Comparison of the effectiveness of virtual reality-based education and conventional teaching methods in dental education: a systematic review

BACKGROUND AND OBJECTIVES

Virtual reality dental simulators as an educational tool may create specific training conditions for dental students, allowing them to practice dental skills in a safe and controlled condition. This study aimed to investigate the effectiveness of virtual reality-based education in dental education compared to traditional education approaches.

METHODS

In this systematic review, four databases (PubMed, Scopus, Web of Science, and Science Direct) were searched until 2023 following PRISMA guidelines. The Quality assessment and risk of bias were assessed by the Cochrane Collaboration Tool for RCTs and GRADE, respectively. Inclusion criteria were restricted to randomized or quasi-randomized trials about virtual reality efficacy in dental education. Two authors independently evaluated the data and reviewed the overall risk of bias for all selected studies. Study design, sample size, hardware, onset time of intervention, duration, and number of procedures performed were among the data extracted.

RESULTS

From the 703 titles, 48 full texts were chosen for review, yielding 14 articles for final inclusion. The review of these articles indicated the effective role of virtual reality dental simulators in improving students' knowledge and practical skills.

CONCLUSIONS

Based on our findings, adding haptic technology to virtual reality can improve students' practical skills, hand skills, theoretical knowledge, self-confidence, and learning environment. Although a fair amount of research needs to be done, notably on cost-effectiveness, student satisfaction, and other potentially adverse effects, virtual reality is a growing phenomenon with immense potential.

Explaining the Nurses' Spiritual Needs in the Oncology Department: A Qualitative Study

Background

It seems that improving the spiritual dimension of cancer patients can play an effective role in their mental and emotional peace. Meanwhile, oncology ward nurses are one of the most important healthcare providers that can help improve patients' relationship with God due to their more interaction and communication with patients. For this reason, this study aimed at explaining nurses' spiritual needs in an oncology ward.

Materials and Methods

This study was conducted based on the qualitative content analysis method. The participants included 11 nurses from the oncology ward of Seyed Al Shahada Hospital in Isfahan from 2021 to 2022. A semi-structured interview was administered to determine nurses' spiritual needs.

Results

Analysis of 11 interviews conducted with nurses revealed a total of four main codes, 13 sub-codes, and four sub-sub-codes. According to nurses' point of view, their spiritual needs can be classified into four dimensions as follows: communication with God, communication with oneself (intrapersonal communication), communication with others (interpersonal communication), and communication with environment. Administered interviews revealed the role of communication with God with six sub-codes as nurses' most important point of attention.

Conclusions

According to nurses' point of view, nurses' spiritual needs were divided into the dimensions of communication with God, communication with oneself, communication with others, and communication with environment. Therefore, it is necessary to simultaneously pay attention to oncology nurses' personal and social aspects to increase their spirituality.

Clinical Breast Cancer Registry of IR. Iran (CBCR-IR): Study Protocol and First Results

BACKGROUND

Breast cancer (BC), as a significant global health problem, is the most common cancer in women. Despite the importance of clinical cancer registries in improving the quality of cancer care and cancer research, there are few reports on them from low- and middle-income countries. We established a multicenter clinical breast cancer registry in Iran (CBCR-IR) to collect data on BC cases, the pattern of care, and the quality-of-care indicators in different hospitals across the country.

METHODS

We established a clinical cancer registry in 12 provinces of Iran. We defined the organizational structure, developed minimal data sets and data dictionaries, verified data sources and registration processes, and developed the necessary registry software. During this registry, we studied the clinical characteristics and outcomes of patients with cancer who were admitted from 2014 onwards.

RESULTS

We registered 13086 BC cases (7874 eligible cases) between 1.1.2014 and 1.1.2022. Core needle biopsy from the tumor (61.25%) and diagnostic mammography (68.78%) were the two most commonly used diagnostic methods. Stage distribution was 2.03% carcinoma in situ, 12% stage I, 44.65% stage II, 21.32% stage III, and 4.61% stage IV; stage information was missing in 1532 patients (19.46%). Surgery (95.01%) and chemotherapy (79.65%) were the most common treatments for all patients.

CONCLUSION

The information provided by this registry can be used to evaluate and improve the quality of care for BC patients. It will be scaled up to the national level as an important resource for measuring quality of care and conducting clinical cancer research in Iran.

Development and implementation of an intraoperative documentation protocol for enhancing patient safety in the operating room: A mixed methods protocol study

BACKGROUND

Documentation is an important part of the patient care process; however, there is no regular program for documenting intraoperative care in Iran. This study was conducted to design an intraoperative documentation for enhancing patient safety in the operating room (OR).

MATERIALS AND METHODS

This exploratory, mixed-methods, qualitative-quantitative study (in 2021) consists of four phases. The first phase involves a conventional content analysis of healthcare providers in the OR to identify the needs, strategies, and content of a pertinent documentation. In this phase, purposeful sampling will be used to collect data through semi-structured interviews. In the second phase, a literature review will be carried out to extract the documentation procedures in the intraoperative period in many other countries. In the third phase, a panel of experts is recruited and the classic Delphi (RAND) technique is run to validate the initial draft of the designed program and, the protocol is then finalized. In the last phase, the designed protocol will be implemented through a quasi-experimental study in one group (before and after intervention), and the effectiveness of the intervention will be evaluated.

DISCUSSION

To design a protocol for intraoperative documentation, healthcare providers' experiences during surgery in the Iranian healthcare setting, where the lack of documentation might forensically harm both the healthcare providers and the patients, will be explored. This information alongside some universal standards developed in other countries should help improve patients' safety in ORs.

The Effect of a Combined Exercise Program on the Fatigue Severity of Patients with Breast Cancer Undergoing Chemotherapy: A Randomized Clinical Trial Study

Background

Breast Cancer (BC) is one of the most common cancers in the world, including in Iran. Chemotherapy as one of the basic treatments for BC leads to many side effects such as fatigue. This study aimed to examine the effect of a combined exercise program on the intensity of fatigue in patients with BC undergoing chemotherapy.

Materials and Methods

This clinical trial study was conducted on 64 patients with BC undergoing chemotherapy referring to the Seyyed al-Shoada and the Al-Zahra clinics from January to April 2022. Eligible patients who met inclusion criteria were recruited by the convenience sampling and then assigned randomly to intervention and control groups. The combined exercise program in the intervention group was done for 8 weeks as three sessions a week (34 sessions) each for 35-40 min. Piper's Fatigue Scale was completed for both groups before and after the intervention. Data were analyzed using descriptive and inferential statistical methods.

Results

The results showed that the mean score of fatigue intensity in both control and intervention groups had a statistically significant difference after the intervention (p = 0.004). The mean fatigue intensity score in the intervention group decreased significantly from mean (SD) 8.17 (1.88) to 5.56 (1.74).

Conclusions

Based on the results, a combined exercise program can reduce fatigue in patients with BC. Therefore, nurses can utilize exercise programs and practices as a subset of complementary medicine alongside other treatment methods, which can effectively promote cancer patients' quality of life by reducing their fatigue.

Barriers and Facilitators of Palliative Care in Older Adults With Heart Failure: A Qualitative Content Analysis

Objectives: The progressive and unpredictable course of heart failure (HF) has made the provision of palliative care (PC) services to older adults with HF a serious challenge. This study aimed to explain the barriers and facilitators of PC in older adults with HF. Methods: This qualitative study was conducted using the content analysis approach. A sample of 15 participants, including 6 patients, 2 family caregivers, and 7 healthcare team members (4 nurses, a psychiatric nurse, a nutritionist, and a PC physician) were selected by purposive sampling over 10 months (November 21, 2020 to September 1, 2021). The data were collected using semistructured in-person interviews until data saturation and analyzed with conventional qualitative content analysis. Results: The findings revealed the main category of "neglecting the provision of PC," with 4 subcategories of "weak organizational structure," "poor social support," "older adults' and healthcare teams' poor knowledge," and "limited financial resources" as the barriers of PC and the main category of "enjoying support potentials" with 3 subcategories of "the cooperation of the government, benefactors, and nongovernmental organizations," "empathy from the family and relatives," and "benefiting from the presence of healthcare workers" as PC facilitators. Conclusions: The findings of this study explained the barriers and facilitators of PC in older adults with HF. Removing the barriers and supporting the facilitators give older adults with HF better access to PC. Therefore, to expand PC centers for older adults with HF, health system officials, and policy-makers should pay attention to organizational infrastructures and remove the barriers at organizational, social, educational, and economic levels with the cooperation of governmental organizations, benefactors, and nongovernmental organizations.

Development, implementation, and evaluation of a program to expand the nurse's roles in colorectal cancer prevention: A mixed-methods protocol study

BACKGROUND

Nurses play an important role in cancer prevention. However, studies conducted on nurses' roles, in the field of cancer prevention in Iran, are very limited. This study will identify the role of nurses and designs, implements, and evaluates a program to expand their role in the prevention of colorectal cancer (CRC).

MATERIALS AND METHODS

This exploratory mixed-methods study will be performed using quantitative-qualitative methods in three consecutive stages. In the first phase, a qualitative study will be conducted to identify the potential and actual roles of nurses in Iran using in-depth semi-structured interviews. Participants will be selected by purposive and snowball sampling, followed by a literature review; the actual and potential roles of nurses at the primary, secondary, and tertiary levels of CRC prevention in Iran and around the world will be extracted. And the actual role is determined. In the second phase, the roles of nurses will be prioritized using the modified Delphi method, and the program will be designed. In the third phase, the part of the program will be implemented as a quasi-experimental intervention, and the effect of the intervention will be evaluated.

CONCLUSION

Developing a program can provide some evidence for promoting nurses' position in cancer prevention. Moreover, it is expected that this program promotes knowledge and empowerment and the position of nurses to provide primary, secondary, and tertiary cancer prevention. The entry of nurses into the field of cancer prevention leads to better quality care and more cost-effectiveness.

Experiences of Nurses in Caring for Patients with COVID-19: A Qualitative Research

Background

The Covid-19 disease was raised as a fundamental public health problem worldwide, and nurses were exposed to many problems and challenges at the front line of fighting this disease. Therefore, the present study aimed to explain the experiences of nurses who took care of Covid-19 patients.

Materials and Methods

This study was a conventional content analysis qualitative study using Granheim and Lundman approach. The study participants included 20 nurses working in Corona referral hospitals in Isfahan, Iran. Participants were selected using purposive sampling and in-depth semi-structured interviews were conducted from September 2020 to March 2021. To assess the trustworthiness of the obtained data, credibility, dependability, confirmability, and transferability criteria were used.

Results

Data analysis led to the production of 700 primary codes, 15 sub-sub-categories, 5 sub-categories and 2 main categories. These two main categories consisted ofpsychological reactions and organizational challenges. Negative emotional experiences and positive emotional experiences were placed in the category of psychological reactions and expectations from superiors, lack of facilities and resources and insufficient quality of care in the category of organizational challenges.

Conclusions

The results of the present study showed that managers and policy- makers should prioritize the nursing empowerment to ensure effective epidemic fight and the psychological and financial support of Covid-19 ward nurses.

Patient education information material assessment criteria: A scoping review

BACKGROUND

Patient education information material (PEIM) is an essential component of patient education programs in increasing patients' ability to cope with their diseases. Therefore, it is essential to consider the criteria that will be used to prepare and evaluate these resources.

OBJECTIVE

This paper aims to identify these criteria and recognize the tools or methods used to evaluate them.

METHODS

National and international databases and indexing banks, including PubMed, Scopus, Web of Science, ProQuest, the Cochrane Library, Magiran, SID and ISC, were searched for this review. Original or review articles, theses, short surveys, and conference papers published between January 1990 and June 2022 were included.

RESULTS

Overall, 4688 documents were retrieved, of which 298 documents met the inclusion criteria. The criteria were grouped into 24 overarching criteria. The most frequently used criteria were readability, quality, suitability, comprehensibility and understandability.

CONCLUSION

This review has provided empirical evidence to identify criteria, tools, techniques or methods for developing or evaluating a PEIM. The authors suggest that developing a comprehensive tool based on these findings is critical for evaluating the overall efficiency of PEIM using effective criteria.

Quality of Palliative Care Guidelines in Patients with Heart Failure: A Systematic Review of Quality Appraisal using AGREE II Instrument

Objectives

While the principles for developing clinical practice guidelines (CPGs) are well established, the quality of published guidelines is very diverse. The present study was conducted to evaluate the quality of existing CPGs in palliative care for heart failure patients.

Material and Methods

The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses. A systematic search was conducted in the Excerpta Medica Database, MEDLINE/PubMed, CINAHL databases and Guideline internet sites: National Institute for Clinical Excellence, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, Guidelines International Network and National Health and Medical Research Council for CPGs published through April 2021. Criteria for including CPGs were: Containing palliative measures for patients with heart failure over 18 years old and preferably interprofessional guidelines that focus on only one dimension of palliative care or focus on diagnosis, definition and treatment were excluded from the study. After initial screening, five appraisers rated the quality of the final selection of CPGs using the Appraisal of Guidelines for Research and Evaluation, 2nd edition (AGREE II).

Results

From 1501 records, seven guidelines were selected for analysis. The 'scope and purpose' and 'clarity of presentation' domains obtained the highest mean and 'rigor of development' and 'applicability' domains obtained the lowest mean scores. Three categories of recommendations were: (1) Strongly recommended (guidelines 1, 3, 6 and 7); (2) recommended with modifications (guideline 2) and (3) not recommended (guidelines 4 and 5).

Conclusion

Clinical guidelines for palliative care in patients with heart failure were of moderate-to-high quality, with the main deficiencies occurring in the rigor of development and applicability domains. The results inform clinicians and guideline developers of the strengths and weaknesses of each CPG. To improve the quality of palliative care CPGs in the future, it is recommended that developers pay detailed attention to all domains of the AGREE II criteria. Funding agent: Isfahan University of Medical Sciences. (IR.MUI.NUREMA.REC.1400.123).

A modified Delphi study to identify strategies to promote health literacy in parents of children with cancer

BACKGROUND

Parents play a key role in the care, monitoring, management of symptoms experienced in children with cancer, the support, and follow-up of treatment. However, there is a paucity of research as how to improve the health literacy of parents with cancer. The aim of this study was to identify the best and most important strategies to promote health literacy in parents of children with cancer.

MATERIALS AND METHODS

A two-step modified Delphi method was used to establish consensus in Iran in 2021. Fourteen experts representing oncology, clinical nursing, and faculty members of nursing were selected by purposive sampling. In round one, 90 strategies to promote health literacy obtained in the qualitative study were distributed to the experts, which were scored from 1 to 5. In order to discuss statements without consensus in the first round, round two was held in a face-to-face meeting. Descriptive statistics such as mean, standard deviation, and percentage of response frequency were used to calculate agreement levels between experts.

RESULTS

In round one, 57 statements reached a consensus. In round two, 21 statements reached a consensus. Finally, 78 statements reached consensus representing four domains including functional health literacy, interactive health literacy, critical health literacy, and care health literacy.

CONCLUSION

Delphi method helps to identify the best and most important strategies to use in health literacy promotion programs for parents of children with cancer. Identifying these strategies will help health officials, planners, and policymakers.

Challanges of Meeting the Palliative Care Needs of Colorectal Cancer patients in Iran: A Qualitative Research

Background

Despite the high prevalence of Colorectal Cancer (CRC) in Iran and the need to pay more attention to the Palliative Care (PC) needs of patients with this disease, a few studies have previously examined the PC needs of them by gaining the patients', family members', and treatment team's views. This study aimed to investigate the challenges in the way of meeting the PC needs of CRC patients.

Materials and Methods

This study was a qualitative content analysis study conducted on 43 participants (including 15 patients, 20 health care providers, and eight family members) through purposive sampling and semi-structured individual interviews in Omid Educational and Medical Center and Iranian Cancer "Control Center (MACSA) in Isfahan from May 2020 to December 2021. Data analysis was performed simultaneously with data collection using conventional qualitative content analysis with the Graneheim and Lundman approach. In order to assess the trustworthiness of the obtained data, credibility, dependability, confirmability, and transferability criteria were used.

Results

Data analysis led to the production of 615 primary codes, 16 sub-categories, and five main categories. These five main categories included "Lack of facilities and equipment", "Lack of quality of services provided by the treatment team", "Insufficient financial support to the patient and family", "Insufficient psychological and emotional support from the patient and family", and "Inefficiency of the patient and community awareness process".

Conclusions

To improve the quality of care and increase patients' satisfaction with the provided services, it is recommended that policymakers should meet the challenges of the PC.

Competency assessment of the operating room staff and some related factors: A multi-center cross-sectional study

Background

Operating Rooms (ORs) are complicated environments that necessitate the improvement of OR staff's knowledge and skills to remain clinically competent and secure patient safety. The aim of this study was to assess clinical competence of OR staff in accordance with some related factors.

Materials and Methods

This descriptive analytical cross-sectional study was conducted on 227 OR staff in nine academic hospitals. Sampling was performed from the beginning to the end of May 2019 and the samples were selected by quota sampling. Data were collected using a researcher-made questionnaire encompassing six dimensions of competency including general knowledge, specialized knowledge, general practical skills, specific practical skills, personality, and motivation. Data analysis was performed using descriptive and interpretive statistics.

Results

The mean (SD) total score of competence was 80.99, which was optimal (11.28). The lowest score was related to the dimension of general practical skills with the mean (SD) score of 53.32 (10.26). The mean score of specialized practical skills was significantly higher in single-specialty ORs (F = 21.53, p < 0.001). Based on multiple linear regression test, it was possible to predict clinical competency through the age and work experience (R-squared = 0.96, beta = 0.31, p = 0.022).

Conclusions

Specialized training has overshadowed the general practical skills that are related to the observation of basic principles of patient safety apart from surgical specialization. Strengthening of competence in general practical skills need to be prioritized in empowerment programs. We need a fixed and permanent space for the continuation of educational programs designed to promote perioperative general practical skills.

The needs of colorectal cancer patients/survivors: A narrative review

BACKGROUND

Identifying and addressing the needs of Colorectal cancer (CRC) patients/survivors' is important to improve patients/survivors' quality of life (QoL) and health. The present study aimed to review studies that have investigated CRC patients/survivors' needs.

MATERIALS AND METHODS

In this narrative review, databases including PubMed, Scopus, Web of Science, Iranmedex, ISC, SID, and Magiran were searched during 2011-2021 using keywords included need, CRC, colon cancer, rectal cancer.

RESULTS

The findings of the studies showed that the needs of the CRC patients/survivors' can be categorized into the 6 domains including informational, psychological, social, physical, financial, and spiritual needs.

CONCLUSIONS

By identifying CRC patients/survivors' needs, healthcare providers particularly nurses can develop and design comprehensive care programs tailored to the needs and priorities of these patients/survivors to improve their QoL and health.

Development, implementation and evaluation a palliative care program for colorectal cancer patients: a mixed methods protocol study

Introduction

Colorectal cancer(CRC) patients are among the incurable groups who need comprehensive palliative care covering all aspects including physical, mental, social, and spiritual. The purpose of this study is to develop, implement, and evaluate a holistic palliative care program for CRC patients in order to improve quality of life of CRC patients.

Methods

This study is an exploratory mixed methods study which will be conducted using a sequential qualitative-quantitative design (QUAL quan) consists of four sequential steps using the approach proposed by Ewles & Sminett to develop the program. In the first phase, a qualitative study (semi-structured interview) will be conducted to discover the needs of CRC patients from the perspective of patients, family members and care providers. In the second phase, the literature review will be performed with the aim of confirming and completing the discovering new needs. In the third phase, in order to prioritize the identified needs and prepare a initial draft of the palliative care program will be done a panel of experts. In the fourth phase, the part of the developed program according to the opinions of the panel of experts, will be implemented as quasi-experimental intervention and the effect of intervention on quality of life will be evaluated.

Discussion

This results of this study are expected to meet the needs of CRC patients and their families through providing a holistic care and improve their quality of life in the socio-cultural context of Iran. This program can be useful in providing care, education, policy making and for future research.

The Effect of a Spiritual Care Program on the Self-Esteem of Patients with Cancer: A Quasi-Experimental Study

BACKGROUND

Despite the importance of self-esteem in cancer patients and the potential role of spiritual care programs in its promotion, no interventional study was found in this field in Iran. The aim of this study was therefore to investigate the effect of a spiritual care program on the self-esteem of patients with various types of cancer.

MATERIALS AND METHODS

This study was quasi-experimental with two groups using a before and after design which was conducted in 2019 in a selected hospital in Isfahan, Iran. A convenience sample of 64 patients randomly assigned into the experimental (n = 32) and the control group (n = 32). Data collection was conducted through a two-part questionnaire including Demographic characteristics and the Coopersmith Self-Esteem Inventory (SEI). The spiritual care program consisted of six sessions based on four domains including individuals' relationship with God, themselves, others, and with the environment. To analyze the data, Chi-square, Fisher's exact test, independent t test, and paired t test were performed.

RESULTS

The total self-esteem mean score and its domains were not significantly different between the two groups before the intervention (p > 0.05). However, after conducting the intervention, the total self-esteem mean score and its domains were significantly higher in the intervention group compared with the control group (p < 0.001).

CONCLUSIONS

The spiritual care program used in this study was effective in promoting the self-esteem of patients with cancer. It is suggested that similar studies are conducted to provide fertile grounds for using such programs in the oncology clinical area.

Self-Compassion and Adherence to Treatment in Patients with Cancer

Background:

Emotional disorders and depression make cancer patients reluctant about adherence to their treatment. The present study was conducted to determine the relationship between self-compassion and adherence to treatment in cancer patients.

Materials and Methods:

This cross-sectional study was conducted on 214 patients with cancer in 2019. They were inpatients aged over 18 years. Two months had passed since their cancer was diagnosed, and they had undergone a course of chemotherapy. Data were collected using a personal details form, Neff's Self-Compassion Scale and the Modanloo Adherence to Treatment Questionnaire and were then analyzed using the mean, frequency, Pearson's correlation coefficient and linear regression analysis.

Results:

The mean (SD) total score of self-compassion was 80.07 (15.68), and the mean (SD) total score of adherence to treatment was 134.44 (38.37). Pearson's correlation coefficient showed a direct relationship between the total score of self-compassion and the total score of adherence to treatment (p < 0.05). The linear regression analysis showed that the score of suffering as a common humanity (β = 0.47, p ≤ 0.001) and the variable of education (β = 0.27, p ≤ 0.001) were significant predictors of the total score of adherence to treatment (R² = 0.33).

Conclusions:

According to the results, suffering as a common humanity and education were significant predictors of adherence to treatment. Oncology nurses are therefore recommended to get further educated about self-compassion, so that they take this concept more seriously in providing patient care. Nurses should also educate the patients with low levels of education about the consequences of not adhering to their treatment.

Current State of Palliative Care in Iran and Related Issues: A Narrative Review

BACKGROUND

Palliative research studies seem to be limited and disperse in Iran. The present study was therefore conducted to review and categorize the Palliative Care (PC) studies performed in Iran in terms of the research type, the type/focus of PC, the measured outcomes in interventional palliative studies and their related results, the disease type, and their geographical distribution.

MATERIALS AND METHODS

This narrative review was conducted in 2021 in which both Iranian and international databases including PubMed, Scopus, Web of science, CINAHL, ProQuest, Magiran, SID, Noormags, ISC were searched. The inclusion criteria were original articles conducted in Iran and results published in Persian or English journals ab initio in which PC was assessed as a variable (dependent or independent) or the main concept.

RESULTS

A total of 1096 articles were identified from which only 44 articles were reviewed. The research studies were mainly focused on cancer and majority conducted in Tehran. Majority of studies were quantitative-interventional leading to a variety of positive changes in dependent variables, including reduce in pain severity, change in life pattern, a good response to therapy, increase life expectancy, improve in dysphagia, improve quality of life, reduce patients' metastasis, and increase in nurses' self-efficacy.

CONCLUSIONS

The PC studies distributed across different fields and cities in Iran resulted to a number of positive outcomes for patients. More focused and robust research studies with different patients need to be conducted in this emerging field in Iran.

Effect of a self-help educational program with peer group on anxiety of mothers of children with cancer: A clinical trial study

BACKGROUND

The mental health of the mothers of the children with cancer is strongly influenced by the child's illness and treatment process. This study aimed to investigate the effect of a self-help educational program with peer group on anxiety of the mothers of the children with cancer.

MATERIALS AND METHODS

This clinical trial study was conducted on 44 mothers of the children with cancer in an educational Hospital of Isfahan University of Medical Sciences, Iran. Convenience sampling method was performed on the eligible mothers, and using random allocation, they were divided into two groups of the intervention (n = 22) and the control (n = 22). Both groups completed the Hamilton Anxiety Questionnaire before and after the intervention. The intervention of the study was a self-help educational program with peer group that was performed in collaboration with the mothers of the children with cancer, a psychiatrist, and cancer nurses in the hospital within 3 months.

RESULTS

The results showed that 55% of the mothers of the intervention group had severe and very severe anxiety before the intervention, but the intensity of their anxiety was reported to be moderate after the intervention. The analysis of covariance with adjusted anxiety score in the two groups showed that the mean score of anxiety in the intervention group decreased from 22.3 to 12.3 after the intervention, showing a significant difference (P < 0.05).

CONCLUSION

The program, designed to support the mothers and guide the specialists and psychiatrists to counsel the mothers, can enhance their self-help and reduce their anxiety level.

The Relationship between Nursing Students' Quality of Life with their Academic Achievement Motivation in Isfahan University of Medical Sciences, Iran

Background:

Quality of Life (QoL) and academic achievement motivation are important aspects of students' living and studying. There is a lack of studies to address the QoL of nursing students and its relationship with their academic achievement motivation in Iran. Therefore, the present study was conducted to investigate this relationship.

Materials and Methods:

This was a correlational study conducted with baccalaureate nursing students of Isfahan University of Medical Sciences, Iran, from December 2019 to February 2020. Data collection tools consisted of three parts: a demographic questionnaire, the World Health Organization QoL-Brief Questionnaire (WHOQOL-BREF), and the Hermans Achievement Motivation Questionnaire. Pearson correlation coefficient and standard multiple regression were used to evaluate the correlation between QoL mean domain scores and academic achievement motivation score.

Results:

The QoL mean (SD) domain scores of physical, psychological, social, environmental, and academic achievement motivation score were 14.95 (2.43), 13.42 (2.74), 13.96 (3.39), 13.62 (2.54), and 84.40 (7.73), respectively. Pearson correlations between physical, psychological, social, and environmental QoL mean domain scores with academic achievement motivation score was 0.30, 0.35, 0.12, and 0.22 (p < 0.05), respectively. Using standard multiple regression, psychological mean domain score (ß = 0.31) was the only statistically significant predictor of academic achievement motivation.

Conclusions:

Relationships exist between academic achievement motivation and QoL domains of nursing students, particularly in the psychological domain. This information provides policymakers to plan multi-faceted arrangements to improve nursing students' academic achievement motivation and QoL particularly in most neglected areas as the psychological aspect.

Psychometric properties of psychosocial dimensions associated with postpartum depression

AIM

The aim of the study was psychometric properties of a questionnaire for assessing psychosocial dimensions associated with postpartum depression (PAPP).

METHODS

Initial form of the questionnaire for assessing PAPP was developed based on the results of a qualitative study. Principal component analysis was used to determine the construct validity, as well as Cronbach's alpha and intraclass correlation coefficient to determine the reliability of the questionnaire. Construct validity, predictability of the questionnaire, and confirmatory factor analysis were evaluated in a longitudinal study on 303 pregnant women in the third trimester of pregnancy. Also, using Edinburgh postnatal depression scale, the level of depression was evaluated 6 weeks after childbirth.

RESULTS

Exploratory factor analysis led to a 47-item questionnaire with five dimensions and confirmed that five factors determined 42.31% variance. Cronbach's alpha was 0.851 for the total score of questionnaire and for the factors, ranged from 0.84 to 0.92. ICC of total was 0.92 (95% confidence interval (CI): 0.69-0.93). Analyzing the confirmatory factor analysis showed that the 47 items questionnaire had a good construct validity (CMIN/DF = 2.01, p = 0.122). The level of the PAPP in women suffered from postpartum depression was higher than women without postpartum depression (odds ratio = 1.01, 95% CI: 1.01-1.02, p = 0.001). A cut-off score of 42 provided the best sensitivity (0.75) and specificity (0.50) for PAPP.

CONCLUSION

The psychometric properties of the PAPP showed an appropriate validity and reliability, and it may applicable to predict of at risk pregnant women for postpartum depression who seeking antenatal care services.

Development and Psychometric Evaluation of the Gerontological Nursing Competence Questionnaire in Iranian Hospitals

BACKGROUND

This study evaluated the Gerontological Nursing Competence Questionnaire-Farsi version (GNCQ-F) in Iranian hospitals.

METHOD

This exploratory sequential study used a mixed-methods design. The questionnaire items were developed based on a qualitative descriptive exploratory study and a review of the literature. The psychometric properties of the initial questionnaire including face validity, content validity, construct validity, internal consistency, and stability were evaluated.

RESULTS

Exploratory factor analysis resulted in the extraction of 42 items in five factors including care competence and patient/older adult and family empowerment, ethical and compassionate care competence, patient safety competence, continuous professional development and self-care competence, and collaborative and team care competence. Cronbach's alpha coefficient confirmed the internal consistency of each subscale and the entire tool (0.942). The stability reliability was 0.973 and was determined by calculating the intra-cluster correlation coefficient.

CONCLUSION

Nurses can use this self-evaluation instrument to assess their gerontological nursing competence. [J Contin Educ Nurs. 2021;52(7):335-343.].

Pediatric Ward Nurses' Caring Self-Efficacy Scale: Development and Validation

BACKGROUND

No instrument specifically designed to investigate the caring self-efficacy of nurses in pediatric wards was found. The aim of the present study was therefore to develop a scale to evaluate pediatric wards nurse's caring self-efficacy.

MATERIALS AND METHODS

In this study, an exploratory, sequential, mixed method was used in 2015 in Iran. Data collected from 27 semi-structured interviews with nurses in pediatric wards were analyzed using conventional content analysis. The initial version of the scale was obtained with 65 items. Face validity was determined using impact score and content validity using the Content Validity Index (CVI) and Content Validity Ratio (CVR). The construct validity of the scale was investigated using exploratory factor analysis with 305 nurses in pediatric wards. The concurrent validity of the scale was acquired using the General Self-Efficacy Scale. Internal consistency and test-retest reliability were also examined.

RESULTS

The scale-CVI (S-CVI) (average) was 0.85. The 14 items with a CVR and CVI of less than 0.51 and 0.70, respectively, were deleted and the final 51-item scale was approved. All 51 items had good impact score (>1.50). In the final scale, four subscales were extracted using construct validity. The concurrent validity of the scale was also obtained (r = 0.77, p < 0.001). The total Cronbach's α correlation coefficient of the scale was 0.96 and test-retest reliability was 0.98.

CONCLUSIONS

The Pediatric Ward Nurses' Caring Self-Efficacy (PWNCSE) scale developed in this study is a practical, reliable, and valid scale to evaluate pediatric ward nurses' caring self-efficacy.

Designing Virtual Patients for Education of Nursing Students in Cancer Course

Background:

One of the best approaches to promote clinical reasoning in nursing education is Virtual Patient (VP). The purpose of this study was to design and implement VPs for nursing student's education in caring for cancer patients.

Materials and Methods:

In the first stage, through a descriptive-exploratory qualitative study using a focus group method, topics with higher priority in cancer nursing were identified. Then, based on the VP Nursing Design Model (VPNDM) for each of these topics, a scenario and then an interactive VP was designed and implemented in the Open Labyrinth application. The content validity of VPs was evaluated by eight experts and then the face validity was examined in the pilot group including 15 nursing students.

Results:

Topics with higher priority in cancer nursing courses were mastectomy, chemotherapy, radiotherapy, hypercalcemia, spinal cord compression, cardiac tamponade, and superior vena cava syndrome. For five scenarios based on the nursing process in three sequences (signs and symptoms, diagnosis and interventions) the VPs were designed. In this process, learning objectives, determining the critical path, adding branches at the decision point, adding feedback, completing the clinical course and related data, and adding multimedia were considered. VPs were revised based on the proposed modifications following face and content validity.

Conclusions:

This article presents VP design steps for use in a nursing student training course. The researchers were able to provide and validate five VPs to care for cancer patients based on the VPNDM.

Termination of Pregnancy for Fetal Anomalies: A Qualitative Study of the Informational and Educational Needs of Women

Background:

Diagnosing congenital fetal anomalies before birth is considered an emotionally devastating experience. To facilitate the process of compatibility with this event, healthcare providers should determine various needs of these women. The present study was conducted to explore the informational and educational needs of women who have experienced pregnancy termination because of fetal anomalies.

Materials and Methods:

The present study was a qualitative content analysis. Forty participants (women, their spouses, and healthcare providers) in Rasht city, Iran, were selected using purposive sampling method with maximum variety and their data were gathered using in-depth interviews and field notes. Data were analyzed using conventional qualitative content analysis with Graneheim and Lundman approach.

Results:

After analyzing the text of the interviews, the informational and educational needs of women who have experienced pregnancy termination because of fetal anomalies were categorized in three main categories of “receiving information tailored to the client's circumstances,” “learning life skills to cope,” and “getting prepared for the next pregnancy.”

Conclusions:

The results, by exploring and magnifying the informational and educational needs of these women, could present an appropriate context for providing principal care and cultural-based interventions with an emphasis on comprehensive education and counseling. Also, proper implementation of the process of obtaining informed consent from the women to terminate the pregnancy is essential. These could facilitate the conditions for their return to normal life and ultimately promote their health.

Evaluating Dose-response of Cataract Induction in Radiotherapy of Head and Neck Cancers Patients

BACKGROUND

Head and neck cancers are currently the most common types of cancers. 3D-conformal radiation therapy is the most common dose delivery technique for head and neck cancers. Eye Lens is a radio sensitive structure and cataract formation as a visual disorder associated with exposure to ionizing radiation which is documented.

OBJECTIVE

Determining the radiation dose to eye lens during head and neck radiography and estimating the probability of cataract induction are essential.

MATERIAL AND METHODS

This experimental study was performed on 14 patients with head and neck cancers through experimental study analysis. The maximum opacity of the eyes lens were measured by pentacamTM before radiation therapy. CT data of patients were transmitted to Isogray treatment planning Software, and dose calculations for each patient was performed. At the end of radiation treatment, 3 and 6 months after radiotherapy, the eye lens opacity of the patients was assessed.

RESULTS

Overall, 28 lenses were studied. Statistical one sample K- S test proved normality of obtained data. Using repeated measures test, the relation before and 3 months after radiotherapy, as well as the relationship before and 6 months after radiotherapy proved a significant relationship.

CONCLUSION

The opacity caused by radiation in eyes is a non-statistical and linear-quadratic response curve with no threshold. This opacity can also appear within 3 months after completion of radiation therapy.

Psychometric evaluation of a questionnaire for measuring factors related to mental health of women in an earthquake

The current study was performed with the aim of the psychometric evaluation of a questionnaire for measuring factors related to women's mental health in an earthquake. This descriptive instrumental study was carried out on a population of 378 women with an earthquake experience in Kerman Province, Iran, in 2017-2018. The formal validity, content validity, criterion validity, factor analysis, and reliability of the questionnaire were measured using Cronbach's alpha coefficient. Moreover, descriptive statistics and Pearson's correlation coefficient were used to report data. In the content validity stage, 34out of 85 items of the questionnaire were eliminated. In the exploratory factor analysis (EFA) stage, 2 items out of the remaining 51 items were removed due to weak factor loading and 49 items were defined in 6 factors. The convergent and divergent validities of the questionnaire were confirmed in relation to the General Health Questionnaire (GHQ) (r = -0.23; P = .030) and World Health Organization Quality of Life-BREF ‎(WHOQOL-BREF) (r = 0.32;P = .001). Using Cronbach's alpha coefficient, the reliability of the questionnaire‎was obtained to be 0.91. The reliability and validity of the study questionnaire were at an appropriate level, and thus, it can be used to perform extensive surveys among women who have ‎experienced earthquake.

A qualitative study exploring the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies in Iran

Background

In order to provide appropriate and adequate care to women who have experienced termination of pregnancy due to fetal anomalies, the health needs of this group should be assessed. Considering the lack of information about the care and services required by these women in Iran, this study was conducted with the aim of exploring the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies.

Methods

This study was conducted with a qualitative approach. 40 participants were selected through purposive sampling, and the data were collected through in-depth semi structured interviews and field notes, and analyzed using conventional qualitative content analysis.

Results

After analyzing the texts, the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies were categorized in the three main categories: “efficient treatment team”, “optimal organizational structure in providing services” and “financial support for families”.

Conclusions

The findings of the present study by exploring and highlighting the needs related to the health system in different dimensions in women with experience of pregnancy termination due to fetal anomalies can be helpful for designing and providing basic and comprehensive care programs.

Incidence Trend of Gastrointestinal Cancer in Markazi, in the Center of Iran, Population-Based Cancer Registry Results: 2010-2014

BACKGROUND

Gastrointestinal cancers are considered as the most common type of cancer among men and the second most common cancer in women after breast cancer in Iran. This study was performed to investigate the epidemiology of gastrointestinal cancer in Markazi Province.

METHODS

This is an epidemiological study in which data was gathered from the population-based cancer registry program in the Markazi province of Iran during the years 2010-2014. Data were recorded in Excel software and coded based on ICD-O. All cases out of Markazi provinces were excluded from study, and cases with code C-15-C20 were included in this study. Stata 11 was used to analyze the data.

RESULTS

In this study, 2975 new cases of gastrointestinal cancer in Markazi province were included in the analysis. The highest number of cancers was stomach (with 1595 cases), followed by colorectal cancer (980 cases), esophageal cancer (318 cases), and finally small bowl cancer (82 cases). The mean age of gastro-intestinal cancer diagnosis was 65.07 years. The results showed that with increasing age, the incidence of gastro-intestinal cancers increased, and in all sites and both sexes, the highest incidence of gastro-intestinal cancer was in the age group above 70 years. In both sexes, the age specific rate of stomach cancer was higher than other sites (with highest incidence in 2013) followed by colorectal cancer, esophageal cancer, and small bowl cancer.

CONCLUSIONS

The results showed similar incidence rate of gastrointestinal cancer in Markazi province to other provinces in Iran. This study found that stomach cancer is the most common cancer in the Markazi province; therefore, identifying effective and preventing factors is necessary.

Competences of academic librarians in providing health research services: A qualitative study

BACKGROUND

One of the most important responsibilities of today's university libraries is supporting research activities. The present research is aimed at explaining the librarians' competencies in providing research services for researchers of Isfahan University of Medical Sciences.

MATERIALS AND METHODS

This study was performed in 2018 with a qualitative approach and conventional content analysis. The participants were 18 faculty members, students, and librarians selected by purposive sampling. Data collection was done by 18 semi-structured interviews. Continuous data analysis was performed by conventional content analysis.

RESULTS

According to the participants' experiences, two major categories were recognized, including "general competencies" and "specialized competencies." The general competencies category included three subcategories of communication skill, professional ethics, and basic abilities. The specialized competencies category included six subcategories of information resource retrieval and evaluation, using research software, research assistance, intellectual property literacy, scientific publication literacy, scientometrics, and altmetrics.

CONCLUSION

According to the participants' experiences, university librarians need specialized competencies in addition to basic and transdisciplinary abilities. It is suggested for research managers and policymakers to plan for empowering librarians regarding the results of the present study.

Estimation of the aerobic capacity by step test in the workers of a tile factory in Yazd in 2017

Introduction: Estimation of the maximum aerobic capacity to find a physiological fitness between worker and the work is of great importance. The purpose of this study was to estimate the highest aerobic capacity and physical work capacity of tile and ceramic workers. Materials and methods: In this cross-sectional study, 90 workers were randomly selected from tile and ceramic workers in Yazd. A questionnaire consisting of two parts was used as data collection tool. The first part of the questionnaire included demographic characteristics completed by the interview. In the second part, parameters including height, weight, BMI and heart rate were inserted in the questionnaire. The Queen step test was used to measure the maximum aerobic capacity. The data were analyzed by SPSS software using Mann-Whitney and Kruskal-Wallis tests and Spearman,s test. Results: The maximum aerobic capacity in tile and ceramic workers was estimated to be 3.60±.0.03 L/m. The results showed that aerobic capacity was significantly correlated with weight and body mass index. Also, there was no significant relationship between aerobic capacity, smoking and exercise, and education, but there was a significant relationship between gob title and aerobic capacity. Conclusion: Weight, BMI and type of occupation affect the aerobic capacity of workers.

Psychological experiences of women with pregnancy termination due to fetal anomalies: a qualitative study from the perspective of women, their spouses, and healthcare providers in Iran

Background

Pregnancy termination due to fetal anomalies has many psychological consequences for women. Providing appropriate and desirable care to this group of women and their families plays an important role in the process of coping with this crisis. The aim of the present study was to explore the psychological experiences of women with pregnancy termination due to fetal anomalies.

Methods

This was a qualitative content analysis study. 40 participants were selected through purposeful sampling with maximum variation and data were collected through in-depth individual interviews, field notes, and analyzed using the conventional qualitative content analysis method simultaneously.

Results

After analyzing the interview transcripts, the psychological experiences of women with pregnancy termination due to fetal anomalies were classified into two main categories: “emotional reactions coinciding with the diagnosis of fetal anomalies” (consisting of two sub-categories of “disbelief and denial of fetal anomalies” and “feelings of sadness and anger”) and “ psychological problems following pregnancy termination” (consisting of two sub-categories of “ feeling helpless, fearful, anxious, and depressed” and “feeling conscience-stricken, and guilty”).

Conclusion

According to findings of the present study, exploring and highlighting the experiences of women with pregnancy termination due to fetal anomalies in the psychological dimension can provide a deeper understanding of the needs of these women for providing optimal care at different times and ultimately promote their psychological health.

Attributable risk fraction of four lifestyle risk factors of thyroid cancer: a meta-analysis

Background

Lifestyle risk factors such as obesity, overweight, smoking and radiation exposure related to thyroid cancer. This study estimated the amount of excess risk that attributed to risk factors.

Methods

Major electronic databases were searched until February 2016. Epidemiological studies addressing the association between lifestyle risk factors and thyroid cancer were enrolled. The results were expressed as ARF with 95% confidence intervals (CIs) using a random-effects-model.

Results

We identified a total of 13 321 references and included 17 studies. The excess risk of thyroid cancer attributable to radiation exposure was 14% (95% CI: 5%, 23%; eight studies, I2 = 88.7%), to obesity was 13% (95% CI: 5%, 21%; four studies, I2 = 68.7%), to overweight was 10% (95% CI: 2%, 17%; four studies, I2 = 4.1%) and to smoking was -13% (95% CI: -33%, 6%; five studies, I2 = 30.6%). So obesity, overweight and radiation exposure are significantly associated with increased thyroid cancer risk and smoking has a protective effect on thyroid cancer but not significant.

Conclusion

A significant amount of the incidence of thyroid cancer is attributable to lifestyle risk factors. Since these factors are entirely preventable, so it is necessary to reduce factors that are associated with increased thyroid cancer risk and proper education to the community. Thus weight loss and protection against radiation can effectively reduce the incidence rate of thyroid cancer but smoking can have a protective effect.

Assessing the Quality of Existing Clinical Practice Guidelines for Chemotherapy Drug Extravasation by Appraisal of Guidelines for Research and Evaluation II

Background:

Extravasation is a potentially hazardous event that may occur during chemotherapy. The aim of this study is to assess the quality of existing Clinical Practice Guidelines (CPGs) for chemotherapy drug extravasation by Appraisal of Guidelines for Research and Evaluation II (AGREE II).

Materials and Methods:

Valid electronic databases and CPGs from 2007 to August 2018 were searched by keywords of CPGs, extravasation, chemotherapy, and cancer. CPGs were evaluated independently by five experts through AGREE II tool, and the consensus among evaluators was calculated by ICC (Intra-class Correlation Coefficient).

Results:

Five of the 111 CPGs matched the inclusion criteria. The methodological quality of CPGs in domains of “scope and purpose,“ “stakeholder involvement,“ “clarity of presentation,“ and “applicability“ were good, in the domain of “rigor of development,“ was acceptable, and in “editorial independence“ domain, it needed more attention of developers of CPGs. The range of assessors' consensus was within a range of moderate to very good (0.55--0.93).

Conclusions:

The methodological quality of existing CPGs of chemotherapy drugs extravasation assessed by AGREE II tool is appropriate. Four CPGs had high level while one had moderate level of quality. Therefore, their use is recommended in the clinic to reduce the risk of chemotherapy extravasation to the entire treatment team and the nurses working in the oncology departments.

Evaluation of the effect of BMSCs condition media and methylprednisolone in TGF-β expression and functional recovery after an acute spinal cord injury

The purpose of this experimental study is evaluation of the effect of BMSCs Condition Media and Methylprednisolone in TGF-β expression and functional recovery after acute spinal cord injury in adult wistar rat.

MATERIAL AND METHODS

After an acute spinal cord injury, MP and BMSC-CM were injected intraperitoneally and the recovery rate was evaluated by BBB and narrow beam test. Real time PCR, H[et]E staining, cavity formation and stereology was done after 12 weeks post injury.

RESULT

There were significant differences in functional recovery between MP+CM group, relative to other groups. TGF-β1 expression decreased in MP+CM group compared to the control group. Cavity size in experimental groups decreased compared to the control group. The mean volume of spinal cord demonstrated a significant increase in the MP+CM group in comparison to the other experimental groups.

CONCLUSION

Simultaneous use of MP and BMSC-CM will improve recovery from the spinal cord injury, reduce inflammation and improve functional recovery (Tab. 1, Fig. 8, Ref. 26).

The impact of family-centered care and meeting the need to learn how much of global anxiety in parents of children with urinary tract infection: a randomized clinical trial

 Backgrounds and Objectives: About 30% of children hospitalized at least once during childhood, and about 5 percent hospitalized several times. The family is the most important source for support child patients so the family centered care is necessary. One of the main sources of stress and anxiety for the family is the crisis by the hospitalization ill children. Attention to the needs of mothers and reducing the anxiety from hospitalization is so important.   The purpose of the study was to investigate the effects of family-centered care and meeting the need to learn how much of global anxiety in parents of hospitalized children. Materials and Methods: In the present Randomized clinical trial study, 70 parents of children suffering from UTI   randomly divided in two groups: control (35) and intervention groups (35). family-centered care done by researcher and participating mothers. Control group received normal care. The data gathering tool was a three-part questionnaire: personal characteristics, Krastinzdottir questionnaire and Spiel Berger’s questionnaire. Information were analyzed by using of SPSS software and chi-squared and t test. Results: The result of this study showed that the anxiety of the both group are the same and both of them are at the midrange. Range of meet information need in intervention and control group had statistically significant differences (p<0.435). Conclusions: The family-centered care is effective at range of meet information needs of hospitalized children parent’s and increase their satisfaction. Keywords: Parent, Family Centered Nursing, Hospitalized Children; anxiety, Urinary Tract Infection

The Needs of Women Who Have Experienced Pregnancy Termination Due to Fetal Anomalies: A Literature Review

BACKGROUND

Pregnancy termination due to fetal anomalies is associated with emotional, psychological, and social injuries for women. Determining the needs of women with these experiences is the key for programming to provide high quality and desirable care. Hence, the present study was conducted to determine the needs of women who have experienced pregnancy termination due to fetal anomalies.

MATERIALS AND METHODS

The present literature review was conducted in March 2018 by searching databases such as Irandoc, SID, MagIran, Iranmedex, Cochrane, Science Direct, ISI Web of science, PubMed, Google Scholar, and Scopus. The used keywords for the search included "fetal anomalies," "pregnancy termination due to fetal anomalies," "therapeutic abortion," "need assessment," and "care program." Publication date was restricted to 2004-2017, and publication language was restricted to English and Farsi. Article search was conducted by two independent reviewers, and all of the studies were evaluated by these two individuals. The searches resulted in finding 88 articles related to the subject from which 16 articles that had more appropriately covered the topic were selected for the present study.

RESULTS

From the results, the needs of these women could be categorized into two groups of "needs related to the care system" and "needs related to the husband, family members, friends, and peers."

CONCLUSIONS

Considering that women who have experienced pregnancy termination due to fetal anomalies have different needs, educating healthcare providers and husbands, family members, friends, and peers for providing comprehensive care tailored to the needs of these individuals seems necessary.

The Components of Nursing Competence in Caring for Older People in Iranian Hospitals: A Qualitative Study

Background:

There is limited research on gerontological nursing competence in hospitals. However, there is no comprehensive and integrated description of the gerontological nursing competence requirements in hospitals. The purpose of this study was to explain the components of nursing competence in caring for older people in Iranian hospitals.

Materials and Methods:

This is a qualitative descriptive-exploratory study. The data were collected through a semi-structured interview with nurses, nurse managers, and clinical educators in teaching hospitals and nursing schools affiliated to Arak, Isfahan, and Tehran Universities of Medical Sciences in Iran from September 2015 to July 2016. Participants included 25 people who were selected by purposive and snowball sampling method. Sampling continued until data saturation. Data were analyzed using conventional content analysis method.

Results:

Data analysis generated three main categories including (1) Patient and family centered care; (2) Process-oriented care; and (3) Self-care and continuing professional development.

Conclusions:

Nurses should have competencies such as participation and empowerment of the patient and family; ease of comfort in the elderly; comprehensive geriatric assessment; development, implementation and evaluation of care plan; development of knowledge and clinical proficiency; and coaching so that they can work effectively during the care of the elderly. The results of this study can be used by nursing educators, nursing students, and nurses to develop their individual and professional skills in the field of gerontological nursing.

Impact of a Spiritual Care Program on Spiritual Wellbeing of Oncology Nurses: A Randomized Clinical Trial

Background:

Spiritual wellbeing (SWB) of nurses working in oncology wards is directly related to quality of care they provide. An increase in their SWB might lead to decrease in their spiritual distress and increase in their coping strategies. The aim of this study was to investigate the impact of a spiritual care program on SWB of nurses.

Materials and Methods:

This study is a clinical trial with before and after intervention groups, which was carried out on 65 nurses in Omid Hospital in Isfahan in 2017. Nurses were randomly assigned into control (n = 34) and intervention groups (n = 31). The data were collected through demographic and SWB scales. Spiritual care program consisting of eight sessions of four relationship-based domains, including relationships with God, self, others, and the environment, were carried out in the intervention group. Two care training sessions in oncology departments were conducted for the control group.

Results:

The results indicated that the differences in SWB mean scores between the intervention and control group after treatment were statistically significant (t = 2.58, p = 0.012). Also, SWB mean scores in the intervention group before and after treatment showed a statistically significant difference (t = 2.86, p = 0.008).

Conclusions:

The results showed that the spiritual care program might have a positive impact on the SWB of nurses working in oncology wards. Therefore, it is indispensable to promote and prioritize the SWB of nurses so that patients and their families will receive better health services.

Effect of smoking on multiple sclerosis: a meta-analysis

Background

Despite our awareness of the significant effect of smoking on multiple sclerosis (MS), there was a serious lack of information about the effect of different types of smoking habit on MS as well as the dose-response relationship between smoking and MS, but this gap was addressed by this meta-analysis.

Methods

Major electronic databases, including PubMed, Web of Science and Scopus were searched until July 2015. Epidemiological studies addressing the association between smoking and MS were enrolled. The heterogeneity across studies was investigated by Q-test and I2 statistic. The probability of publication bias was explored using Begg's and Egger's tests. The results were expressed as odds ratio (OR) with 95% confidence intervals (CI) using a random effects model.

Results

We identified a total of 10 687 references and included 34 studies involving 623 852 participants. Compared with nonsmokers, the OR estimate of MS was 1.46 (1.33, 1.59) among ever smokers, 1.57 (1.34, 1.80) among current smokers, 1.36 (1.27, 1.46) among ex-smokers and 1.12 (0.87, 1.36) among passive smokers. In addition, analyzing the effect of cigarette pack-year on MS indicated that the OR estimate of MS was 1.34 (1.06, 1.61) for 1-5 cigarette pack-years, 1.56 (1.15, 1.97) for 6-10 cigarette pack-years, 1.74 (1.16, 2.33) for 11-15 cigarette pack-years and 1.46 (0.49, 2.43) for more than 15 cigarette pack-years.

Conclusions

Smoking habits are significantly associated with MS, although the association is not very strong. However, there is a dose-response relationship between the smoking habits and MS.

A Survey of Nurses' Compliance with Hand Hygiene Guidelines in Caring for Patients with Cancer in a Selected Center of Isfahan, Iran, in 2016

Background

Hand hygiene is one of the key ways of preventing healthcare-associated infections (HCAI), especially in patients with cancer. The aim of this study was to determine nurses' compliance with hand hygiene guidelines in caring for patients with cancer in a selected center in Isfahan, Iran, in 2016.

Materials and Methods

The present observational study was conducted on nurses in a cancer center in Isfahan in 2016. The participants were selected via convenience sampling method. Nurses serving at bedsides and willing to participate were entered into the study. Data were collected through the direct observation of nurses during delivering routine care, using the standard checklist for direct observation of the "five moments for hand hygiene" approach.

Results

In the present study, 94 nurses were studied at 500 clinical moments. The overall hand hygiene compliance rate was 12.80%. The highest hand hygiene compliance rate was observed in the after body fluid exposure moment (72.70%). In addition, hand hygiene compliance rate in preprocedure indications (before patient contact and before aseptic procedure) and postprocedure indications (after patient contact, after body fluid exposure, and after patient surrounding contact) were 3.40 and 21%, respectively, which had a significant correlation (p = 0.001).

Conclusions

The findings indicate that the hand hygiene compliance rate among nurses was low. Further research in this regard is recommended in order to find the causes of low compliance with hand hygiene and design interventions for improvement in hand hygiene compliance rate among nurses.