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Pouy S, Taheri-Ezbarami Z, Rassouli M, Darbandi B, Javadi-Pashaki N. Factors Improving Oncology Nurse Role Performance in Providing Pediatric Palliative Care: A SWOT Analysis. Asian Pac J Cancer Prev 2023; 24:3501-3508. [PMID: 37898856 PMCID: PMC10770675 DOI: 10.31557/apjcp.2023.24.10.3501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 10/07/2023] [Indexed: 10/30/2023] Open
Abstract
OBJECTIVE Palliative care is provided by an interdisciplinary team in which, nurses play an important role, and improving their role performance can be effective in providing high-quality care. This study aimed to explore the factors related to improving oncology nurses' role performance in providing pediatric palliative care. METHODS This qualitative study was conducted using semi-structured interviews with 22 nurses, physicians, hospital supervisors, children, and their parents from September 2022 to January 2023. Data analysis was performed based on conventional content analysis proposed by Elo and Kyngas using MAXQDA 2020. Finally, subcategories of each main category were summarized in the SWOT analysis matrix. RESULT Data analysis led to the extraction of 1250 codes, three main categories (nurse-related factors, child and family-related factors, and organizational factors), five generic categories, and 32 subcategories that were ultimately classified in the SWOT analysis matrix. CONCLUSION This study showed that oncology nurses' role performance in providing palliative care is influenced by many internal and external factors. In this regard, in order to improve their role performance, increasing knowledge among nurses, nursing students, and the community on integrating pediatric palliative care topics into the nursing curriculum, fair access to palliative care services, drug accessibility, financial support, and further research are recommended.
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Affiliation(s)
- Somaye Pouy
- Department of Pediatric Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
| | - Zahra Taheri-Ezbarami
- Department of Pediatric Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Bahram Darbandi
- Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
| | - Nazila Javadi-Pashaki
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran.
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Zahedi F, Kadivar M, Khanali Mojen L, Asadabadi M, Tajalli S, Ilkhani M, Barasteh S, Elahikhah M, Larijani B. The ethical challenges of palliative care from the perspectives of pediatricians: A qualitative study in Iran. Front Pediatr 2022; 10:928476. [PMID: 36105856 PMCID: PMC9464941 DOI: 10.3389/fped.2022.928476] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adherence to ethical principles is a requirement for palliative care delivery to children and a main concern of healthcare providers. Physicians usually face ethical challenges during their daily practice in hospitals and need adequate skills and the ability to identify and manage them. This study sought to explore the ethical challenges of palliative care from the perspectives of pediatricians. METHODS This qualitative study was conducted between April and July 2019 using the content analysis approach. Participants were fifteen pediatric medical residents, specialists, and subspecialists purposively recruited from pediatric hospitals in Tehran, Iran. Data were collected using in-depth semi-structured interviews and were analyzed using Graneheim and Lundman's approach to conventional content analysis. Trustworthiness was ensured through the four criteria proposed by Guba and Lincoln. RESULTS Participants' experiences of the ethical challenges of palliative care for children were grouped into two main categories, namely "bewilderment in dealing with children and their families" (with two subcategories) and "conflicts in decision making" (with three subcategories). The final five subcategories were: (a) inability to effectively communicate with children and their families, (b) inability to tell the truth about the disease, (c) physician-parent conflicts, (d) parent-child conflicts, and (e) physician-physician conflicts. CONCLUSION The main ethical challenges of palliative care from the perspectives of Iranian pediatricians are the inability to effectively communicate with children and their families, the inability to tell them the truth, and the inability to manage physician-parent, parent-child, and physician-physician conflicts. Identification and management of these challenges may help improve the quality of pediatric palliative care in Iran. Further studies are needed to confirm these findings in other settings.
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Affiliation(s)
- Farzaneh Zahedi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maliheh Kadivar
- Division of Neonatology, Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Khanali Mojen
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Asadabadi
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saleheh Tajalli
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Mahnaz Ilkhani
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Salman Barasteh
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Maryam Elahikhah
- Students Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Medical Ethics and History of Medicine Research Centre, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ahmadnia S, Ghalibaf AK, Kamkar S, Mohamadzadeh Z, Ghalibafian M. Survivor and parent engagement in childhood cancer treatment in Iran. Ecancermedicalscience 2021; 15:1220. [PMID: 34158824 PMCID: PMC8183647 DOI: 10.3332/ecancer.2021.1220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Indexed: 02/01/2023] Open
Abstract
In Iran (with a population of 83 million), 19,973 children were diagnosed with cancer from 2009 to 2019 (MAHAK Charity). This study was part of the International Society of Paediatric Oncology, Paediatric Oncology in Developing Countries Committee, ‘Patient, Family and Stakeholder Engagement Task Force’ engagement study in ten low- and middle-income countries in 2019. We documented childhood cancer survivors and parents’ experiences and quality of engagement, including perceptions and expectations, during their cancer treatment journey in Iran. Fourteen in-depth interviews and three focus group discussions were conducted by three Iranian qualitative researchers with 29 participants: recent adolescent/young adult survivors (12–20 years), long-term survivors (21–30 years) and parents [36–61 years (six mothers and four fathers)] from diverse socio-economic and ethnic backgrounds. Data were recorded, transcribed and analysed, and then translated from Farsi into English. Participants’ expectations included inter alia improved communication and information flow among the key stakeholders including doctors, nurses, parents and patients. A need for improved patterns of doctor–patient relationships and communication, more effective psychosocial support and the importance of peer support groups (for survivors and parents) were reported. Participants identified areas of satisfaction and dissatisfaction regarding their actual engagement and decision-making. The dominance of a medical-only approach instead of multidisciplinary approach in care, the shortage of psychosocial support, the lack of an integrated system for providing information and delivering a package of printed material about the treatment journey and the absence of patient navigator in childhood cancer care systems were among obstacles for successful engagement of patients and parents throughout their cancer journey.
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Affiliation(s)
| | | | - Saba Kamkar
- MAHAK Charity-Society to Support Children Suffering from Cancer, Tehran 1956993461, Iran
| | - Zahra Mohamadzadeh
- MAHAK Charity-Society to Support Children Suffering from Cancer, Tehran 1956993461, Iran
| | - Mithra Ghalibafian
- MAHAK Paediatric Cancer Treatment and Research Centre (MPCTRC), Tehran 1956993461, Iran
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Farahani AS, Heidarzadeh M, Tajalli S, Ashrafizade H, Akbarpour M, Khaki S, Khademi F, Beikmirza R, Masoumpoor A, Rassouli M. Psychometric Properties of the Farsi Version of Posttraumatic Growth Inventory for Children-Revised in Iranian Children with Cancer. Asia Pac J Oncol Nurs 2021; 8:295-303. [PMID: 33850963 PMCID: PMC8030598 DOI: 10.4103/apjon.apjon-2093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/08/2020] [Indexed: 11/20/2022] Open
Abstract
Objective: Coping with childhood cancer, as a stressful incident, can lead to a growth in various aspects of the child's life. Therefore, this study aims to validate Posttraumatic Growth Inventory for Children-Revised (PTGI-C-R) in children with cancer. Methods: This methodological research was carried out in referral children hospitals in Tehran. PTGI-C-R was translated and back-translated. Content and face validity were assessed. Confirmatory factor analysis (CFA) was performed on 200 children with inclusion criteria, using LISREL V8.5. Due to the rejection of the model, an exploratory factor analysis (EFA) was done, using SPSS V21. The correlation of posttraumatic growth (PTG) with the variables, i.e., age and gender, was investigated. Results: Some writing changes were made in phrases in the sections concerning face and content validity. CFA rejected the five-factor model due to the undesirable fit indices. Therefore, an EFA was used and the three-factor model was not approved, either despite the statistical appropriateness or due to the lack of similarity between the items loaded on factors. The results also indicated a significant relationship between PTG and age (r = 0.13, P = 0.05). There is no significant relationship between PTG and gender (z = −1.35, P = 0.83). Conclusions: PTGI-C-R does not have desirable psychometric properties in Iranian children with cancer and may not be able to reflect all the aspects of PTG experienced by them. Therefore, it cannot be used as an appropriate scale, and it is necessary to develop and validate a specific tool through a qualitative study.
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Affiliation(s)
- Azam Shirinabadi Farahani
- Department of Pediatric and Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Heidarzadeh
- Department of Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Saleheh Tajalli
- Department of Pediatric and Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hadis Ashrafizade
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marjan Akbarpour
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soore Khaki
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Khademi
- Department of Nursing, Faculty of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Razieh Beikmirza
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Masoumpoor
- Department of Pediatric and Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rassouli
- Department of Pediatric and Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Nukpezah RN, Khoshnavay FF, Hasanpour M, Nasrabadi AN. Striving to reduce suffering: A Phenomenological Study of nurses experience in caring for children with cancer in Ghana. Nurs Open 2021; 8:473-481. [PMID: 33318855 PMCID: PMC7729530 DOI: 10.1002/nop2.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/26/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022] Open
Abstract
Aim To provide insights into nurses lived experiences in caring for children with cancer. Background Little is known about the paediatric oncology nurses shared practices of caring for children with cancer in Ghana. Design A hermeneutic phenomenological qualitative study. Methods A semi-structured interview with 14 purposely sampled Ghanaian paediatric oncology nurses. Findings were analysed using Diekelman, Allen and Tanner's approach. Results The theme "Striving to reduce suffering" and three relational subthemes: "knowing children's needs," "Rendering a hopeful fight" and "Ensuring continuity and coordination of care" emerged. Increased awareness of this phenomenon for the nurses who care for these children is vital to ensure quality and holistic care that is meaningful and satisfying by nurses for children with cancer. Paediatric oncology nurses can use the result of the study to evaluate their caring practice and as an avenue to develop better caring practice.
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Affiliation(s)
- Ruth Nimota Nukpezah
- Department of Pediatric NursingSchool of Nursing and MidwiferyInternational campus‐Tehran University of Medical SciencesTehranIran
| | - Fatemeh Fomani Khoshnavay
- Department of Pediatric NursingSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Marzieh Hasanpour
- Department of Pediatric NursingNIDCAP ProfessionalSpiritual Health Branch of Rresearch Center of the Quran; Hadith and MedicineSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Alireza Nikbakht Nasrabadi
- Department of Medical and Surgical NursingSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
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Barasteh S, Rassouli M, Parandeh A, Vahedian-Azimi A, Zaboli R, Khaghanizadeh M. Palliative Care in the Health System of Iran: A Review of the Present Status and the Future Challenges. Asian Pac J Cancer Prev 2020; 21:845-851. [PMID: 32212816 PMCID: PMC7437322 DOI: 10.31557/apjcp.2020.21.3.845] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Indexed: 12/17/2022] Open
Abstract
Objectives: In the near future, the health system of Iran will face serious public health challenges means increase in the elderly population and the rate of chronic diseases. Therefore, it is anticipated that providing palliative care for chronic diseases will be one of the priorities of the country’s health system. The purpose of the present study was to explain the present status and the future challenges of providing palliative care in the health system of Iran and help policy-makers to create a future roadmap by presenting a picture of the present status. Methods: In this qualitative study, 17 semi-structured interviews were conducted with policy-makers, researchers, and managers of the centers providing palliative care in 2018-2019. Interviews were analyzed using directed content analysis based on the Public Health Strategy and framework analysis. Results: According to the WHO Public Health Strategy, palliative care challenges categorized in 13 subcategory and four main category include policy-making, program implementation, comprehensive education and drug availability. Conclusion: Providing palliative care that is currently dispersed in some centers does not meet the needs of chronic diseases. Establishing the palliative care system as one of the major goals of the health system of Iran is possible through reforming the fourfold structure of policy-making, implementation, education and drug availability. Therefore, it is suggested that authorities perform comprehensive and systematic management of challenges using foresight methods.
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Affiliation(s)
- Salman Barasteh
- Medicine, Quran and Hadith Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akram Parandeh
- Medicine, Quran and Hadith Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Rohallah Zaboli
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Morteza Khaghanizadeh
- Medicine, Quran and Hadith Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Borji M, Tarjoman A, Abdi A, Otaghi M. Efficacy of Implementing Home Care Using Eye Movement Desensitization and Reprocessing in Reducing Stress of Patients with Gastrointestinal Cancer. Asian Pac J Cancer Prev 2019; 20:1967-1971. [PMID: 31350952 PMCID: PMC6745210 DOI: 10.31557/apjcp.2019.20.7.1967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Indexed: 12/14/2022] Open
Abstract
Background: Gastrointestinal cancer is the third most common types of cancer in the world which leads to a
lot of stress among sufferers. Pharmacological and non-pharmacological approaches are used to treat stress induced
by serious diseases. Eye movement desensitization and reprocessing (EMDR) technique is considered as one of
non-pharmacological method for decreasing patient’s stress. Objective: This study was conducted to determine the
effect of home care using EMDR technique on the stress of patients with gastrointestinal cancer. Materials and
Methods: The current semi-experimental study was performed on patients with gastrointestinal cancer residing in
Ilam, Iran. The patients were randomly divided into two groups of intervention (n=30) and control (n=30). Home
care was provided for intervention group in patients’ homes which included 2 sessions (a total of 60 sessions for all
patients). Each session lasted for 45 to 60 minutes according to EMDR protocol. The data were analyzed using SPSS
(version 16). Results: The findings of this study showed that most of patients were male (36, 60%), had diploma
degrees (44, 73.3%), had a monthly income less than 500 thousand (38, 63.3%), were married (39, 65 %). The mean
age of the patients was 69.18 ± 11.58 years. No statistically significant difference was observed between two groups
before the intervention in terms of patients’ perceived stress (P>0.05). However, efficacy and perceived distress of the
intervention group significantly was decreased following the intervention (P<0.05). Conclusions: According to the
findings regarding the impact of home care using EMDR technique on reducing stress in patients with gastrointestinal
cancer, the implementation of this intervention and provision of education for patients are recommended to expand the
nursing duty to community health wards as well as to improve the health status of patients.
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Affiliation(s)
- Milad Borji
- Department of Nursing, Faculty of Nursing and Midwifery, Kermanshah University of Medical Science, Kermanshah, Iran
| | - Asma Tarjoman
- Student Research Committee, Kermanshah University of Medical Science, Kermanshah, Iran
| | - Alireza Abdi
- Department of Nursing, Faculty of Nursing and Midwifery, Kermanshah University of Medical Science, Kermanshah, Iran
| | - Masoume Otaghi
- Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Science, Ilam, Iran.
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