS

The data analysis resulted in the emergence of a single theme, which was achievements of providing care for people with intellectual disabilities. This theme was comprised of four main categories: a new outlook on life, family caregivers' peace of mind, strengthening of family ties, and improvement of social status. The provision of care for people with intellectual disabilities created positive changes, affecting family functioning and care provision for people with intellectual disabilities.

CONCLUSION

It is recommended that families of people with intellectual disabilities focus on these positive experiences and share them with other families who may be struggling with a recent diagnosis of intellectual disability in their child.

Iranian nurses' perceptions of core competencies required for disaster risk management

BACKGROUND

With an increase in the incidence and severity of disasters, disaster risk management receives an important priority in the health system. Nurses at all levels of healthcare play an important role in disaster risk management and they must have core preparation and competencies to respond to disasters. This study aimed to evaluate Iranian nurses' core competencies required for disaster risk management.

METHODS

This cross-sectional study was conducted on 277 nurses working in three hospitals affiliated to Kerman University of Medical Sciences in 2022. The demographic information questionnaire and the nurses' perceptions of disaster core competencies scale (NPDCC) were used to collect data, and SPSS21 was used to analyze data.

RESULTS

Nurses' competencies in disaster risk management were favorable (3.67 ± 0.77), with the subscales of technical skills and special diagnostic skills receiving the highest (3.91 ± 0.65) and the lowest mean scores, respectively (3.46 ± 0.87). The results found a significant difference between the scores of nurses' competencies in disaster risk management in terms of education level, age, work experience, employment status, participation in training courses related to disaster risk management, work experience in incidents and disasters.

CONCLUSION

The study results suggested nurses' high level of competency in disaster risk management, but indicated gaps in their core competencies. The study results recommend authorities provide various training courses related to disaster risk management for all nurses.

A virtual training program for improving cultural competence among academic nurse educators

BACKGROUND

Everyday, nursing students interact with culturally diverse clients. Nursing education recognizes that cultural competence is a necessary outcome of nursing programs. Nurse educators expect all nursing students to provide culturally congruent care to multicultural clients. Therefore, nurse educators must be culturally competent in order to prepare culturally competent nursing students for clinical practice. This study aimed to evaluate the effect of virtual training program on the cultural competence of academic nurse educators.

METHODS

This randomized controlled study included nurse educators working in six nursing schools affiliated with medical universities of Kerman province in southeastern Iran. Sixty-nine nurse educators were randomly assigned to the intervention (n = 35) and control (n = 34) groups. The training program consisted of three 2-hour sessions for a month. Cultural Diversity Questionnaire for Nurse Educators Revised (CDQNE-R) was used to evaluate the cultural competence of educators before and one month after the virtual training program.

RESULTS

Both the intervention (3.29 ± 0.58) and control (3.24 ± 0.58) groups demonstrated a similar level of cultural competence before the training program (t = 0.05, p = 0.95). After the training, the intervention group showed a significant increase in cultural competence (3.80 ± 0.7) compared to the control group (3.23 ± 0.67). This improvement resulted in culturally competent participants becoming culturally proficient, as evidenced by a large effect size (t = -4.76, p = 0.001).

CONCLUSION

The virtual training program had a positive impact on the cultural competence of nurse educators. Given the importance of cultural competence in nursing education, continuing education programs that focus on strengthening the cultural competence of nurse educators should be prioritized. The experiences gained from implementing virtual training programs can serve as a valuable resource for nurse educators seeking to enhance their cultural competence.

Active aging needs from the perspectives of older adults and geriatric experts: a qualitative study

Introduction

With an increasing rate of population aging and its consequences, preparation for active aging based on older adults' needs is an unavoidable priority. Active aging needs must be identified to help strategic planning for older adults' health and wellbeing. This study aimed to explore the active aging needs from the perspectives of older adults and geriatric experts.

Methods

This exploratory-descriptive qualitative study was conducted in four provinces with the oldest populations in Iran. Semi-structured and focus group interviews were conducted with 41 participants (20 older adults and 21 geriatric experts), who were chosen through purposive and snowball sampling. Data were analyzed using the conventional content analysis.

Results

This study identified three themes and thirteen categories from the data: (1) basic individual needs with three categories of physiological, psycho-emotional, and spiritual needs; and (2) managerial needs with seven categories of political-legal, socio-economic, and cultural-spiritual infrastructures, academic strategies, an age-friendly environment; technological services, and provision of specialized services and daycare for older adults, and (3) educational needs with three categories of training self-care and self-efficacy, empowering the health care workers; and empowering the family.

Conclusion

The results revealed personal, managerial, and educational needs for active aging and could assist policymakers and geriatric experts to promote and meet active aging needs successfully.

Nurses' perceptions of critically ill patients' eye care: a qualitative study in Iran

BACKGROUND

Despite the high prevalence of ocular complications in patients admitted to the intensive care unit (ICU), eye care, as an important component of the care plan, has not received much attention from nurses. To improve the quality of eye care, the challenges and concerns of ICU nurses should be studied deeply. Thus, the present study aimed at exploring the challenges faced by ICU nurses in taking care of patients admitted to the ICU.

METHODS

The present conventional qualitative content analysis study was carried out on 11 nurses and 3 head nurses selected purposefully by observing the maximum variation. The data were collected through face-to-face, in-depth, and semi-structured interviews. All data were recorded, transcribed, and analyzed using the conventional content analysis method proposed by Graneheim and Lundman (Nurse Educ Today 24:105-12, 2004). The Max Q Data software 2020 was run to record the interviews and extract codes from the transcriptions.

RESULTS

The participants' mean age was 37.14 ± 6.41 years and their average work experience in ICU was 10.29 ± 7.63 years. The core category that emerged from data analysis was "the lack of an evidence-based approach", which was subdivided into five categories: "education, the missing link", "nurses' inadequate professional competence", "unsafe nursing care", "organizational requirements", and "difficulty in eye care evaluation".

CONCLUSION

Evidence-based practice plays a minor role in the field of eye care in Iran, despite its critical importance. Thus, the Ministry of Health and Medical Education of Iran is recommended to adapt the clinical guidelines so that more attention is paid to this field.

Improving the Hope and Happiness of Patients With an Ostomy: Effects of Group Cognitive Therapy

PURPOSE

The purpose of this study was to evaluate the effectiveness of group cognitive therapy (GCT) on hope and happiness in patients with ostomy.

DESIGN

A single-group before-after study.

SUBJECTS AND SETTING

The sample comprised 30 patients living with an ostomy for at least 30 days. Their mean age was 64.5 (SD 10.5) years; most were male (66.7%, n = 20).

METHODS

The study setting was a large ostomy care center in the city of Kerman, located in southeastern Iran. The intervention was 12 GCT sessions, each lasted 90 minutes. Data were collected before and 1 month after GCT sessions using a questionnaire designed for purposes of this study. The questionnaire queried demographic and pertinent clinical data, and incorporated 2 validated instruments: the Miller Hope Scale and the Oxford Happiness Inventory.

RESULTS

The mean pretest score on the Miller Hope Scale was 121.9 (SD 16.7) and the mean score on the Oxford Happiness Scale was 31.9 (SD 7.8); posttest mean scores were 180.4 (SD 12.1) and 53.4 (SD 8.3), respectively. Scores on both instruments significantly increased in patients living with an ostomy following 3 GCT sessions (P = .0001).

CONCLUSION

Findings suggest that GCT enhances hope and happiness in persons living with an ostomy.

Using mindfulness-based stress reduction group therapy to reduce perceived stress of vulnerable women in south of Iran

Provision of educational and health services to vulnerable women in drop-in centers can reduce their traumas. Mindfulness-Based Stress Reduction (MBSR) group therapy is a psychological intervention to reduce perceived stress these women. This quasi-experimental study aimed to evaluate the effectiveness of MBSR group therapy in the perceived stress of 63 vulnerable women who referred to two drop-in centers in southeastern Iran. The participants were assigned into the intervention (n = 30) and control (n = 33) groups. The intervention group members were required to attend the MBSR intervention held in eight 90-minute sessions. Perceived Stress Scale (PSS) was administered to collect data before and one month after the MBSR. Based on the findings, the pre-test scores of perceived stress were not significantly different between the intervention (38.16 ± 6.04) and control (39.06 ± 5.30) groups (t = -0.62, p = 0.53). However, the perceived stress scores reduced significantly in the intervention group (30.20 ± 2.89) than the control group scores (37.96 ± 4.18) in the posttest (t = -8.35, P = 0.001). Given the significant reduction of perceived stress in participants after attending the MBSR group therapy, expert counselors, psychologists, and psychiatrists are recommended to conduct this therapy to reduce perceived stress in vulnerable women.

Psychological wellbeing, family cohesion, and purposeful life in male prisoners: A cross-sectional study

Background

Psychological wellbeing, family cohesion, and purposeful life are important determinants of the prisoners' overall wellbeing and health; therefore, their evaluation is extremely important in prisoners as a vulnerable group.

Objective

This study evaluated psychological wellbeing, family cohesion, purposeful life, and their correlations in male prisoners.

Methods

This cross-sectional study used simple random sampling to select 259 male prisoners. Data were collected using questionnaires of Ryff psychological wellbeing, Fischer family cohesion, and Crumbaugh and Maholick purpose in life.

Results

Majority of (78%) the participants were 20-40 years old and married (59%). The mean scores of psychological wellbeing, family cohesion, and purposeful life of the male prisoners were moderate. Psychological wellbeing was directly correlated to family cohesion in male prisoners, but it had no significant correlation with a purposeful life. Family cohesion was not significantly correlated to a purposeful life.

Conclusion

Regarding the moderate level of psychological wellbeing in prisoners, it is suggested to pay more attention to educational and supportive programs in prisons for promoting such indicators in prisoners.

Two-sided perspective on tele-speech therapy: Experiences of stuttering patients, and their parents

The purpose of this study was to investigate the benefits and challenges of the tele-speech therapy from the perspective of patients who stutter, and their parents. Semi-structured interviews were conducted with 12 patients and three parents in two rehabilitation centers. Data were analyzed using a qualitative content analysis approach proposed by Graneheim and Lundman. Seven categories were determined: accessible treatment, motivation of comfort in tele-speech therapy, challenges of tele-therapy, satisfaction, virtual competency, lower quality compared to face-to-face therapy, and uncertainty about the effectiveness of tele-speech therapy. The participants had a two-sided perspective regarding tele-speech therapy. Positive experiences included benefitting from more qualified therapists at multiple locations, faster access to treatment, and saving cost and time. Negative experiences and challenges consisted of low-quality of technology infrastructure for rehabilitation including low quality of shared images and videos, ineffective communication, insufficient sympathy, indirect communication, and technology incompetency. Findings showed that the participants were interested in the application of tele-speech therapy, as this method could increase their accessibility and provide the opportunity to choose proper therapists. The determined benefits and challenges can provide the policy-makers with beneficial information to implement tele-speech therapy.

Improving psychiatric nurses' competencies in spiritual care and integration of clients' religion/spirituality into mental healthcare: outcomes of an online spiritual care training program

BACKGROUND

Religion/spirituality (R/S), which is associated with individuals' well-being and psychological health, plays a significant role in most clients' lives in healthcare systems. Although clients in mental healthcare settings prefer their R/S to be employed in nursing care, R/S has neither been adequately integrated into mental healthcare nor discussed in the assessment and nursing interventions of mental healthcare. Evidence shows that most psychiatric nurses receive little or no training in spiritual care (SC) and are unable to integrate clients' R/S into mental healthcare. To address this gap, the present study aimed to investigate the effects of an online SC training program on psychiatric nurses' competencies in SC and the integration of clients' R/S into mental healthcare.

METHODS

This experimental study was conducted with nurses working in a psychiatric hospital affiliated with a large University of Medical Sciences in southeast Iran. Random sampling was performed and 95 nurses were assigned to the intervention (n = 50) and control (n = 45) groups. Online SC training was conducted for the intervention group in four sessions over four weeks. Data were collected using the Self-Assessment of Spiritual Care Competency and R/S Integrated Practice Assessment Scale before and one month after the training program.

RESULTS

There were no significant differences between the two groups before training (p > 0.05). After the training, nurses in the intervention group obtained significantly higher scores in competencies in SC and integration of clients' R/S into mental healthcare compared to the control group, with a considerable effect size (P < 0.05).

CONCLUSION

The online training program positively affected psychiatric nurses' competencies in SC and the integration of clients' R/S into mental healthcare. Since SC is a critical need for clients, specifically in mental healthcare settings, nurses must receive continuous education to provide SC to various clients.

Workplace Violence Against Prehospital Paramedic Personnel (City and Road) and Factors Related to This Type of Violence in Iran

Medical personnel such as those working in emergency medical systems are in direct contact with the patient or the injured and are exposed to workplace violence. This study aimed to determine workplace violence against prehospital paramedical personnel and factors related to this type of violence in Iran. The cross-sectional study was conducted in 72 prehospital emergency centers affiliated with Kerman University of Medical Sciences in 2019. Using a researcher-made questionnaire, we assessed workplace violence and factors associated with this type of violence in prehospital paramedical personnel with a census method (N = 308). Data were analyzed using descriptive statistics including mean and standard deviation (SD), frequency, percentage, and analytic statistics, such as the Kolmogorov-Smirnov, ANOVA, t test, and multiple linear regression tests. The results of this study showed that the most frequent types of workplace violence were verbal violence (47%), physical violence (32.50%), cultural violence (16%), and no violence (4.50%), respectively. From the perspective of paramedical personnel, the total mean score of workplace violence was at a moderate level (52.19 ± 10.72). The most important factors affecting workplace violence from the perspective of paramedical personnel were "lack of awareness of people about the duties of emergency medical personnel" and "lack of specialists in prehospital (city or road) bases." Majority of the paramedical personnel believed that "no reaction and observance of patients and their families' rights" were the most important types of reactions. They also believed that violence was normal at the workplace and should not be considered in emergency medical services. Results suggest that national and local policies in Iran should provide prehospital paramedical personnel with various training courses about how to decrease the rate of workplace violence, promote public health, and decrease their psychological stresses and occupational burnout.

Identifying the content, functionalities, and features of a mobile application for contact lens wearers

BACKGROUND

Lack of attention to end-users' requirements and preferences may lead to the failure of health information technology (IT) interventions. Identifying users' needs for designing a mobile application can lead to the development of an acceptable intervention. This study aimed to determine the requirements for designing a mobile application to educate and provide needed information to contact lens (CL) wearers.

METHODS

A qualitative study was conducted on 24 CL wearers and nine eye care practitioners from the three CL clinics in Iran. Data were collected through semi-structured interviews and analyzed using the conventional content analysis proposed by Lundman and Graneheim. Lincoln and Guba's criteria were used to ensure the trustworthiness of the data.

RESULTS

The three main categories that emerged from the interviews were mobile application content, mobile application functionalities, and mobile application features. Ten subcategories and 57 sub-subcategories were also identified. It was determined that mobile content should focus on advice and information for optimizing the CL wearing experience and training regarding the use of CLs. Entering information required for self-care, computational capability, interactivity, updates, and reminders were determined as needed functionalities. The participants recommended features for the structure and user interface of the mobile application and information presentation methods.

CONCLUSION

This study identified the information needed to develop a mobile application for CL wearers. This also provides insights regarding required functionalities when applying IT interventions. These findings can be used by CL clinics, developers of health information systems, policymakers, and health planners to design better CL-related care and compliance interventions.

Improving Cultural Competence and Self-Efficacy Among Postgraduate Nursing Students: Results of an Online Cultural Care Training Program

INTRODUCTION

Since nurses and nursing students interact with culturally diverse clients in health care settings, training programs are required to improve cultural competence and self-efficacy among them. This study aimed to investigate the effect of an online cultural care training program on cultural competence and self-efficacy among postgraduate nursing students.

METHODS

The present interventional study used random sampling to allocate 80 postgraduate nursing students into the intervention and control groups. Cultural care training program was held for the intervention group.

RESULTS

No significant difference in cultural competence and self-efficacy scores was found between the intervention and control groups in the pretest. However, the intervention group scored higher in terms of cultural competence and self-efficacy after the intervention.

DISCUSSION

Given cultural diversity and prevalence of medical tourism, nursing instructors need to pay special attention to cultural care education at all academic levels.

Using a model to design, implement, and evaluate a training program for improving cultural competence among undergraduate nursing students: a mixed methods study

BACKGROUND

Due to changing population, culturally diverse clients with different perceptions of illness and health are present in healthcare settings. Therefore, it is increasingly important for nursing students to have high levels of cultural competence in order to meet diverse client needs. A training program is essential to enhance students' cultural competence. This study aimed to design, implement, and evaluate a cultural care-training program to improve cultural competence of undergraduate nursing students.

METHODS

This exploratory mixed methods study used six steps proposed in the Talbot and Verrinder model to design a training program. In the first step, a conventional qualitative study was conducted and 18 participants were interviewed using purposive sampling. In the second and third steps, literature review and the classic Delphi technique were used for initiation and finalization of the program. The fourth, fifth, and sixth steps were completed by implementing, monitoring, and evaluating the cultural care program (five two-hour sessions) among 73 nursing students using a quasi-experimental design. Finally, effectiveness of program was evaluated through the cultural care inventory before and 1 month after the program. Data were analyzed via SPSS25, independent samples t- test, paired t- test, chi-square test, analysis of covariance, and multivariate linear regression tests.

RESULTS

A systematic model was used to identify key elements of a cultural care program, including main topics, educational objectives and contents, assignments and activities for students, teaching and evaluation methods. The curricular objectives and educational contents were implemented in five sessions to produce measurable results. The quantitative step showed that nursing students' cultural competence in the intervention group (184.37 ± 22.43) improved significantly compared with the control group (153.19 ± 20.14) (t = 6.24, p = 0.001) after intervention.

CONCLUSION

A cultural care training program can be designed by the model applied in this study in order to improve cultural competence of nursing students. This training program will be effective if students' learning needs, appropriate assignments, and acceptable teaching methods are addressed. Therefore, nurse educators can design comprehensive training programs to improve nursing students' cultural competence in different cultures and contexts. This training program is highly efficient because it is applicable in many disciplines of nursing education.