Investigating the level of respect for human dignity and its related factors in providing care for the elderly with COVID-19 in shahid Beheshti Hospital, Kashan, 2021

BACKGROUND

Patients' dignity includes the feelings of being valuable, maintaining their respect, and respecting their physical and spiritual privacy. Coronavirus disease of 2019 (COVID-19) is one of the life-threatening diseases that affect the dignity of the elderly. Therefore, the aim of this study was to investigate the level of respect for human dignity and its related factors in providing care for the elderly with COVID-19 in Shahid Beheshti Hospital in Kashan, 2021.

MATERIALS AND METHODS

This cross-sectional study investigated 250 nurses caring for the elderly with COVID-19 and 300 elderly with COVID-19 in Shahid Beheshti Hospital of Kashan in 2021. A sampling of the elderly with COVID-19 was performed continuously based on the inclusion criteria and sampling of nurses by census method. The research tools included the questionnaire on background variables of nurses and the elderly, the questionnaire on respect for human dignity from the perspective of nurse and patient, and the job stress questionnaire. Then, the results were analyzed using Pearson's correlation coefficient tests, t-tests, and multiple regression in SPSS 21 software.

RESULTS

Based on the results, the mean and standard deviation of patient dignity was 132.13 ± 71.52 and 129.14 ± 06.44 from the perspective of the nurses and the elderly, respectively. The results revealed that the level of respect for human dignity from the nurses' perspective was significantly related to gender and job stress (P < 0.05). Moreover, a significant relationship was found between the human dignity score from the elderly's perspective and the elderly's marital status and education (P < 0.05). According to the results of regression, the variables of nurses' gender and job stress explained about 8.7% of the variance of the patient's dignity observed by the nurses (Adjusted R-Square = 0.087). Finally, the variables of marriage and education of the elderly explained about 4% of the variance of their dignity observed by the nurses (Adjusted R-Square = 0.040).

CONCLUSION

The results showed that with the increase of job stress in female nurses, their human dignity toward the patient decreases. Elderly people who are married and have a high school diploma have a better understanding of respect for human dignity. Since respect for human dignity is important from the point of view of nurses and the elderly, it is suggested to teach nurses how to respect patient dignity.

Effect of educating health promotion strategies model on self-care self-efficacy in elderly with kidney transplantation

BACKGROUND

After kidney transplantation, older adults encounter numerous problems which can negatively affect their self-care self-efficacy. According to studies, behavior modeling training has an effect on patient's self-care. Therefore, the present study was conducted to determine the effect of implementing health promotion strategies on self-care self-efficacy in older adults undergoing kidney transplantation.

MATERIALS AND METHODS

This quasi-experimental study was conducted on 60 older adults undergoing kidney transplantation in Tehran's Shahid Doctor Labbafinejad Hospital in 2020. Patients were randomly divided into intervention and control groups by using block randomization method. For the patients of the intervention group, the educations were provided based on the model of individual health promotion strategies in eight sessions (i.e., 8 weeks, one session per week) for 40-60 minutes. The subjects of the control group received only their routine care. The two groups completed on-line the self-care self-efficacy questionnaire, before, immediately after and one month after the intervention. The results were analyzed by Chi-square, t-test and repeated measures analysis of variance in SPSS v19.

RESULTS

According to the results, no significant difference was observed between the two groups in terms of demographic characteristics and the mean score of self-care self-efficacy before the intervention (P > 0.05). The mean score of self-care self-efficacy (P = 0.001) and some of its dimensions including stress reduction (P = 0.01) and adaptability (P = 0.01) was significantly different in the two groups in the three time intervals. Moreover, the two dimensions of decision making (P = 0.07) and enjoying the life (P = 0.20) were not significant.

CONCLUSION

According to the results, education based on health promotion strategies can effectively improve self-care self-efficacy and some its dimensions. Therefore, teaching health promotion strategies as a low-cost and simple method can positively affect self-care self-efficacy in older adults undergoing kidney transplantation.

The effects of Rosa damascene aromatherapy on anxiety and sleep quality in burn patients: A randomized clinical trial

INTRODUCTION AND OBJECTIVE

Sleep disorders and anxiety are common problems in burn patients, and aromatherapy is a common complementary treatment in medicine. The aim of this study was to determine the effects of aromatherapy with the inhalation of rose essential oil on anxiety and sleep quality in burn patients.

MATERIALS AND METHODS

This randomized controlled clinical trial was performed on 60 patients admitted to the Valiasr Hospital B in Arak from March 2021 to the end of July 2021. The patients were chosen by the convenience sampling method and then randomly divided into the intervention and control groups based on the block randomization method (six blocks). Aromatherapy along with the routine care was provided to the participants of the intervention group for three consecutive nights. These participants inhaled five drops of 40 % rose essential oil. The members of the control group also inhaled five drops of distilled water as a placebo. In both groups, anxiety and sleep quality were assessed using the St. Mary's Hospital Sleep Quality Questionnaire (SMHSQ) and the Spielberger State-Trait Anxiety Inventory (STAI), respectively, before and after the intervention.

RESULTS

The sleep quality scores of the intervention and control groups after the intervention were 17.88 ± 2.04 and 26.11. 3.31, respectively, showing a statistically significant difference (P < 0.05). Our results also showed a statistically significant difference in the anxiety score between the intervention and control groups after aromatherapy (P < 0.05).

RESULTS

Rose essential oil aromatherapy reduced anxiety and improved sleep quality in burn patients, suggesting this approach as a useful complementary method along with other therapeutic measures in these patients.

The barriers and facilitators of developing clinical competence among master's graduates of gerontological nursing: a qualitative descriptive study

BACKGROUND

Clinical competence development is a main goal of specialized nursing courses. Nonetheless, some master's graduates of gerontological nursing programs have inadequate Clinical competence. The aim of this study was to explore the barriers and the facilitators to clinical competence development among the master's graduates of gerontological nursing.

METHOD

This qualitative descriptive study was conducted in 2020. Participants were twenty nursing master's students, master's graduates, and instructors of gerontological nursing. They were purposively selected from several faculties of nursing and midwifery in Tehran, Isfahan, and Kashan, Iran. Semi-structured interviews were held for data collection and the conventional content analysis proposed by Graneheim and Lundman was used for data analysis. Data were managed using the MAXQDA 10 software.

RESULTS

The main barriers to clinical competence development were students' neglectfulness towards learning, inefficiency of educational system, and ineffective management. The main facilitators to clinical competence development were effective educational planning and management improvement.

CONCLUSION

There are different personal, educational, and managerial barriers and facilitators to clinical competence development among master's graduates of gerontological nursing. Effective educational planning and management improvement are needed for clinical competence development among master's students and graduates of gerontological nursing.

The safety of a novel single-drape cover for sterile back tables in the operating room compared to the standard two-drape method: an experimental study

BACKGROUND

Covering the prepared sterile back tables (PSBTs) during periods of nonuse and during active surgeries may decrease contamination of sterile surgical instruments that have direct contact to surgical wound. The Association of periOperative Registered Nurses (AORN) declared that an easy method for covering and removing the drape will ultimately be most effective (e.g. standard two-drape method). Hence, this study was designed to test the hypothesis that using a novel single-drape cover had more efficiency and safety in decreasing airborne bacteria-carrying particles (ABCPs) settling on the PSBTs during static and dynamic periods than the standard two-drape method.

METHODS

This experimental study was conducted with using 918 agar plates to detect contamination of the PSBTs with ABCPs on two conditions (static and dynamic) at an academic medical center in Kashan, Iran, from September 25, 2021, to January 20, 2022. The contamination of PSBTs was evaluated by 6 agar settle plates (n = 918 in total) on each PSBT in static and dynamic operating room (OR) conditions. At each time-point, this set-up was repeated on two occasions else during data collection, establishing 81 PSBTs in total. Tested groups included the PSBTs covered with the standard two-drape method, the novel single-drape cover, or no cover. The plates were collected after 15, 30, 45, 60, 120, 180, 240 min and 24 h. The primary outcome measured was comparison of mean bioburden of ABCPs settling on covered PSBTs on two conditions by using agar settle plates. The secondary outcomes measured were to determine the role of covering in decreasing contamination of PSBTs and the estimation of time-dependent surgical instrument contamination in the uncovered PSBTs on two conditions by using agar settle plates.

RESULTS

Covering the PSBTs during static and dynamic OR conditions lead to a significantly decreased bioburden of ABCPs on them (P < 0.05). No differences were seen between the standard two-drape method and the novel single-drape cover (P > 0.05).

CONCLUSIONS

We found that there is no preference for using the novel single-drape cover than the standard two-drape method. Our results showed a significant decrease in bioburden of ABCPs on the PSBTs when those were covered during static and dynamic OR conditions, indicating the efficiency for covering the PSBTs during periods of nonuse and during active surgery.

Effectiveness of a PRECEDE-PROCEED Model-based Educational Program on Health-Related Quality of Life and Preventive Behaviors in Patients with Breast Cancer Undergoing Chemotherapy

Background: Cancer is a chronic disease that affects different aspects of Quality of Life (QoL), including physical, financial, social, and emotional aspects. The PRECEDE-PROCEED model is a comprehensive method for assessing patients’ needs, and designing, implementing, and evaluating health promotion programs to meet their needs. This study aims to determine the effect of an educational program based on the PRECEDE-PROCEED model on Health-Related Quality of Life (HRQOL) and preventive behaviors in patients with breast cancer undergoing chemotherapy. Methods: This quasi-experimental impact evaluation study was performed on 90 outpatients with breast cancer (stages I and II) undergoing chemotherapy in Shahid Beheshti Hospital, Kashan, Iran from September 2018 to December 2019. The participants were randomly assigned into two groups of training (n=45) and control (n=45). The training group, in addition to routine care, received the educational program based on the PRECEDE-PROCEED model at eight two-hour group sessions for one month. The control group received routine care for cancer patients only. The participants completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and a researcher-made questionnaire based on the PRECEDE-PROCEED model (assessing predisposing, enabling, and reinforcing factors) before the study, immediately after, and two months after the intervention. Results: In the training group, the total Mean±SD of HRQOL before, immediately after, and two months after the intervention were 52.65±17.14, 64.79±15.66, and 63.95±18.63, respectively. Their total score of HRQOL and its dimensions (physical functioning, role functioning, emotional functioning, and symptoms) increased significantly over time (P<0.01). In this group, the scores of predisposing and enabling factors also increased immediately after and two months after the intervention (P<0.05); however, the score of reinforcing factors (social support) showed no significant increase (P>0.05). Conclusion: The educational program based on the PRECEDE-PROCEED model can improve the HRQOL and preventive behaviors in terms of predisposing factors (knowledge, attitude), and enabling factors (family support) in patients with breast cancer undergoing chemotherapy. We recommend this educational program for improving these patients’ QoL.

Intuitive Decision-making by Iranian Nurses of Patients with COVID-19: A Qualitative Study

Introduction: Clinical decision-making related to coronavirus disease 2019 (COVID-19) is a new experience; thus, there is a lack in knowledge in this area. The aim of this study is to explore critical care nurses’ experience of intuitive decision-making in patients diagnosed with COVID-19.

Methods: In this qualitative descriptive study, 16 nurses who had the experience of providing care for patients diagnosed with COVID-19 were selected through purposive sampling and participated in semi-structured interviews. The interviews were transcribed and finally analyzed through the conventional content analysis approach.

Results: 62.5% of participants were females and the mean (SD) of the participant’s age and working experience were 36.56 (6.58) and 12.62 (5.59) years, respectively. Three main themes emerged out of the experiences of the nurses, including (a) inner revolution, (b) holistic awareness and (c) clinical wisdom.

Conclusion: Critical care nurses use intuition in novel, complex situations where they often have to make quick and independent decisions. Understanding the phenomenon of intuition in clinical decision making increases the professional practice of nursing and leads to better quality care for patients, especially in acute, critical situations and pandemic diseases.

The effect of Swedish massage on pain in rheumatoid arthritis patients: A randomized controlled trial

BACKGROUND AND PURPOSE

Joint pain is one of the most common symptoms in rheumatoid arthritis patients and require medical attention. The purpose of this study was to assess the effects of Swedish massage on pain and painkiller consumption in rheumatoid arthritis patients.

MATERIALS AND METHODS

A total of 60 patients participated in the experiment, with half assigned to the control group (n = 30) and half to the experimental (n = 30) group using the block randomization method. On patients in the experimental group, a 30-min Swedish massage was performed regularly for eight weeks: twice a week for the first four weeks, and three times a week for the last four weeks. The control group received routine care. The visual analogue scale-pain was used to measure pain in the two groups at three points of time: before the beginning of the experiment, immediately after the last session, and one month after the last session of the intervention.

RESULTS

The analysis of covariance showed that there were significant differences between the two groups' mean scores of pain and painkiller consumption immediately after and one month after the last session of the intervention (p = 0.01). Furthermore, in the experimental group, the mean scores of pain and painkiller consumption decreased over the three points of time (p < 0.05).

CONCLUSION

Swedish massage can be effective in reducing pain and the need to use painkillers in rheumatoid arthritis patients.

The Effects of Improving Emotional Intelligence on Death Anxiety in Older Adults

Introduction: Death anxiety is one of the main elements in mental health in older adults. Objective: This study aimed to determine the effects of improving emotional intelligence on death anxiety in older adults in Kashan City, Iran. Materials and Methods: This quasi-experimental study was carried out on 60 older adults referred to health clinics in Kashan City, Iran, in 2019. The participants were randomly allocated to the control and experimental groups. Before the intervention, a demographics data questionnaire and death anxiety scale was filled out by the two groups. The experimental group received emotional intelligence education in eight sessions (twice a week). The control group received no intervention. The study measures included a demographic checklist and the Templer Death Anxiety Scale (TDAS). Immediately and one month after the intervention, both groups filled out the death anxiety scale again. The collected data were analyzed using descriptive and analytical tests such as t test, the Chi-square, and repeated-measures Analysis of Variance (ANOVA). Results: The results showed that 22 participants (73.3%) and 17 (56.7%) were in the 61-65 age range in the experimental and control groups, respectively. Based on the Chi-square test, there was no significant difference between the two groups regarding demographical data, including age, gender, marital status, education, and job. The results of repeated-measures ANOVA in the experimental group showed that the mean scores of death anxiety decreased over the 3 time points (P<0.05). Also, the post hoc test showed a significant difference in death anxiety scores at different time points in the experimental group (P<0.05). The t test results showed no statistically significant difference in the mean score of death anxiety before the intervention between the two groups, but at the end of the sessions (P=0.006) and one month after the intervention (P=0.001), this difference was significant. Conclusion: The results indicated that improving emotional intelligence in older adults decreased their death anxiety. It is recommended that nurses use this method to decrease death anxiety in older adults.

Effect of craniosacral therapy on the intensity of chronic back pain of nurses: A randomized controlled trial

Background & Aim: Chronic low back pain is a common disease among nurses. According to the literature, complementary medicine can reduce low back pain, one of which is craniosacral therapy. This study was designed to investigate the effect of craniosacral therapy on the intensity of chronic back pain of nurses. Methods & Materials: This randomized clinical trial study was conducted on 60 nurses with chronic back pain. The participants were randomly assigned into intervention and control groups. The intervention group’s participants received eight individual sessions of craniosacral therapy. In the control group, a light-touch in the lumbar region was performed as a placebo. The therapist met each participant separately in a private room of the hospital. The two groups completed the McGill Pain Questionnaire at the baseline, immediately after the intervention, and one month after the intervention.  The collected data was analyzed in SPSS (v.16) using descriptive and analytical tests such as t-test, Chi-Square, ANCOVA, and repeated measures ANOVA. Results: The ANCOVA test results showed a significant difference between the two groups’ mean scores of pain intensity and its subscales (P<0.05). The results of repeated measures ANOVA showed that the mean scores of pain intensity and its subscales (sensory, affective, pain evaluation, and miscellaneous) decreased over the three time points in the intervention group (P<0.05). Conclusion: The findings affirmed the positive effects of the craniosacral therapy on the intensity of pain in nurses with chronic back pain. Therefore, it is recommended that this approach be performed as a complementary, effective, non-invasive intervention to decrease chronic back pain.

Prevalence of Anesthesia Complications in Orthopedic Surgeries and its Related Factors

Background: The duration of surgery in orthopedic surgeries is often longer than one hour. Therefore, these patients are at further risk of complications induced by general anesthesia. The present study aimed to determine the prevalence of anesthesia complications in orthopedic surgeries and its related factors. Methods: This cross-sectional study was performed on 400 patients undergoing orthopedic surgery in Shahid Beheshti Hospital of Kashan Province, Iran, in 2020. The study subjects were recruited by convenience sampling method. We included those who similarly underwent general anesthesia for elective surgery and were transferred to Post-Anesthesia Care Unit (PACU). The research instruments included a demographic questionnaire and a checklist for recording complications (shivering, pain, nausea, vomiting, & vital signs). The necessary data were recorded after the patient was admitted to the PACU, as well as half an hour and one hour later. The obtained data were analyzed using the Chi-squared test, Independent Samples t-test, one-way Analysis of Variance (ANOVA), Pearson correlation coefficient, and logistic regression analysis in SPSS v. 16. Results: The present research results suggested that the most and least frequent complications were vomiting (91.8%) and changes in blood pressure (5%), respectively. Gender was significantly associated with pain, nausea, and hypertension (P<0.05). The Pearson correlation coefficient data indicated a significant relationship between the duration of anesthesia and the mean scores of shivering, pain, nausea, tachycardia, and tachypnea (P<0.05). There was also a significant relationship between the types of surgery and shivering, pain, blood pressure, and nausea (P<0.05). Pulse rate was significantly associated with complete intravenous anesthesia and the duration of anesthesia (P<0.05). Conclusion: The relatively high incidence of post-anesthesia complications in orthopedic surgeries indicates the significance of employing skilled personnel as well as using adequate monitoring equipment at the PACU. Such measures help to decrease mortality and morbidity among patients, also save on hospital costs.

The Effect of Training Based on James Brown Model on Self-efficacy in Adolescents with Type 1 Diabetes Mellitus

Introduction: Type 1 Diabetes Mellitus (T1DM) is one of the most frequent chronic diseases among children and adolescents. Educational strategies underscore patient’s roles in the management of diseases and enhance self-efficacy behaviors. Objective: The purpose of this study was to investigate the effects of an educational intervention based on James Brown’s model on self-efficacy in adolescents with T1DM. Materials and Methods: In this randomized clinical trial, 70 participants were selected and assigned to the control and intervention groups by random block. The two groups received routine care for T1DM. The intervention group was also provided with educational sessions, 60 minutes twice a week for 4 weeks, based on the educational model. The participants completed the diabetes management self-efficacy instrument at the beginning, at the end, and a month after the end of the study. Data analysis was performed using the Chi-square, Independent samples t-test, Covariance (ANCOVA), and repeated measures ANOVA. Results: The mean±SD age of the intervention and control groups was 14.81±2.05 and 15.18±2.11 years, respectively. Before the intervention, the two groups were not different statistically in terms of demographic variables (age, sex, duration of diabetes, insulin intake, etc.) and self-efficacy. The results showed that immediately after the intervention and also in the follow-up stage, the mean scores of self-efficacies and its subscales (nutrition, blood glucose monitoring, physical activity, and medical treatment) in the intervention group were significantly higher than the control group (P<0.05). The mean scores of self-efficacies at the beginning, at the end, and a month after the end of the study were 27.97±5.08, 41.46±4.41, and 44.55±4.38, respectively. In the control group, however, these differences were not significant. Conclusion: The education based on James Brown’s model can improve self-efficacy among adolescents with T1DM. It is recommended that nurses use this method to increase self-efficacy in adolescents with T1DM.

Clinical competence in nursing: A hybrid concept analysis

BACKGROUND

Clinical competence (CC) is central issue in nursing. There are some controversies about this concept that needs further investigation. The present study was conducted to analyze the concept of clinical competence in nursing.

METHODS

This concept analysis was conducted using the three-phase hybrid model. In the theoretical phase, the Science Direct, PubMed, CINAHL, ProQuest, Scopus, Web of Science, SID, Iranmedex, and Magiran databases were searched to retrieve articles published from 2000 to 2020. Forty two eligible articles were included and analyzed. In the fieldwork phase, semi-structured interviews were held with eighteen university lecturers, clinical instructors, students, and hospital nurses and the data were analyzed through conventional content analysis. In the final analytic phase, the findings of the first and the second phases were combined.

RESULTS

The majority of literature defined CC in nursing as a combination of knowledge, and skills, and attitudes that is consistent with those of the fieldwork phase. Most participants in fieldwork stated that gaining CC is a process that is achieved over time through practice and repetition and increasing experience. A nurse needs to acquire personal, social and professional competencies during the study and work period. The CC has antecedents of efficient education, and organizational support. It also has consequences for patients and nurses such as satisfaction, and quality care.

CONCLUSION

CC is a continuous process of obtaining knowledge, values, and attitudes, and skills such as critical thinking skills that brings creativity and innovation in nursing practice.

Clinical decision-making approaches by health caregivers of patients with COVID-19

The Coronavirus disease of 2019 COVID-19) is the current health crisis in the world- a new, complex phenomenon that has affected and hospitalized many people around the world. Health care providers deal with COVID-19 patients daily and care for the patients while there is no definitive cure for it. Clinical decision-making is an important task of health professionals that plays an essential role in preserving the patient's life and providing quality care. Therefore, understanding clinical decision-making approaches by healthcare providers, such as nurses and physicians, especially in crises such as COVID-19, is essential.

Effects of glycerin oil and lavender oil massages on hemodialysis patients' restless legs syndrome

OBJECTIVES

To determine the effects of glycerin oil and lavender oil massages on hemodialysis patients' restless legs syndrome (RLS).

METHODS

Ninety hemodialysis patients with RLS were randomly allocated into two intervention groups and one control group, each consisting of 35 participants. The control group received routine care, and the intervention groups received effleurage massage with lavender and glycerin oil in addition to routine care for one month. RLS intensity was measured among the three groups using the Restless Legs Syndrome Rating Scale.

RESULTS

At the beginning of the study, the results showed no significant difference among the three groups' scores. At the end of the study, the mean RLS scores were significantly lower in the intervention groups compared to the control group (F = 63.4, p ≤ 0.001). This difference was not significant between the two intervention groups; nonetheless, the differences between the control and lavender oil groups, as well as the control and glycerin oil groups, were significant (p < 0.05).

CONCLUSION

The findings showed the effectiveness of the oils through the effleurage massage for reducing RLS in a sample of hemodialysis patients.

The effect of tactile-kinesthetic stimulation on growth indices of healthy neonates

Therapeutic touch is emphasized by healthcare professionals for improvement of neonates' growth and development. However, inconsistencies exist regarding effects and methods of massage in neonates. The purpose of this clinical trial is to assess and comprise intervention and control groups regarding the effects of tactile-kinesthetic stimulation (TKS) by mothers on growth indices of healthy term neonates. Sixty healthy term neonates were randomly assigned into intervention and control groups. Mothers of neonates in the experimental group were trained to perform TKS for their newborns at home before feeding for at least 28 consecutive days, two times a day, and 15 min each time. Neonates in the control group were not required to receive this intervention. The neonates' growth indices were measured within 24 h after birth, and then at days 14 and 28. During the study and the three consecutive measurements, no significant difference was found between the mean weights, heights, and head circumferences of the neonates in the two groups (p > 0.05).

Religious Practices and Self-Care in Iranian Patients with Type 2 Diabetes

This study aimed to examine the relationship between religious practices and self-care of patients with type 2 diabetes. A descriptive cross-sectional survey was conducted on 154 diabetic patients who were referred to two general teaching hospitals in Qom City (Iran). Data were collected using demographic questionnaire, private and public religious practices, and summary of diabetes self-care activities questionnaires. Data were analyzed using descriptive statistics and statistical tests including independent t test, and Pearson correlation coefficient. Significant positive correlations were observed between religious practices and self-care activities in diabetic patients (p < 0.05). Significant positive correlations were also found between some religious practices and self-care activities subscales (p < 0.05). Healthcare providers should be aware of the role that religion plays in the lives of diabetic patients and be able to take religious factors into account when developing care plans. Doing so will enhance a more patient-centered approach and thereby support patients in their role as self-care decision-makers.

The effect of mentoring on clinical perioperative competence in operating room nursing students

AIMS AND OBJECTIVES

The aim of this study was to investigate the effects of mentoring on the clinical perioperative competence of nursing operating room students in Iran.

BACKGROUND

Mentoring is an essential part of clinical education, which has been studied in different populations of students. However, there is a need to assess its effectiveness in operating room students' competence.

DESIGN

A randomised controlled trial was performed.

METHODS

Sixty nursing operating room students were randomly assigned to experimental and control groups. Both the control and experimental groups had routine training in the form of faculty supervision. The experimental group had an additional mentoring program. Using the Persian Perceived Perioperative Competence Scale-Revised, clinical competence was compared between the two groups, before and after the intervention. Using SPSS 19, descriptive and inferential statistics, including chi-square and t-tests, were conducted.

RESULTS

In the experimental group, the difference between the mean scores of clinical competence before (19·43 ± 2·80) and after (27·86 ± 1·87) the intervention was significant (p ≤ 0·001). After intervention, the difference between the mean scores of the control (3·9 ± 0·15) and experimental (8·61 ± 0·68) groups was significant (p ≤ 0·003).

CONCLUSION

Findings affirmed the positive effect of mentorship programmes on clinical competence in nursing operating room students.

RELEVANCE TO CLINICAL PRACTICE

Mentoring is an effective method for preparing nursing students in practice. Health care systems may improve as a result of staff-student relationships that ultimately increase the quality care for patients.

Mothers' satisfaction with two systems of providing care to their hospitalized children

Background:

Despite the paramount importance of the patient’s satisfaction, there are limited data on mothers’ satisfaction with the nursing care provided to their children in Iranian clinical settings.

Objectives:

This study aimed to evaluate mothers’ satisfaction with two systems of providing care to their hospitalized children.

Patients and Methods:

This research was a two-group quasi-experimental study. Primarily, the basics of the case method and the functional care delivery systems were educated to the practicing nurses of the study setting. Each system was implemented independently. After the implementation of each system, 200 mothers whose children were hospitalized in the pediatric care ward of Shahid Beheshti Hospital, Kashan, Iran, were invited to respond to the 28 -item Pediatric Family Satisfaction Questionnaire. Study data were analyzed by SPSS v. 16.0.

Results:

Results were indicative of mothers’ satisfaction with medical care delivered by case method as 13.2 ± 5.2 and by functional method as 13.17 ± 5.56. Also, no significant difference was seen between two groups (P = 0.4). Mothers’ satisfaction with nursing care delivered by case method was 17.7 ± 4.43 and by functional method was 13.33 ± 5.69 and there was a significant difference between two groups (P = 0.004). Mothers’ satisfaction with accommodations by case method was 16.78 ± 4.07 and by functional method was 17.9 ± 6.67 with a significant difference between two groups (P = 0.06).

Conclusions:

Improving the quality of care is associated with higher patient’s satisfaction. Accordingly, developing and implementing programs for improving nurses’ communication and clinical skills can improve both care quality and patient outcomes.

Effect of music on postoperative pain in patients under open heart surgery

Background:

Music, as a non-pharmacological and inexpensive nursing intervention, can be used easily as a complementary technique in reducing pain along with other methods. While some studies have demonstrated pain to decrease after music, others found music to be ineffective on pain.

Objectives:

The aim of this study was to investigate the effect of music on postoperative pain in patients under open heart surgery.

Patients and Methods:

A quasi-experimental study was performed on 60 patients under open heart surgery referred to ICU of Shahid Beheshti hospital in Kashan city. Patients were randomly divided into two groups including experimental and control groups. Patients in music group listened to nonverbal music for 30 minutes after surgery by headphones. The control group did not receive any intervention other than routine care. Before and after intervention, pain intensity was measured and recorded by visual analog scale in two groups. Data was analyzed using Chi-Square and t-tests.

Results:

Before intervention, the mean of pain intensity was 6.32 ± 0.21 and 6.10 ± 0.21 for experimental and control groups, respectively; and the difference was not significant (P = 0.21). After intervention, the mean of pain intensity was 3.11 ± 0.12 and 5.81 ± 0.38 for experimental and control groups, respectively; and the difference was significant (P = 0.04).

Conclusions:

Listening to the relaxant music can reduce postoperative pain. It is suggested that relaxant music be used as a complementary method in patients in order to reduce prospective pain.

Effect of self - care education on quality of life in patients with primary hypertension: comparing lecture and educational package

Background:

Hypertension is a dangerous risk factor for public health. It profoundly affects the patients’ quality of life. However, there is lack of agreement on the best method for self-care management in patients with hypertension.

Objectives:

This study was conducted to compare the effect of lecture and educational pamphlets on quality of life (QOL) in patients with primary hypertension.

Patients and Methods:

A quasi-experimental study was performed on 90 patients with chronic primary hypertension referred to two outpatient clinics in Kashan city. Patients were randomly divided into three groups including lecture group, educational package group, and control group. The participants’ quality of life was measured using the SF-36 questionnaire at the beginning of the study, and two months later. Data was analyzed using ANOVA and Chi-Square tests.

Results:

No significant differences were observed between the three groups for demographics characteristics and QOL before the intervention except for marital status. Mean scores of QOL dimensions of the intervention groups were increased at the end of the study, except for the dimension of bodily pain. Tukey post-Hoc test showed that except for general health, the two intervention groups were not significantly different in other dimensions, and significant differences were observed between the control group and the two intervention groups (P < 0.05). At start and the end of the study, the mean differences in the general health dimension in three groups were 2.25 ± 0.1, 0.07 ± 0.01, and -1.70 ± 0.01 respectively. There were significant differences among groups (P = 0.04).

Conclusions:

Lecture and educational package can both improve some dimensions of the QOL in patients with hypertension. However, as pamphlets are cheap and easy to use, this method may be used as an effective method for self-care education in health care settings in Iran, where the system is faced with nursing shortage.