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Contributing factors involved in the safety of elderly people with chronic illness in home healthcare: a qualitative study. BMJ Open Qual 2023; 12:e002335. [PMID: 37451802 PMCID: PMC10351293 DOI: 10.1136/bmjoq-2023-002335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Patients receiving home care are often elderly people with chronic illnesses that increasingly experience patient safety barriers due to special care needs. OBJECTIVE The present study was conducted to determine the factors involved in the safety of elderly patients with chronic illnesses receiving home care. METHODS A qualitative study with a conventional content analysis method was conducted in home care agencies of Tehran, Iran from August 2020 to July 2022. For data generation, semistructured interviews were conducted with 11 nurses, 2 nurse assistants, 1 home care inspector (an expert working at the deputy of treatment) and 3 family caregivers. Moreover, four observational sessions were also held. Data analysis was done using the five-step Graneheim and Lundman method. RESULTS According to the results, the facilitators of the safety of the elderly patients with chronic illnesses included the family's participation, nurse's competence, efficiency of the home care agency management and patient's participation in patient safety. The barriers to patient safety included problems created by the family, nurse's incompetence, inefficiency of the home care agency, patient's prevention of patient safety, home care setting limitations and health system limitations. CONCLUSION The majority of the factors involved in the safety of elderly patients with chronic diseases receiving home care had dual roles and could serve as a double-edged sword to guarantee or hinder patient safety. Identification of the facilitators and barriers can assist nurses and the healthcare system in planning and implementing patient safety improvement programmes for elderly patients with chronic illnesses.
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Patient safety in home health care: a grounded theory study. BMC Health Serv Res 2023; 23:467. [PMID: 37165357 PMCID: PMC10171141 DOI: 10.1186/s12913-023-09458-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 04/27/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND The home environment is designed for living, not for professional care. For this reason, safe patient care is one of the most important challenges of home health care. Despite abundant research on safe care, there is still little understanding of safety issues in home care. DESIGN The aim of the present study was to explain the process of safe patient care in home health care. A qualitative, grounded theory study was conducted based on the approach proposed by Corbin & Strauss in 2015. METHOD In total, 22 interviews were conducted with 16 participants including 9 home care nurses, 2 home care nursing assistants, 1 home care inspector, 1 home care physician and 3 family caregivers in Tehran, Iran. Four observation sessions were conducted in different homes. Purposeful sampling was used followed by theoretical sampling from August 2020-July 2022. Data analysis was carried out based on the approach proposed by Corbin & Strauss in 2015. RESULTS The results showed that the healthcare members (nurses, family caregivers, patients and home care centers) used the model of safe patient care in home health care based on four assessment methods, i.e. prevention, foresight, establishment of safety and verification. The core variable in this process is foresight-based care. CONCLUSION The results of this study showed that the key to safe patient care in home health care, which helps to maintain patient safety and prevent threats to safe care, is the foresight of healthcare members, which is essential for identifying threats to safe care considering the many risks of home health care.
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Effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of patients with cancer: a randomized controlled trial. BMC Psychiatry 2023; 23:220. [PMID: 37005577 PMCID: PMC10068160 DOI: 10.1186/s12888-023-04715-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 03/23/2023] [Indexed: 04/04/2023] Open
Abstract
Family caregivers of dying cancer patients may suffer from grief experiences and bereavement complications. Previous studies have proposed some psycho-emotional interventions for the management of these complications. However, little attention has been given to family-based dignity intervention and expressive writing. This study was conducted to examine the effects of family-based dignity intervention and expressive writing, combined and alone, on anticipatory grief in family caregivers of dying cancer patients. This was a randomized controlled trial, in which 200 family caregivers of dying cancer patients were randomly assigned to four intervention groups: family-based dignity intervention (n = 50), expressive writing intervention (n = 50), combined family-based single dignity intervention and expressive writing (n = 50), and control group (n = 50). In three times (baseline, 1 week, and 2 weeks after the interventions), anticipatory grief was assessed by a 13-item anticipatory grief scale (AGS). Finally, we found a significant reducing effect of family-based dignity intervention on AGS (-8.12 ± 1.53 vs. -1.57 ± 1.52, P = 0.01) and its subscales including behavioral (-5.92 ± 0.97 vs. -2.17 ± 0.96, P = 0.04) and emotional (-2.38 ± 0.78 vs. 0.68 ± 0.77, P = 0.03) subscales compared to the control group. However, no significant effect was seen for expressive writing intervention and combined interventions of expressive writing and family-based dignity intervention. In conclusion, family-based dignity intervention may be a safe intervention for relieving anticipatory grief among family caregivers of dying cancer patients. Additional clinical trials are needed to confirm our findings. Registration number: IRCT20210111050010N1. Trial registration date:2021-02-06.
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"Attempting to protect self and patient:" A grounded theory study of error recovery by intensive care nurses. Nurs Open 2023. [PMID: 36915234 DOI: 10.1002/nop2.1719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 08/23/2022] [Accepted: 02/17/2023] [Indexed: 03/16/2023] Open
Abstract
AIM The aim of this study was to explore the process of error recovery (ER) by nurses in intensive care unit (ICU). DESIGN This qualitative study was conducted in 2018-2020 using the grounded theory methodology. METHODS Participants were 20 staff nurses, head nurses and nursing managers recruited from the ICUs. Sampling was started purposively and continued theoretically. Data were collected using semi-structured interviews and were analysed using the approach proposed by Corbin and Strauss. RESULTS The findings indicated that nurses' primary concern was for the patient and their own personal/professional identity. Five strategies were found including evaluating situation, identifying error, analysing error and situation, determining the agent for error correction, and reducing error effects. Contextual factors were also highlighted as being important in the error recovery. Attempting to protect self and patient" was the core category of the study. Nurses' concern about protecting patient life and their own personal/professional identity make them use unprofessional approaches for ER.
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Exploring family caregiver challenges in caring for patients with COVID-19 in intensive care units. Front Public Health 2023; 11:1057396. [PMID: 36969646 PMCID: PMC10034162 DOI: 10.3389/fpubh.2023.1057396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/20/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundFamilies of individuals hospitalized in an intensive care unit (ICU) with severe illnesses, such as COVID-19, are experiencing a range of physical and emotional stressors. Identifying the challenges faced by family members and providing support to loved ones battling life-threatening diseases can lead to improved treatment and care for the said family members in a healthcare setting.AimThe current study was conducted to explore and understand the experiences of family caregivers caring for their loved ones battling COVID-19 in an ICU.MethodsThis descriptive qualitative study was conducted from January 2021 to February 2022, based on the experiences of 12 family caregivers of patients with COVID-19 hospitalized in the ICU. Data collection was conducted through purposeful sampling using semi-structured interviews. MAXQDA10 software was used for data management, and conventional content analysis was used for qualitative data analysis.ResultsThe present study conducted interviews with caregivers to understand their experiences while caring for a loved one in an ICU. Three main themes emerged from the analysis of these interviews: hardship of care trajectory, pre-loss mourning, and contributing factors in resolving family health crises. The first theme, the hardship of care trajectories, encompasses categories such as immersion in the unknown, lack of care facilities, negligence in care, neglect of families by healthcare providers, self-ignorance, and perceived stigma. The second these was pre-loss mourning that included some categories such as emotional and psychological turmoil, witnessing the exhaustion of loved ones, separation suffering, the fearing of loss, anticipatory grief, blame related to the disease causative agents, and perceived helplessness and despair. The third theme was contributing factors in resolving family health crises that included categories of the critical role of family caregivers in health engagement, the role of healthcare professionals in health engagement, and the role of interpersonal factors in health engagement. A total of 80 subcategories were also obtained based on the experiences of the family caregivers.ConclusionThis study's findings indicate that families can play an important role in resolving their loved ones' health problems in life-threatening situations such as the COVID-19 pandemic. Moreover, healthcare providers must recognize and prioritize family-based care and trust the families' ability to effectively manage health crises. Healthcare providers should also be attentive to the needs of both the patient and their family members.
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2022 Canadian Surgery Forum Sept. 15–17, 202201. Operative classification of ventral abdominal hernias: new and practical classification02. Watchful waiting for large primary splenic cysts03. Transversus abdominis plane (TAP) blocks with and without dexamethasone in colorectal surgery04. What factors determine publication of resident research day projects?05. Characterization of near-infrared imaging and indocyanine green use amongst general surgeons06. Variation in opioid prescribing after outpatient breast surgery: Time for a streamlined approach?07. Trends in graduate degree types and research output for Canadian academic general surgeons08. Would you prefer to undergo breast-conserving therapy or a mastectomy for early breast cancer? Comparison of perceptions of general and plastic surgeons09. Lack of representation of women and BIPOC individuals in Canadian academic surgery10. Medical student interest and perspectives on pursuing surgical careers: a multicentre survey evaluating 5-year trends11. Difficult cholecystectomy with cholecystogastric fistula12. Surviving nonsurvivable injuries: patients who elude the “lethal” Abbreviated Injury Scale (AIS) score of six13. Gunshot wounds sustained during legal intervention v. those inflicted by civilians: a comparative analysis14. The impact of delayed time to first head CT on functional outcomes after blunt head trauma with moderately depressed GCS15. Contemporary utility of diagnostic peritoneal aspiration in trauma16. Impact of delayed time to first head CT in traumatic brain injury17. Radiologic predictors of in-hospital mortality after traumatic craniocervical dissociation18. Measurement properties of a patient-reported instrument to evaluate functional status after major surgery19. The safety of venous thromboembolism chemoprophylaxis use in endoscopic retrograde cholangiopancreatography20. Characterizing Canadian rural surgeons: trends over time and 10-year replacement needs21. Contextual interference for skills development and transfer in laparoscopic surgery: a randomized controlled trial22. Evaluating the accuracy and design of visual backgrounds in academic surgical journals23. Defining rural surgery in Canada24. Validity of video-based general and procedure-specific self-assessment tools for surgical trainees in laparoscopic cholecystectomy25. Examining the equity and diversity characteristics of academic general surgeons in Canada26. Video-based coaching for surgical residents: a systematic review and meta-analysis27. Very-low-energy diets prior to nonbariatric surgery: a systematic review and meta-analysis28. Factors associated with resident research success: a descriptive analysis of Canadian general surgery trainees29. Global surgery pilot curriculum in Canadian undergraduate medical education: a novel approach30. How useful is ultrasound in predicting surgical findings of “mild cholecystitis”?31. Implementing a colorectal surgery “virtual hospital”: description of a novel outpatient care pathway to advance surgical care32. Trends in training and workforce planning for Canadian pediatric surgeons: a 10-year model33. Patient perspectives on intraoperative blood transfusion: results of semistructured interviews with perioperative patients34. Understanding intraoperative transfusion decision-making variability: a qualitative study using the Theoretical Domains Framework35. Effectiveness of preoperative oscillating positive expiratory pressure (OPEP) therapy in reduction of postoperative respiratory morbidity in patients undergoing surgery: a systematic review37. Accuracy of point-of-care testing devices for hemoglobin in the operating room: a systematic review and meta-analysis38. Opioid-free analgesia after outpatient general surgery: a qualitative study focused on the perspectives of patients and clinicians involved in a pilot trial39. The impact of the COVID-19 pandemic on general surgery residency: an analysis of operative volumes by residents at a Canadian general surgery residency program40. Postoperative care protocols for elderly emergency surgical patients: a quality improvement initiative42. Adverse events following robotic compared to laparoscopic and open surgery: a population-based analysis43. Is accrual higher for patients randomized to pragmatic v. exploratory randomized clinical trials? A systematic review and meta-analysis44. Effect of preoperative proton-pump inhibitor use on postoperative infectious and renal complications after elective general surgery45. The early burden of COVID-19 in emergency general surgery care across Canada46. Laparoscopic subtotal cholecystectomy for the difficult gallbladder: evolution of technique at a single teaching hospital and retrospective review47. The demand for emergency general surgery in Canada: a public health crisis48. Attitudes of Canadian general surgery staff and residents toward point-of-care ultrasound49. Psychological impact of COVID-19 on Canadian surgical residents50. Validation of an artificial intelligence platform for the guidance of safe laparoscopic cholecystectomy51. Predictors of recurrent appendicitis after nonoperative management: a prospective cohort study52. The effect of the first wave of the COVID-19 pandemic on colorectal and hepatobiliary oncologic outcomes at a tertiary care centre53. Trends in training and workforce representation for Canadian general surgeons working in critical care: a descriptive study54. White presentation: teaching safe opioid prescription and opioid use disorder management in Canadian universities56. How bad is really bad, eh? Impact of the first wave of the COVID-19 pandemic on residents’ operative volume: the experience of a Canadian general surgery program57. Surgeon-specific encounters within a multidisciplinary care pathway: Is there a role for shared care models in surgery?59. A pan-Canadian analysis of approach to treatment for acute appendicitis60. Appendix neoplasm stratified by age: understanding the best treatment for appendicitis61. Predicting acute cholecystitis on final pathology to prioritize surgical urgency: an evaluation of the Tokyo criteria and development of a novel predictive score62. Obesity is an independent predictor of acute renal failure after surgery64. Validation of a clinical decision-making assessment tool in general surgery65. Moral distress in the provision of palliative care delivery for surgical patients in British Columbia: lessons learned from the perspectives of general surgeons66. Delays in presentation and severity of illness predict adverse surgical outcomes among patients transferred from rural Indigenous communities for acute care surgery67. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial68. Modified Delphi consensus on appropriate use of laboratory investigations in acute care surgery patients72. Impacts of inpatient food at a tertiary care centre on patient satisfaction, nutrition and planetary health73. Racial disparities in health outcomes for oncological surgery in Canada75. Risk of recurrent laryngeal nerve injury from thyroidectomy is lower when intraoperative nerve monitoring (IONM) is used: an analysis of 17 688 patients from the NSQIP database01. The impact of the COVID-19 pandemic on non-smallcell lung cancer pathologic stage and presentation02. Screening criteria evaluation for expansion in pulmonary neoplasias (screen)03. Robotic-assisted lobectomy for early-stage lung cancer provides better patient-reported quality of life than video-assisted lobectomy: early results of the RAVAL trial04. Breathe Anew: designing and testing the feasibility of a novel intervention for lung cancer survivorship05. Learning objectives for thoracic surgery: developing a national standard for undergraduate medical education06. Plasma cell-free DNA as a point-of-care well-being biomarker for early-stage non-small-cell lung cancer patients07. Sarcopenia determined by skeletal muscle index predicts overall survival, disease-free survival and postoperative complications in resectable esophageal cancer: a systematic review and meta-analysis08. The short- and long-term effects of open v. minimally invasive thymectomy in myasthenia gravis patients: a systematic review and meta-analysis09. Optimizing opioid prescribing practices following minimally invasive lung resections through a structured quality improvement process10. Effects of virtual postoperative postdischarge care in patients undergoing lung resection during the COVID-19 pandemic11. Initiating Ethiopia’s first minimally invasive surgery program: a novel approach for collaborations in global surgical education12. Patient outcomes following salvage lung cancer surgery after definitive chemotherapy or radiation13. Replacing chest X-rays after chest tube removal with clinical assessment in postoperative thoracic surgery patients14. Updating the practice of thoracic surgery in Canada: a survey of the Canadian Association of Thoracic Surgeons15. The impact of COVID-19 on the diagnosis and treatment of lung cancer16. Development of a prediction model for survival time in esophageal cancer patients treated with resection17. The development and validation of a mixed reality thoracic surgical anatomy atlas18. Routine placement of feeding tubes should be avoided in esophageal cancer patients undergoing surgery19. Nodal count is no different during robotic segmentectomy compared with robotic lobectomy20. Point-of-care ultrasound-guided percutaneous biopsy of solid masses in the thoracic outpatient clinic: a safe, high-yield procedure to accelerate tissue diagnosis for patients with advanced thoracic malignancy21. Sarcopenia and modified frailty index are not associated with adverse outcomes after esophagectomy for esophageal cancer: a retrospective cohort study22. Near-infrared-guided segmental resection for lung cancer: an analysis of the learning curve23. Routine use of feeding jejunostomy tubes in patients undergoing esophagectomy for esophageal malignancy is safe and associated with low complication rates01. Ghost ileostomy versus loop ileostomy following total mesorectal excision for rectal cancer: a systematic review and meta-analysis02. Analysis of 100 consecutive colorectal cancers presenting at a Canadian tertiary care centre: delayed diagnosis and advanced disease03. Clinical delays and comparative outcomes in younger and older adults with colorectal cancer: a systematic review04. Recurrence rates of rectal cancer after transanal total mesorectal excision (taTME): a systematic review and meta-analysis05. Transanal total mesorectal excision for abdominoperineal resection (taTME-APR) is associated with poor oncological outcomes in rectal cancer patients: a word of caution from a multicentric Canadian cohort study06. Association between survival and receipt of recommended and timely treatment in locally advanced rectal cancer: a population-based study07. Trends and the impact of incomplete preoperative staging in rectal cancer08. Postoperative outcomes after elective colorectal surgery in patients with cirrhosis09. Bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a multicentre, single-blinded, randomized controlled trial10. Recurrence following perineal rectosigmoidectomy ( Altemeier) with levatorplasty: a systematic review and meta-analysis11. Nonmodifiable risk factors and receipt of surveillance investigations following treatment of rectal cancer12. Safety and effectiveness of endoscopic full-thickness resection for the management of colorectal lesions: a systematic review and meta-analysis13. Impact of preoperative carbohydrate loading before colectomy: a systematic review and meta-analysis of randomized controlled trials14. Statin therapy in patients undergoing short-course neoadjuvant radiotherapy for rectal cancer15. Feasibility of targeted lymphadenectomy during complete mesocolic excision for colon cancer using indocyanine green immunofluorescence lymphatic mapping16. Feasibility of expanding an ambulatory colectomy protocol: a retrospective analysis of early discharge following minimally invasive colectomy in an enhanced recovery pathway17. Impact of rectal cancer on bowel dysfunction before treatment and its relationship with post-treatment function18. Canadian cost–utility analysis of artificial-intelligence-assisted colonoscopy for adenoma detection in fecal immunochemical-based colorectal cancer screening19. A comparison of outcomes following intracorporeal and extracorporeal anastomotic techniques in laparoscopic right colectomies20. Assessment of metabolic signatures using desorption electrospray ionization mass spectrometry (DESI) and rapid evaporative ionization mass spectrometry (REIMS) of rectal cancer samples to assist in determining treatment response21. The association between hospital characteristics and minimally invasive rectal cancer surgery: a population-based study22. Cancer centre level designation and the impact on treatment and outcomes in those with rectal cancer: a population-based study23. Oncological outcomes after colorectal cancer in patients with liver cirrhosis: a systematic review and meta-analysis24. Optimal preoperative nutrition for penetrating Crohn disease: a systematic review and meta-analysis25. Lymph node ratio as a predictor of survival for colon cancer: a systematic review and meta-analysis26. Barriers and facilitators for use of new recommendations for optimal endoscopic localization of colorectal neoplasms according to gastroenterologists and surgeons27. Emergency colorectal surgery in patients with cirrhosis: a population-based descriptive study28. Local recurrence rates and associated risk factors after transanal endoscopic microsurgery for benign polyps and adenocarcinomas29. Bowel dysfunction impacts mental health after restorative proctectomy for rectal cancer30. Evolution of psychological morbidity following restorative proctectomy for rectal cancer: a systematic review and meta-analysis31. Frailty predicts LARS and quality of life in rectal cancer survivors after restorative proctectomy32. Low anterior resection syndrome in a reference North American population: prevalence and predictive factors33. The evolution of enhanced recovery: same day discharge after laparoscopic colectomy34. Effect of ERAS protocols on length of stay after colorectal surgery: an interrupted time series analysis35. Practice patterns and outcomes in individuals with cirrhosis and colorectal cancer: a population-based study36. Understanding the impact of bowel function on quality of life after rectal cancer surgery37. Right-sided colectomies for diverticulitis have worse outcomes compared with left-sided colectomies38. Symptom burden and time from symptom onset to cancer diagnosis in patients with early-onset colorectal cancer39. The impact of access to robotic rectal surgery at a tertiary care centre: a Canadian perspective40. Management of rectal neuroendocrine tumours by transanal endoscopic microsurgery41. The gut microbiota modulates colorectal anastomotic healing in patients undergoing surgery for colorectal cancer42. Is there added risk of complications for concomitant procedures during an ileocolic resection for Crohn disease?43. Cost of stoma-related hospital readmissions for rectal cancer patients following restorative proctectomy with a diverting loop ileostomy: a nationwide readmissions database analysis44. Older age associated with quality of rectal cancer care: an ACS-NSQIP database study45. Outcomes of patients undergoing elective bowel resection before and after implementation of an anemia screening and treatment program47. Loop ileostomy closure as a 23-hour stay procedure: a randomized controlled trial48. Extended duration perioperative thromboprophylaxis with low-molecular-weight heparin to improve disease-free survival following surgical resection of colorectal cancer: a multicentre randomized controlled trial (PERIOP-01 Trial)49. Three-stage versus modified 2-stage ileal pouch anal anastomosis: perioperative outcomes, function and quality of life50. Compliance with extended venous thromboembolism prophylaxis in rectal cancer51. Extended-duration venous thromboembolism prophylaxis after diversion in rectal cancer52. Financial and occupational impact of low anterior resection syndrome: a qualitative study53. Nonoperative management for rectal cancer: patient perspectives54. Trends in ileostomy-related emergency department visits for rectal cancer patients55. Long-term implications of treatment of fecal incontinence: a single Canadian centre’s retrospective cohort study: a 17-year follow-up56. Externally benchmarking colorectal resection outcomes in our province against the ACS NSQIP risk calculator: identifying opportunities for improvement57. Externally benchmarking our provincial colectomy outcomes against the ACS NSQIP using the Codman Score: to identify possible opportunities for improvement of outcomes58. Rural v. urban documentation of recommended practices for optimal endoscopic colorectal lesion localization01. Incidence of in-hospital opioid use and pain after inguinal hernia repair02. Ventral hernia repair following liver transplantation: outcome of repair techniques and risk factors for recurrence01. Impact of the COVID-19 pandemic on bariatric surgery in North America: a retrospective analysis of 834 647 patients02. Patient selection and 30-day outcomes of SADI-S compared to RYGB: a retrospective cohort study of 47 375 patients03. New persistent opioid use following bariatric surgery: a systematic review and pooled proportion meta-analysis04. Bariatric surgery should be offered to active-duty military personnel: a retrospective study of the Canadian Armed Forces experience05. Opioid prescribing practices and use following bariatric surgery: a systematic review and pooled summary of data06. Sacred sharing circles: urban Indigenous Manitobans’ experiences with bariatric surgery07. Gastrogastric hernia after laparoscopic gastric great curve plication: a video presentation08. Characterization of comorbidities predictive of bariatric surgery09. Efficacy of preoperative high-dose liraglutide in patients with superobesity10. The effect of linear stapled gastrojejunostomy size in Roux-en-Y gastric bypass11. Fragility of statistically significant outcomes in randomized trials comparing bariatric surgeries12. Weight loss outcomes for patients undergoing conversion to Roux-en-Y gastric bypass after sleeve gastrectomy13. Are long waiting lists for bariatric surgery detrimental to patients? A single-centre experience14. Does upper gastrointestinal swallow study after bariatric surgery lead to earlier detection of leak?15. Pharmaceutical utilization before and after bariatric surgery16. Same-day discharge Roux-en-Y gastric bypass at a Canadian bariatric centre: pathway implementation and early experiences17. Safety and efficiency of performing primary bariatric surgery at an ambulatory site of a tertiary care hospital: a 5-year experience18. Impact of psychiatric diagnosis on weight loss outcomes 3 years after bariatric surgery19. Ursodeoxycholic acid (UDCA) for prevention of gallstone disease after laparoscopic sleeve gastrectomy (LSG): an Atlantic Canada perspective20. Fecal microbial transplantation and fibre supplementation in patients with severe obesity and metabolic syndrome: a randomized double-blind, placebo-controlled phase 2 trial01. Incidence, timing and outcomes of venous thromboembolism in patients undergoing surgery for esophagogastric cancer: a population-based cohort study04. Omission of axillary staging and survival in elderly women with early-stage breast cancer: a population-based cohort study05. Patients’ experiences receiving cancer surgery during the COVID-19 pandemic: a qualitative study06. Cancer surgery outcomes are better at high-volume centres07. Attitudes of Canadian colorectal cancer care providers toward liver transplantation for colorectal liver metastases: a national survey08. Quality of narrative central and lateral neck dissection reports for thyroid cancer treatment suggests need for a national standardized synoptic operative template09. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications and technique10. Temporal trends in lymph node assessment as a quality indicator in colorectal cancer patients treated at a high-volume Canadian centre11. Molecular landscape of early-stage breast cancer with nodal metastasis12. Beta testing of a risk-stratified patient decision aid to facilitate shared decision making for postoperative extended thromboprophylaxis in patients undergoing major abdominal surgery for cancer13. Breast reconstruction use and impact on oncologic outcomes among inflammatory breast cancer patients: a systematic review14. Association between patient-reported symptoms and health care resource utilization: a first step to develop patient-centred value measures in cancer care15. Complications after colorectal liver metastases resection in Newfoundland and Labrador16. Why do patients with nonmetastatic primary retroperitoneal sarcoma not undergo resection?17. Loss of FAM46Cexpression predicts inferior postresection survival and induces ion channelopathy in gastric adenocarcinoma18. Liver-directed therapy of neuroendocrine liver metastases19. Neoadjuvant pembrolizumab use in microsatellite instability high (MSI-H) rectal cancer: benefits of its use in lynch syndrome20. MOLLI for excision of nonpalpable breast lesions: a case series22. Patients awaiting mastectomy report increased depression, anxiety, and decreased quality of life compared with patients awaiting lumpectomy for treatment of breast cancer23. Is microscopic margin status important in retroperitoneal sarcoma (RPS) resection? A systematic review and meta-analysis24. Absence of benefit of routine surveillance in very-low-risk and low-risk gastric gastrointestinal stromal tumors25. Effect of intraoperative in-room specimen radiography on margin status in breast-conserving surgery26. Active surveillance for DCIS of the breast: qualitative interviews with patients and physicians01 Outcomes following extrahepatic and intraportal pancreatic islet transplantation: a comparative cohort study02. Cholang-funga-gitis03. Evaluating the effect of a low-calorie prehepatectomy diet on perioperative outcomes: a systematic review and meta-analysis04. Toxicity profiles of systemic therapy for advanced hepatocellular carcinoma: a systematic review to guide neoadjuvant trials05. Should cell salvage be used in liver resection and transplantation? A systematic review and meta-analysis06. The association between surgeon and hospital variation in use of laparoscopic liver resection and short-term outcomes07. Systematic review and meta-analysis of prognostic factors for early recurrence in intrahepatic cholangiocarcinoma after curative-intent resection08. Impact of neoadjuvant chemotherapy on postoperative outcomes of patients undergoing hepatectomy for intrahepatic cholangiocarcinoma: ACS-NSQIP propensity-matched analysis09. The impact of prophylactic negative pressure wound therapy on surgical site infections in pancreatic resection: a systematic review and meta-analysis10. Does hepatic pedicle clamping increase the risk of colonic anastomotic leak after combined hepatectomy and colectomy? Analysis of the ACS NSQIP database11. Development of a culture process to grow a full-liver tissue substitute12. Liver transplantation for fibrolamellar hepatocellular carcinoma: an analysis of the European Liver Transplant Registry13. Arming beneficial viruses to treat pancreatic cancer14. Hepaticoduodenostomy versus hepaticojenunostomy for biliary reconstruction: a retrospective review of a single-centre experience15. Feasibility and safety of a “shared care” model in complex hepatopancreatobiliary surgery: a 5-year analysis of pancreaticoduodenectomy16. Laparoscopic v. open pancreaticoduodenectomy: initial institutional experience and NSQIP-matched analysis17. Laparoscopic spleen-preserving distal pancreatectomy: Why not do a Warshaw?18. The impact of COVID-19 on pancreaticoduodenectomy outcomes in a high-volume hepatopancreatobiliary centre19. Transitioning from open to minimally invasive pancreaticoduodenectomy: the learning curve factor in an academic centre20. Closed-incision negative-pressure wound therapy following pancreaticoduodenectomy for prevention of surgical site infections in high-risk patients21. Robotic Appleby procedure for recurrent pancreatic cancer22. The influence of viral hepatitis status on posthepatectomy complications in patients with hepatocellular carcinoma: a NSQIP analysis. Can J Surg 2022. [DOI: 10.1503/cjs.014322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Psychometric evaluation of Persian version of Diabetes Acceptance Scale (DAS). BMC Endocr Disord 2022; 22:225. [PMID: 36076182 PMCID: PMC9461147 DOI: 10.1186/s12902-022-01123-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/05/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Acceptance of diabetes is a psychological adaptation to the potential limitations of the disease. Poor acceptance of diabetes impairs effective self-management of diabetes, leading to worsening metabolic control. This study aimed at determining the psychometric properties of the Persian version of the Diabetes Acceptance Scale. METHODS This cross-sectional methodological study was performed on diabetic patients in Iran in 2021. The questionnaire consisted of two parts: demographic characteristics and Diabetes Acceptance Scale. The questionnaire was translated into Persian through the forward-backward translation method. The face validity and content validity were performed qualitatively and quantitatively. Exploratory (n = 200) and confirmatory (n = 200) factor analysis were performed to evaluate the validity of the structure. Internal consistency and temporal stability were estimated to determine reliability. RESULTS Exploratory factor analysis on the polychoric correlation matrix obtained three factors: Rational dealing, Resentment and Avoidance, which explained 68.8% of the total DAS variance. Confirmatory factor analysis showed that the 3-fractor model had a good fit to a second independent data set. Finally, Ordinal Cronbach's alpha coefficient was 0.96, 0.94 and 0.93, respectively for the Rational dealing, Resentment, and Avoidance factor. Also, using intraclass correlation coefficient, the stability of the instrument was 0.97. CONCLUSION Based on the findings of this study, the Persian version of DAS has sufficient validity and reliability to measure the admission of Iranian diabetic patients.
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Implementation of a nursing rehabilitation model to improve quality of life of patients with hand burns: A randomized clinical trial. Eur J Transl Myol 2022; 32:10650. [PMID: 36036351 PMCID: PMC9830405 DOI: 10.4081/ejtm.2022.10650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 01/13/2023] Open
Abstract
Burn is known as a life-threatening event in people's lives, causing numerous physical, psychological, and social harms and negatively affecting patients' quality of lives. This study was designed to evaluate the effectiveness of implementing a nursing rehabilitation model in improving the quality of life of people with hand burns. This was a randomized clinical trial conducted on 60 burn patients admitted to the Shahid Motahari Hospital, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran in 2021. The patients were randomly allocated into two groups of intervention and control (n = 30 per group). The participants of the intervention group received a 5-week nursing rehabilitation program in two phases: at the acute phase (admission) and the recovery phase (before discharge). Data were collected using the Burns Specific Health Scale Brief (BSHS-B) questionnaire before each phase. The quality of life (Qol) - was significantly different comparing the two groups before the intervention (p = 0.042). Covariance analysis showed that after the intervention, the mean quality of life score was significantly higher in the intervention than the control group, indicating a better Qol in the recent group (p <0.001). In the control group, the mean score of Qol was not significantly different before and after the intervention; however, this difference was statistically significant in the intervention group (p = 0.001). The implementation of the nursing rehabilitation model improved the Qol of patients with hand burns. So, this model seems to be an appropriate and effective strategy to accelerate the rehabilitation of patients with hand burns and their return to society.
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Challenges of type 2 diabetes mellitus (T2DM) management from the perspective of patients: A conventional content analysis (Preprint). Interact J Med Res 2022; 11:e41933. [PMID: 36301605 PMCID: PMC9650573 DOI: 10.2196/41933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/01/2022] [Accepted: 09/23/2022] [Indexed: 11/28/2022] Open
Abstract
Background Patients with type 2 diabetes mellitus (T2DM) face significant challenges in the treatment process, which can have a negative impact on disease management. Proper management of the disease can reduce symptoms and complications, improve glycemic indices, and reduce mortality and readmission. Objective Given the influential role of patients in prevention and self-care, this study was conducted to explore the challenges of diabetes management from the perspective of patients. Methods Two rounds of focus group discussions with T2DM patients were conducted. The principal investigator of the study and a research assistant compiled a list of volunteer patients with names and contact information and selected participants based on their medical information. Participants were chosen via a purposive sampling technique. The questions were designed to encourage patients to share their views on how the treatment team communicates and participates in treatment, how they are trained, and the health care system. The discussion continued until data saturation. During 2 rounds of focus group discussions, the voices of the participants were recorded by 2 voice recorders, and one of the team members was a transcriber. After discussion, participant views were transcribed, and common issues were identified, sorted, and reported as categories and subcategories. Results According to the conventional content analysis, 88 primary codes were extracted from the detailed and in-depth description of the participants. The codes were summarized after repeated readings and classified based on their similarities and semantic relevance. Through analysis and comparison, 4 categories and 7 subcategories were identified: communication challenges (poor medical staff communication, lack of psychological support), challenges to participation in treatment (lack of patient participation), educational challenges (training program bugs, inadequate training), and challenges of the health care system (inefficiency of the care system, caregiver inefficiency). Conclusions This study showed that the treatment team members should pay more attention to the challenges of care and treatment from the perspective of patients with T2DM. Therefore, recommendations for future policies to overcome these obstacles include establishing a multidisciplinary health care team; using trained health care workers to provide organized treatment and care services; holding individual counseling sessions with patients in need of counseling; and providing counseling services, involving patients in the treatment and self-care process, and designing a comprehensive diabetes education program with an emphasis on education. Necessary information should be provided to the patients, and effective communicate should address patient concerns.
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Iranian Nurses’ Perception of Factors Contributing to Medical Errors in Intensive Care Unit: A Qualitative Study. ACTA MEDICA IRANICA 2022. [DOI: 10.18502/acta.v60i3.9005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Patient safety is a major health concern throughout the world, and medical errors are the most important factor threatening patient safety, especially in the Intensive Care Unit (ICU). To prevent errors and improve patient safety, it is necessary to identify the underlying causes of error from the perspective of nurses working in ICUs. This study aimed to explore nurses’ experiences of factors contributing to medical errors in the Intensive Care Unit. The present qualitative study was conducted using conventional content analysis. The participants included 17 nurses working in ICUs in two educational hospitals affiliated with the Iran University of Medical Sciences in Tehran. Data were collected using in-depth semi-structured interviews and were analyzed through the conventional content analysis approach based on Graneheim and Lundman's model. Four main categories (a) extra-organizational challenges; (b) Organizational position; (c) The specificity of the care environment, (d) Individual reason and nine subcategories: (accreditation problems, non-native care standards, organizational management, organizational Features, critical condition of patients, physical structure of unit, neglect in the process of care, lack of clinical knowledge and experience, and physical and psychological problems) were identified. From the nurses' perspective, a series of factors associated with the health system, the organization, the ICUs, and the individual play a role in the occurrence of errors; therefore, it is necessary for planners, policy-makers, nursing managers to think about these underlying factors and with in-service training, and a positive, supportive atmosphere; lead nurses to support the patient and improve patient safety.
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The effects of interactive E-learning on delirium recognition ability and delirium-related strain of care among critical care nurses. J Intensive Care Soc 2022; 23:44-52. [PMID: 37593534 PMCID: PMC10427842 DOI: 10.1177/1751143720972627] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
Background Nursing care for patients with delirium is very complex and stressful and is associated with considerable care strain for nurses. Delirium recognition is the first step to the prevention and management of delirium and reduction of strain of care. Education is one of the strategies for improving nurses' delirium recognition ability. Objectives This study aimed to evaluate the effects of interactive E-learning on delirium recognition ability and delirium-related strain of care among critical care nurses. Methods This quasi-experimental study was conducted in 2019 using a two-group pretest-posttest design. Participants were 98 critical care nurses recruited through a census from two hospitals in Iran. They were non-randomly allocated to an intervention and a control group. Study intervention was an interactive E-learning program with four parts on delirium, its prevention, its treatment, and its diagnostic and screening procedures. The program was uploaded on a website and its link was provided to participants in the intervention group. Before and two months after the intervention, data were collected using the Strain of Care for Delirium Index and five case vignettes. For data analysis, the Chi-square, Fisher's exact, independent-sample t, and paired-sample t tests were performed usingthe SPSS software (v. 16.0). Findings Groups did not significantly differ from each other regarding the pretest mean scores of delirium recognition ability and strain of care. After the intervention, the mean score of delirium recognition ability in the intervention group was significantly greater and the mean score of strain of care was significantly lower than the control group (P < 0.05). Conclusion Interactive E-learning is effective in significantly improving critical care nurses' delirium recognition ability and reducing their strain of care. As nurses' heavy workload and limited free time are among the main barriers to their participation in face-to-face educational programs, interactive E-learning can be used for in-service education.
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The effect of pulsatile versus non-pulsatile flow during cardiopulmonary bypass on cerebral oxygenation: A randomized trial. Asian Cardiovasc Thorac Ann 2021; 30:441-448. [PMID: 34904903 DOI: 10.1177/02184923211045915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The present study aims to compare regional oxygen supply determined by Near-Infrared Spectroscopy in the course of pulsatile perfusion with non-pulsatile perfusion during cardiopulmonary bypass in patients undergoing valvular heart surgery. METHODS In this prospective randomized single-blinded trial, we enrolled adult subjects aged 18-65 years scheduled for elective valvular heart repair/replacement surgery with non-stenotic carotid arteries, employing a consecutive sampling method. Eligible patients were then randomly assigned in a 1:1 ratio to pulsatile or non-pulsatile perfusion during aortic cross-clamp. The primary outcome was regional cerebral oxygenation monitored by Near-Infrared Spectroscopy in each group. RESULTS Seventy patients were randomly assigned, and each group comprised 35 patients. Mean age was 46.8 and 46.5 years in pulsatile and non-pulsatile groups, respectively. There were no significant between-group differences in regional cerebral oxygen saturation at different time points of cardiopulmonary bypass (p-value for analysis of variance repeated measures: 0.923 and 0.223 for left and right hemispheres, respectively). Moreover, no significant differences in regional cerebral oxygen saturation levels from baseline between pulsatile and non-pulsatile groups at all desired time points for the left (p = 0.51) and right (p = 0.22) hemispheres of the brain were detected. CONCLUSION Pulsatile perfusion during cardiopulmonary bypass does not offer superior regional cerebral oxygenation measured by Near-Infrared Spectroscopy than non-pulsatile perfusion during cardiopulmonary bypass. Nonetheless, the efficacy of pulsatile flow in the subgroup of patients in whom cerebral blood flow is impaired due to carotid artery stenosis needs to be explored and evaluated by this method in future studies.
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Hypertension and pre-hypertension in Middle East and North Africa (MENA): A meta-analysis of prevalence, awareness, treatment, and control. Curr Probl Cardiol 2021; 47:101069. [PMID: 34843808 DOI: 10.1016/j.cpcardiol.2021.101069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/11/2021] [Accepted: 11/21/2021] [Indexed: 01/03/2023]
Abstract
Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact prevalence of prehypertension (pre-HTN) and HTN in the Middle East and North Africa (MENA) is lacking. This meta-analysis was conducted to evaluate prevalence of pre-HTN and HTN, awareness, treatment, and control in the MENA region. PubMed, Web of Science, and Scopus databases were searched from inception to April 30, 2021. Keywords included hypertension, pre-hypertension, awareness, treatment, and control. The quality of the included studies was evaluated using the Hoy scale. A random-effects model was evaluated based on overall HTN. The heterogeneity of the preliminary studies was evaluated using the I2 test. A total of 147 studies involving 1,312,244 participants were included in the meta-analysis. Based on the results of the random-effects method (95% CI), the Prevalence of pre-HTN and HTN were 30.6% (95% CI: 25.2, 36.0%; I2 = 99.9%), and 26.2% (95% CI: 24.6, 27.9%; I2 = 99.8%), respectively. The prevalence of HTN awareness was 51.3% (95% CI: 47.7, 54.8; I2 = 99.0%). The prevalence of HTN treatment was 47.0% (95% CI: 34.8, 59.2; I2 = 99.9%). The prevalence of HTN control among treated patients was 43.1% (95% CI: 38.3, 47.9; I2 = 99.3%). Considering the high prevalence of HTN, very low awareness, and poor HTN control in the region, more attention should be paid to preventive programs for HTN reduction.
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Effects of family-based dignity intervention and expressive writing on anticipatory grief of family caregivers of patients with cancer: a study protocol for a four-arm randomized controlled trial and a qualitative process evaluation. Trials 2021; 22:751. [PMID: 34711262 PMCID: PMC8552199 DOI: 10.1186/s13063-021-05718-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family caregivers of dying cancer patients are affected by grief experiences and bereavement complications. Several approaches such as psycho-emotional care and an increase in spirituality have been suggested to diminish these complications. However, the knowledge about the effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of dying cancer patients is limited. This is a study protocol describing a hospital-based mixed-methods study on the effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of dying cancer patients. METHODS This mixed-methods study will be done in an embedded explanatory design with two quantitative and qualitative phases. In the first phase (quantitative), a randomized clinical trial will be done, in which 200 family caregivers of dying cancer patients will be randomly assigned to one of the four groups: family-based single dignity intervention (group 1), expressive writing intervention (group 2), combined family-based single dignity intervention and expressive writing (group 3), and control (group 4). At baseline, 1 week and 2 weeks after the interventions, anticipatory grief will be assessed by a 13-item anticipatory grief scale. After the quantitative phase, the qualitative phase will be conducted through the conventional content analysis approach of Granheim and Lundman, in which an individual semi-structured interview will be taken from participants in the first phase to collect data on their experiences on interventions. Finally, data from the quantitative and qualitative phases will be analyzed and discussed. DISCUSSION Family caregivers of dying cancer patients usually experience depression, anxiety, and psychological distress due to isolation and inadequate social support. Psychological interventions such as dignity and expressive writing interventions may help caregivers to obtain a better understanding of themselves and to increase their abilities to cope with caregiving difficulties. Therefore, there is a need for a comprehensive study confirming the effects of mentioned interventions on family caregivers of dying cancer patients. TRIAL REGISTRATION Iranian Registry of Clinical Trials ( www.irct.ir ) identifier: IRCT20210111050010N1. Date of trial registration: Feb 6, 2021. This is the first version of this protocol.
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The Effects of E-Learning on Patient Safety Culture in Emergency Nurses. JOURNAL OF CLIENT-CENTERED NURSING CARE 2021. [DOI: 10.32598/jccnc.7.3.378.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Patient Safety (PS) is a priority for all healthcare organizations. Instilling best practices is necessary for PS improvement. This study assessed the effects of Electronic Learning (e-learning) on PS culture among emergency nurses and nursing managers. Methods: This quasi-experimental study was conducted in March-August 2020 using a two-group pre-test, post-test non-randomized design. The study subjects included 69 nurses who were selected from the emergency rooms and 20 nursing managers of two hospitals in Qazvin City, Iran. They were recruited to study through the census sampling method. They were non-randomly allocated to either e-learning or a comparison group. The comparison group received PS-related education through two 1.5-hour lectures on two consecutive days. The experimental group received PS training through a 15-part online course in two months. PS culture was assessed before and 3 months after initiating the intervention. The necessary data were collected through the self-report method using a demographic data questionnaire and the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire. The obtained data were analyzed by Chi-squared test, Fisher’s Exact test, Independent-Samples t-test, Paired-Samples t-test, and Analysis of Covariance (ANCOVA) in SPSS. Results: The pre-test mean score of PS culture in the e-learning group was significantly less than that in the comparison group (P=0.002). The mean score of PS culture significantly increased in both research groups after the intervention (P<0.05). Besides, the post-test mean score of PS culture in the e-learning group was significantly greater than that in the comparison group (P<0.001). Conclusion: E-Learning is more effective than conventional lecturing in improving PS culture among emergency nurses. This method is suggested to be used as an effective approach to PS culture improvement among emergency nurses.
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Home healthcare in Iran: A hybrid concept analysis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:196-203. [PMID: 34277369 PMCID: PMC8262539 DOI: 10.4103/ijnmr.ijnmr_198_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/21/2020] [Accepted: 02/23/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Healthcare is changing from a focus on acute care health issues to one of managing chronic conditions. This change has resulted in the development of home health-care systems as a way of managing chronic conditions outside the hospital. The aim of this study was to analyze the concept of home healthcare using a hybrid model. MATERIALS AND METHODS This hybrid concept analysis consisted of three phases: theoretical, fieldwork, and analytical. Science Direct, PubMed, ProQuest, and Scopus were searched with related terms in the theoretical phase. In the fieldwork phase, six professionals with experience in home healthcare were interviewed and after each interview, qualitative content analysis was conducted. During the final phase, descriptions and themes from the first two phases were combined. RESULTS In the theoretical phase, the definition of home healthcare included descriptions answering the Who, What, When, Where, and Why questions. In the fieldwork phase, the results were divided into three areas: 1-comprehensive care; 2-extent of services; and 3-outcomes. The final analysis phase of this study indicated that the home health-care concept is a comprehensive, professional, and holistic care system accompanied by medical services and professionals whose goals are to support an individual's health and provide care in their home. Healthcare provided in one's home was found to preserve a patient's dignity and reduce health-care costs. CONCLUSIONS The definition of the home healthcare concept establishes a foundation for developing a comprehensive home health-care system. This concept analysis for home healthcare could be a guide for future studies.
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The effect of a supportive home care program on caregiver burden with stroke patients in Iran: an experimental study. BMC Health Serv Res 2021; 21:346. [PMID: 33858400 PMCID: PMC8048267 DOI: 10.1186/s12913-021-06340-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 04/01/2021] [Indexed: 02/03/2023] Open
Abstract
Background Stroke can impose a heavy burden on caregivers. Caring for stroke patients at home is more challenging than in hospitals with facilities. The purpose of this study was to evaluate the effect of a supportive home care program on caregiver burden with stroke patients. Methods This was an experimental study. One hundred sixteen caregivers of stroke patients were recruited using convenience sampling from two university-affiliated hospitals in Tehran from June 2019 to February 2020. They were randomly allocated into two groups (supportive home care program and routine hospital education program) using a randomized block design. The supportive home care program included eight educational sessions delivered in the hospital before discharge, and with home visits after hospital discharge. Caregiver burden was measured using Caregiver Burden Inventory. The data were analyzed using independent samples t-test and Analysis of Covariance. Results Caregiver burden in the routine education group increased significantly after 2 weeks, from 52.27 ± 23.95 to 62.63 ± 22.68. The mean of caregiver burden scores in the supportive home care program decreased from 44.75 ± 17.21 to 40.46 ± 17.28. The difference between the scores of the two groups before the intervention was not significantly different (t = 1.941, df = 114, p = 0.055). There was a significant difference between the two groups regarding caregiver burden scores after the intervention period (η2 = 0.305, P < 0.001). Conclusions Caregiver burden increased significantly after the discharge without proper interventions in the caregivers of stroke patients. Providing support for home care providers can help to decrease or prevent the intensification of caregiver burden.
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The relationship between missed nursing care and teamwork in emergency nurses: A predictive correlational study. NURSING PRACTICE TODAY 2021. [DOI: 10.18502/npt.v8i2.5121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background & Aim: Missed nursing care can reduce nursing care quality by eliminating or delaying any aspect of the patient’s necessary nursing care. Teamwork has been a solution to improve the quality of care and safety of patients. The present study was conducted to determine the relationship between missed nursing care and emergency nurses’ teamwork in the educational-medical centers affiliated to Iran University of Medical Sciences in 2019.
Methods & Materials: This cross-sectional study is predictive correlational in nature. It was conducted on 213 nurses working in the emergency department who were selected based on the census method from March 2018 to December 2019. The self-report data were collected using Nursing Teamwork Survey and Missed Nursing Care questionnaires. The data were analyzed through conducting ANOVA, t-test, Pearson correlation, and multiple regression analysis in SPSS version 16.
Results: The mean score of missed nursing care in the emergency nurses was 2.25±0.65, and the nurses’ average teamwork was 3.53±0.55. There was a statistically significant yet inverse correlation between teamwork and missed nursing care (p<0.001) (r= -0.29). The determination coefficient of the multiple linear regression modeling was used to predict the missed nursing care based on the total teamwork score indicated that 14% of the missed nursing care was explained under the influence of independent variables.
Conclusion: Due to the inverse relationship between teamwork and missed nursing care, it is necessary to design and plan training courses to further enhance the nurses’ ability to perform teamwork and collaborative work.
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Effect of a Smartphone-Based App on the Quality of Life of Patients With Heart Failure: Randomized Controlled Trial. JMIR Nurs 2020; 3:e20747. [PMID: 34406971 PMCID: PMC8373375 DOI: 10.2196/20747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/18/2020] [Accepted: 10/02/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Patients with heart failure have low quality of life because of physical impairments and advanced clinical symptoms. One of the main goals of caring for patients with heart failure is to improve their quality of life. OBJECTIVE The aim of this study was to investigate the effect of the use of a smartphone-based app on the quality of life of patients with heart failure. METHODS This randomized controlled clinical trial with a control group was conducted from June to October 2018 in an urban hospital. In this study, 120 patients with heart failure hospitalized in cardiac care units were randomly allocated to control and intervention groups. Besides routine care, patients in the intervention group received a smartphone-based app and used it every day for 3 months. Both the groups completed the Minnesota Living with Heart Failure Questionnaire before entering the study and at 3 months after entering the study. Data were analyzed using the SPSS software V.16. RESULTS The groups showed statistically significant differences in the mean scores of quality of life and its dimensions after the intervention, thereby indicating a better quality of life in the intervention group (P<.001). The effect size of the intervention on the quality of life was 1.85 (95% CI 1.41-2.3). Moreover, the groups showed statistically significant differences in the changes in the quality of life scores and its dimensions (P<.001). CONCLUSIONS Use of a smartphone-based app can improve the quality of life in patients with heart failure. The results of our study recommend that digital apps be used for improving the management of patients with heart failure. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT2017061934647N1; https://www.irct.ir/trial/26434.
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The impact of social network-based nursing care training on oncology nurses’ occupational stress and self-efficacy: Non-randomized clinical trial. NURSING PRACTICE TODAY 2020. [DOI: 10.18502/npt.v8i1.4494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background & Aim: Inadequate clinical knowledge is one of the leading causes of stress and low occupational self-efficacy among nurses. Nursing training can enhance self-efficacy and reduce stress. Therefore, this study aimed to determine the effect of social network-based nursing care training, using mobile phones, occupational stress, and self-efficacy among oncology nurses.
Methods & Materials: This non-randomized clinical trial study was conducted on 78 nurses working in oncology wards of two selected educational hospitals in Tehran in 2018. The nurses entered the study through available sampling. They were randomly assigned to two groups of control and intervention. Nursing care training in chemotherapy was provided to the nurses in the intervention group through a mobile phone social network for four weeks. On the other hand, the nurses in the control group were provided with the routine training pamphlets and brochures in the oncology ward. The nurses’ stress level was examined using an expanded nursing stress scale and their occupational stress was measured using a job self-efficacy questionnaire once before the intervention and then one month after the intervention. The data analysis was then performed according to independent t-test, paired t-test, and chi-square using SPSS software version 16.
Results: The two groups were homogeneous in terms of age, gender, work experience, and education. There was no significant difference in terms of occupational stress and self-efficacy between the two groups before the intervention (P<0.05). The changes in the occupational stress score were statistically significant (P<0.05) among the nurses in the intervention group. Moreover, the changes in the occupational self-efficacy score were statistically significant among nurses in the intervention group compared to the control group (P<0.05).
Conclusion: Educational intervention through social networking can lead to a reduction of occupational stress and an increase in self-efficacy among oncology nurses. Reducing stress and increasing nurses’ occupational self-efficacy will improve their performance at the bedside. This is an easy, inexpensive, and effective training method that can be used by health managers and educators to enhance employee’s performance.
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Abstract
BACKGROUND Error communication includes both reporting errors to superiors and disclosing their consequences to patients and their families. It significantly contributes to error prevention and safety improvement. Yet, some errors in intensive care units are not communicated. OBJECTIVES The aim of the present study was to explore factors affecting error communication in intensive care units. DESIGN AND PARTICIPANTS This qualitative study was conducted in 2019. Participants were 17 critical care nurses purposively recruited from the intensive care units of 2 public hospitals affiliated to Iran University of Medical Sciences, Tehran, Iran. Data were collected through in-depth semi-structured interviews and were analyzed through the conventional content analysis method proposed by Graneheim and Lundman. ETHICAL CONSIDERATIONS The Ethics Committee of Iran University of Medical Sciences, Tehran, Iran approved the study (code: IR.IUMS. REC.1397.792). Participants were informed about the study aim and methods and were ensured of data confidentiality. They were free to withdraw from the study at will. Written informed consent was obtained from all of them. FINDINGS Factors affecting error communication in intensive care units fell into four main categories, namely the culture of error communication (subcategories were error communication organizational atmosphere, clarity of processes and guidelines, managerial support for nurses, and learning organization), the consequences of errors for nurses and nursing (subcategories were fear over being stigmatized as incompetent, fear over punishment, and fear over negative judgments about nursing), the consequences of errors for patients (subcategories were monitoring the effects of errors on patients and predicting the effects of errors on patients), and ethical and professional characteristics (subcategories were ethical characteristics and inter-professional relationships). DISCUSSION The results of this study show many factors affect error communication, some facilitate and some prohibit it. Organizational factors such as the culture of error communication and the consequences of error communication for the nurse and the patient, as well as individual and professional characteristics, including ethical characteristics and interprofessional relationship, influence this process. CONCLUSION Errors confront nurses with ethical challenges and make them assess error consequences and then, communicate or hide them based on the results of their assessments. Health authorities can promote nurses' error communication through creating a supportive environment for them, developing clear error communication processes and guidelines, and providing them with education about the principles of ethical practice.
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The effect of using smartphone applications on self-care in patients with heart failure. NURSING PRACTICE TODAY 2020. [DOI: 10.18502/npt.v7i4.4041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background & Aim: Due to the chronic nature of heart failure, it is necessary to observe and maintain self-care behaviors accordingly. Tele-monitoring using smartphone applications can be effective in this regard. This study aimed to determine the effect of using smartphone applications on self-care behaviors in patients with heart failure.
Methods & Materials: This randomized controlled clinical trial was conducted between August and March in 2018. Using consecutive sampling, 120 patients were selected and were allocated to the two groups by a random quadruple block approach. The participants in both groups completed the European heart failure self-care questionnaire before and after the intervention. Patients in both groups received routine hospital care; however, patients in the intervention group used an Android smartphone application for three months daily as well. Via the application, there were ongoing interactions between patients and researchers, depending on the needs of patients and their conditions. The data were analyzed using SPSS V.16 software.
Results: There was a statistically significant difference between groups in terms of the mean score of self-care after the intervention where the mean score in the intervention group was lower (p<0.001), which indicates better self-care. Based on the results, the intervention effect was reported at 0.787.
Conclusion: The findings of this study showed that using a smartphone application can improve self-care in patients with heart failure. Therefore, it is recommended to health care providers to use this mobile application to care and monitor remote patients with HF.
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The Effect of Aromatherapy and the Benson Relaxation Technique on the Anxiety of Patients With Acute Coronary Syndrome: Randomized Controlled Trial. JOURNAL OF CLIENT-CENTERED NURSING CARE 2020. [DOI: 10.32598/jccnc.6.2.34.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Anxiety is a common symptom in patients with the Acute Coronary Syndrome (ACS), which can threaten their quality of life. This study was done to compare the effects of aromatherapy using lavender and Benson’s relaxation technique on the anxiety of patients with ACS. Methods: In this randomized clinical trial, 96 patients with ACS were selected using consecutive sampling method from two hospitals in an urban area of Iran. The patients were randomly assigned to three groups of aromatherapy (n=32), Benson’s relaxation (n=32), and control (n=32) using the block size of six. The interventions were performed on two consecutive days, once a day for 20 min. Anxiety was measured before and immediately after the intervention using the Spielberger’s Anxiety Inventory. Data were analyzed using the Chi-square test, Fisher’s exact test, one-way Analysis Of Variance (ANOVA), Bonferroni post hoc test, and mixed-model repeated-measures ANOVA with a 3*2*2 design by the SPSS V. 16. Results: There was no statistically significant difference in state and trait anxiety scores between the groups after the intervention on different time points (P> 0.05). The time (P=0.001), group-day interaction (P=0.005), and time (pretest and posttest) and day (P=0.029) effect on state anxiety was statistically significant. The time (P<0.001) and the group-day interaction (P<0.001) effect on trait anxiety was statistically significant. Conclusion: Benson’s relaxation method and lavender aromatherapy did not significantly reduce anxiety in patients with ACS. Considering the anxiety and its complications in patients with ACS and the importance of its management, further studies are needed to determine appropriate care and treatment for these patients and reduce their anxiety.
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The effect of simulation-based education on nursing students’ knowledge and performance of adult basic cardiopulmonary resuscitation: A randomized clinical trial. NURSING PRACTICE TODAY 2020. [DOI: 10.18502/npt.v7i2.2730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background & Aim: Cardiopulmonary arrest as a life-threatening condition needs urgent interventions to protect individuals’ life and prevent irreversible damages to vital organs. This study aimed to investigate the effect of simulation-based education on the knowledge and performance of nursing students of adult essential life support cardiopulmonary resuscitation (BLS-CPR).
Methods & Materials: This study used a pretest-posttest study with a control group. It was conducted at Iran University of medical sciences, Tehran, Iran, in 2017. In this study, 49 nursing students at the sixth education semester were assigned using the simple random allocation into two groups of intervention (n=28) and control (n=21). Initially, the conventional BLS education was provided to the two groups of intervention and control using the conventional method. Next, the intervention group received a simulation-based education. The knowledge and performance of the students before, immediately after, and three months after the intervention was assessed using a modified knowledge assessment questionnaire and a modified performance evaluation checklist about BLS in adults.
Results: The students’ knowledge in the intervention group immediately after (p<0.001) and three months after the intervention (p<0.05) were significantly higher than the control group. The mean scores of performance immediately after (p<0.001) and three months after the intervention (p<0.001) were significantly higher than the control group.
Conclusions: Simulation-based education increased the knowledge and performance of nursing students in the field of BLS-CPR. According to the results, integrating conventional training with simulation-based education can be effective in learning BLS among nursing students.
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Factors related to knowledge, attitude, and practice of nurses in intensive care unit in the area of pressure ulcer prevention: A multicenter study. J Tissue Viability 2020; 29:76-81. [PMID: 32061501 DOI: 10.1016/j.jtv.2020.02.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/12/2020] [Accepted: 02/02/2020] [Indexed: 10/25/2022]
Abstract
INTRODUCTION As one of the main members of the health team, nurses have an important role in pressure ulcer prevention in health care centers. The aim of this study was to investigate knowledge, attitude, and practice of nurses on the prevention of pressure ulcers and their related factors. METHODS This cross-sectional study was carried out in 2018. The total number of ICU nurses employed in educational-health centers affiliated to Iran University of Medical Sciences were examined. Among a total of 328 nurses, 308 questionnaires were completed by the participants. Pressure Ulcer Knowledge Questionnaire, Attitude Toward Pressure Ulcer, and Practice of Pressure Ulcer Prevention questionnaires were used to collect data. SPSS software version 16 and independent t-test, Chi-square, Fisher exact, one-way Analysis of variance, and multiple linear regressions tests were used for data analysis. FINDINGS Based on the mean score of knowledge, attitude, and practice of the nurses about the pressure ulcer prevention were 63.47 ± 10.31, 39.10 ± 40.22, and 32.03 ± 6.17, respectively. There was a positive and significant relationship between these three variables. Findings revealed that knowledge was increased by 0.051 units, with a one-year increase in work experience of nurses in the ICU. Moreover, women's knowledge and their attitude were higher than those of men as 3.132 and 1.65 units, respectively. Based on the findings, attitude of nurses increased by 0.43 units for an hour of extra work per week. Nurses' attitude score in the General ICU and their practice were higher than scores of other nurses as 2.144 and 2.574 units, respectively. Moreover, practice of nurses increased by 0.162 unit with one-year increase of their age. CONCLUSION Given the undesirable level of knowledge and attitude and relatively desirable practice of nurses in the field of pressure ulcer prevention and the importance of improving the safety of patients admitted to the ICU, it is suggested that appropriate educational planning be developed to raise the level of knowledge, attitude, and practice of health care providers, especially nurses, in the area of pressure ulcer prevention.
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The challenges of using physical restraint in intensive care units in Iran: A qualitative study. J Intensive Care Soc 2020; 22:34-40. [PMID: 33643430 DOI: 10.1177/1751143719892785] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide. Aim This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units. Methods This qualitative study was conducted in 2018-2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0). Findings Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint). Conclusion Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues.
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Abstract
Background: Discriminative nursing care is one of the most important challenges in the field of ethical care and the rights of patients. Experiencing discrimination has negative impacts. Objective: The aim of this study was to explore the process of the development of the discriminative nursing care. Methods: Sampling was begun purposefully and gradually continued, according to the obtained codes and categories, using theoretical sampling until data saturation. Data collection methods included semi-structured interviews, observations, and field notes. In this study, 13 clinical nurses and 5 patients in Iran were selected from public hospitals. The inclusion criteria were willingness to participate, having adequate experience about the considered phenomenon, and being able to discuss the subject. Data analysis was performed simultaneously to data collection using the method of Corbin and Strauss 2008. Results: Five categories were extracted. The categories include: “context,” “causal conditions,” “phenomena,” “strategies,” and “outcomes.” Each of these categories contained subcategories with specific characteristics. The context was classified into “nurse's characteristics” and “patient's characteristics. “”Complete conflict” and “hatred” were extracted from the category of causal conditions. The causal conditions and context led to “discriminative nursing care” phenomena. The two strategies were “avoiding the patients” and “robotic care.” Outcomes were located in a spectrum ranging from “annoyance and discomfort” to “imposition of costs.” Finally, the categories were connected together and the meaning of “care in the context of the sense of interaction with the patient” was theorized. Conclusions: It is important to provide nursing education on the development of discriminative nursing care and its associated complications. Nurses should understand the nature, components, and the process of discriminative care. Understanding discrimination improves the action of nurses.
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Abstract
BACKGROUND Physical restraint is among the commonly used methods for ensuring patient safety in intensive care units. However, nurses usually experience ethical dilemmas over using physical restraint because they need to weigh patient autonomy against patient safety. AIM The aim of this study was to explore factors behind ethical dilemmas for critical care nurses over using physical restraint for patients. DESIGN This is a qualitative study using conventional content analysis approach, as suggested by Graneheim and Lundman, to analyze the data. METHODS Seventeen critical care nurses were purposefully recruited from the four intensive care units in Tehran, Iran. Data were collected through in-depth semi-structured interviews and were concurrently analyzed through conventional content analysis as suggested by Graneheim and Lundman. ETHICAL CONSIDERATION This study was approved by the Ethics Committee of Iran University of Medical Sciences, Tehran, Iran with the code: IR.IUMS.REC.1397.795. Before interviews, participants were provided with explanations about the aim of the study, the confidentiality of the data, their freedom to participate, and the right to withdraw the study, and their free access to the study findings. Finally, their consents were obtained, and interviews were started. RESULTS Factors behind ethical dilemmas for critical care nurses over using physical restraint were categorized into three main categories, namely the outcomes of using physical restraint, the outcomes of not using physical restraint, and emotional distress for nurses. The outcomes of using physical restraint were categorized into the three subcategories of ensuring patient safety, physical damage to patients, and mental damage to the patient. The outcomes of not using physical restraint fell into two subcategories, namely the risks associated with not using physical restraint and legal problems for nurses. Finally, the two subcategories of the emotional distress for nurses main category were nurses' negative feelings about restraint use and uncertainty over the decision on physical restraint use. CONCLUSION Decision-making for restraint use is often associated with ethical dilemmas, because nurses need to weight the outcomes of its use against the outcomes of not using it and also consider patient safety and autonomy. Health authorities are recommended to develop clear evidence-based guidelines for restraint use and develop and implement educational and counseling programs for nurses on the principles of ethical nursing practice, patient rights, physical restraint guidelines and protocols, and management of emotional, ethical, and legal problems associated with physical restraint use.
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Comparison of the effects of inhalation aromatherapy using Damask Rose aroma and the Benson relaxation technique in burn patients: A randomized clinical trial. Burns 2019; 45:1205-1214. [PMID: 30948278 DOI: 10.1016/j.burns.2019.03.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/22/2019] [Accepted: 03/01/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Burn injuries are often accompanied by painful and distressing consequences, which can lead to long-term psychological issues. The most common form of anxiety in burn patients is pain anxiety. It is described as the feeling of fear and pain prediction caused by painful procedures. AIM To compare the effects of inhalation aromatherapy using damask rose aroma and the Benson relaxation technique on pain anxiety in burn patients. METHODS This randomized clinical trial was conducted on 132 patients hospitalized in Motahari Burn Hospital from October 2017 to March 2018. The subjects were selected using a sequential sampling method. Next, they were randomly allocated by the Permuted block randomization method into four groups of rose aroma (5 drops of 40% rose aroma), the Benson relaxation technique, combined rose aroma-Benson relaxation and control. The interventions were performed for three consecutive days and once a day for 20 min, and each session lasted from 45 to 30 min before the daily dressing change. Data was collected using the Persian version of burn specific pain anxiety scale (BSPAS). Data was analyzed using descriptive and inferential statistics via the SPSS software version 16. RESULTS Immediately after the intervention, on the first, second and third days, significant differences in pain anxiety among four groups were reported. On the first day, the Scheffé ad hoc test indicated statistically significant differences in pain anxiety between all groups (p < 0.001), except rose aroma-plus-Benson relaxation and rose aroma groups (p = 0.15). On the second and third days, there were significant differences between the groups in pain anxiety (p < 0.001). Furthermore, after wound dressing, on the first, second and third days, statistically significant differences in pain anxiety among four groups were reported. On the first day, the Scheffé ad hoc test revealed statistically significant differences in pain anxiety between all groups (p < 0.001). On the second and third days, there were statistically significant differences in pain anxiety between the groups (p < 0.001), except the rose aroma and Benson relaxation groups. Immediately after the intervention, the maximum effect size was on the first day in the group of rose aroma-plus-Benson relaxation and the lowest effect size was on the first day in the Benson relaxation group. However, after wound dressing, the maximum effect size was on the third day in the rose aroma-pus-Benson relaxation group and the lowest effect size was on the first day in the Benson relaxation group. CONCLUSION The combination of the rose aroma and Benson relaxation has a synergistic effect and has more effects in the reduction of pain anxiety in burn patients than a single intervention. Health care providers can provide these interventions simultaneously and help reduce pain anxiety in burn patients before conducting painful interventions.
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Comparison of the effects of nature sounds and reflexology on hemodynamic indices among traumatic comatose patients: A randomized controlled clinical trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2019; 16:/j/jcim.ahead-of-print/jcim-2018-0106/jcim-2018-0106.xml. [PMID: 30730838 DOI: 10.1515/jcim-2018-0106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/08/2018] [Indexed: 12/11/2022]
Abstract
Background Traumatic comatose patients may experience disturbances in hemodynamic indices due to the nature of their disorder. This study aimed to compare the effects of nature sounds and reflexology on hemodynamic indices in traumatic comatose patients. Methods This randomized clinical trial using a factorial design was conducted on 120 traumatic comatose patients in two teaching hospitals in two urban areas of Iran. The patients were selected using a sequential sampling method and assigned into randomized quadruple blocks as control, nature sounds, reflexology and nature sounds-reflexology (combined) groups. The interventions were performed twice daily in two consecutive days lasting 30 min each time. The hemodynamic indices were measured before, and immediately, 30 min, and 2 h after the intervention using calibrated monitors. Descriptive and inferential statistics, including one-way ANOVA, Scheffe ad hoc, repeated measure ANOVA, Bonferroni ad hoc Chi-square test and Fisher's exact tests were used for data analysis via the SPSS software V.16. Results Significant differences were reported in terms of the mean arterial pressure between the control and reflexology groups (p=0.002), and the combined group (p=0.008) immediately after the interventions. The combined group showed statistically differences in systolic blood pressure compared to the nature sounds (p=0.007) and control (p=0.015) groups 30 min after the interventions. The nature sounds group showed differences in the pulse rate from the reflexology (p=0.048) and control (p=0.015) groups 30 min after the interventions in the second day. Conclusions While the immediate effects of the interventions on induction of the feeling of relaxation and tranquility, and reduction of hemodynamic indices were reported, they diminished over time. Nature sounds and reflexology as low-cost and relaxing tranquilizing methods can be used for the reduction of tension and improvement of hemodynamic indices among traumatic comatose patients.
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Effect of education using the virtual social network on the knowledge and attitude of emergency nurses of disaster preparedness: A quasi-experiment study. NURSE EDUCATION TODAY 2019; 73:88-93. [PMID: 30550943 DOI: 10.1016/j.nedt.2018.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/04/2018] [Accepted: 12/02/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Nurses play an important role in helping people to cope with disasters. Dealing with disasters requires proper knowledge, attitudes and skills that can be achieved through education. Education through virtual social networks as a method of distance education can be used due to its accessibility and ease of use. OBJECTIVES To investigate the effect of education using the virtual social network on the knowledge and attitude of emergency nurses of disaster preparedness. DESIGN This was a pre-test and post-test quasi-experimental study with a control group. SETTING The study was conducted in two hospitals in Tehran, Iran. PARTICIPANTS A total of 60 nurses (n = 30 nurses in each group) participated in this study. Before the study, they signed the informed consent form. METHODS They were selected using a census method and were divided into two control (n = 30) and intervention groups (n = 30). Data was collected before and after the intervention using the disaster preparedness questionnaire. The intervention group received 34-session education of disaster preparedness via the virtual social network (Telegram application). Data was analyzed using descriptive and inferential statistics via the SPSS v.22 software. RESULTS No statistically significant difference was reported between the groups regarding the pretest knowledge score, but the posttest knowledge score was significantly higher in the intervention group compared to the control group (p < 0.001). In the intervention group, knowledge scores significantly increased at the posttest compared to the pretest (p < 0.01). No a similar condition happened in the control group. While the posttest attitude score was higher than the pretest attitude score, it was not statistically significant. CONCLUSIONS A significant increase in the knowledge score of the intervention group was reported compared to the control group indicating the effectiveness of learning through the virtual social network. Also, the high level of attitude scores before and after education indicated the positive attitude of emergency nurses toward the need for disaster preparedness.
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The Effect of Self-Care Compact Disk-Based Instruction Program on Physical Performance and Quality of Life of Patients with Burn At-Dismissal. World J Plast Surg 2019; 8:25-32. [PMID: 30873359 PMCID: PMC6409141 DOI: 10.29252/wjps.8.1.25] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Burn injuries still negatively influence the various aspects of life like physical performance and quality of life. This study was conducted to investigate at-dismissal self-care compact disk-based instruction program on the physical performance life quality of the patients with burns. METHODS One-hundred burn patients in Shahid Motahhari Burn Center, Tehran, Iran were randomly assigned to two equal groups of intervention (n=50) and control (n=50). The latter received only routine dismissal self-care program and the former an instruction compact disc plus the routine self-care program at dismissal. The demographic information and burn patients’ quality of life questionnaires were completed before and at months three and six after the intervention self-report program. RESULTS The physical performance of the intervention and control groups before intervention was 1.61±0.71 and 1.45±0.47, respectively (p=0.41). The physical performance of the intervention group was higher than the control group at three and six months after the intervention (p<0.001). CONCLUSION At-dismissal self-care compact disk-based instruction program can increase physical performance and quality of life in patients with burns. Therefore, the burn patients can be instructed based on self-care compact disk-based instruction program as an easy, available and less-costly method to take part in more satisfied treatment.
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Design and implementation of clinical competency evaluation system for nursing students in medical-surgical wards. J Family Med Prim Care 2019; 8:1408-1413. [PMID: 31143730 PMCID: PMC6510106 DOI: 10.4103/jfmpc.jfmpc_47_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: In nursing, it is important to ensure the evaluation of students’ clinical competency and using a valid and reliable evaluation system is necessary. The aim of this study was to design a clinical competency evaluation system for nursing students in medical-surgical wards and determine its validity and reliability. Methods: This cross-sectional study was conducted on the nursing students who were spending their practicum courses at the medical-surgical wards. First, the educational objectives and applicable evaluation tools were determined. Then, three tools of: Direct Observation of Procedural Skills (DOPS), Mini Clinical Evaluation Exercise (Mini-CEX), and Clinical Work Sampling (CWS) were determined as appropriate tools. Finally, the evaluation system was designed and its validity was confirmed using content validity index (CVI) and content validity ratio (CVR). Reliability of the tools was calculated using Cronbach's alpha coefficient. Results: CWS tool had CVI = 0.91 and CVR = 0.93, DOPS tool had CVI = 0.98 and CVR = 0.94, and Mini-CEX tool had CVI = 0.93 and CVR = 1. These results indicated desirable validity of the designed evaluation system. In addition, all items had appropriate CVR. Reliability was also higher than 0.7. Significant difference was found between the results of students’ evaluation using the School's current evaluation method and the designed evaluation system. From the perspective of teachers and students, the designed evaluation system was accepted. Conclusion: The designed evaluation system had high reliability and validity. Its application satisfied the majority of teachers and students. Therefore, it can be used as a useful evaluation system for assessing clinical competencies in medical-surgical wards.
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Prehospital Trauma Management: Evaluation of a New Designed Smartphone Application. JOURNAL OF CLIENT-CENTERED NURSING CARE 2018. [DOI: 10.32598/jccnc.4.4.193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Effects of the self-management education program using the multi-method approach and multimedia on the quality of life of patients with chronic heart failure: A non-randomized controlled clinical trial. Contemp Nurse 2018; 54:409-420. [PMID: 30381006 DOI: 10.1080/10376178.2018.1538705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Self-management behaviors help patients deal issues related to the treatment process and lead to appropriate health outcomes. OBJECTIVE To compare the effects of the self-management education program using the multi-method approach and multimedia on the quality of life among patients with chronic heart failure. METHODS This non-randomized controlled clinical trial was conducted on 111 patients suffering from chronic heart failure. They were assigned into the multi-method approach (n = 36), multimedia (n = 37), and control (n = 38) groups. The Iranian heart failure quality of life questionnaire was used for data collection before and three months after the education program. Data was analyzed using descriptive and inferential statistics via the SPSS software. RESULTS Statistically significant differences were reported between the multi-method approach and multimedia groups in terms of the quality of life after the intervention compared with the control group (p < 0.001 and p = 0.002, respectively). Also, statistically significant differences were found between the two intervention groups in terms of the dimension of self-efficacy and knowledge (p = 0.047). No statistically significant differences were seen between the intervention groups in other domains of the quality of life. CONCLUSION The education program improved the quality of life in patients with chronic heart failure. However, the multi-method approach was more effective compared to other methods in patients with chronic heart failure. Healthcare providers especially nurses should consider different educational approaches for patient education. Also, they need to consider patient's preferences during education to improve their quality of life.
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The effect of slow-stroke back massage on anxiety in female patients with heart failure. BALI MEDICAL JOURNAL 2018. [DOI: 10.15562/bmj.v7i2.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Effect of the self-management education program on the quality of life in people with chronic heart failure: a randomized controlled trial. Electron Physician 2018; 10:7028-7037. [PMID: 30128093 PMCID: PMC6092147 DOI: 10.19082/7028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 05/12/2018] [Indexed: 02/03/2023] Open
Abstract
Background Chronic Heart Failure (CHF) is a syndrome that negatively affects a person's Quality of Life (QOL). The efficient self-management education program increases the individual's abilities and skills for following and participating in a long-term healthcare plan. Objective The aim of this study was to determine the effect of the self-management education program on QOL in people with CHF. Methods This randomized controlled trial study was conducted on 60 people with CHF and without sensory-cognitive problem from April-August 2015. They were selected using the convenience sampling method, and were randomly assigned into the intervention and control groups. The control group received the routine education presented to participants at discharge. However, besides the routine education, the intervention group received the self-management education program consisting of three sessions followed for a 3-month period. The Iranian heart failure QOL questionnaire was used for data collection before and after the intervention. The independent-samples and paired-samples t-tests, Chi-square and Fisher exact tests were used for data analysis via the SPSS v.16 software. P<0.05 was considered statistically significant. Results No statistically significant differences were reported between the groups in terms of demographic and clinical characteristics, indicating that they were homogeneous. A statistically significant difference was reported between the two groups after the intervention in terms of the mean changes of total QOL (p<0.001) and its dimensions, including symptoms (p=0.002), social interference (p=0.01), psychological condition (p=0.013), and self-efficacy and knowledge (p<0.001). In addition, an improvement was observed in the total QOL in the intervention group after the education (p<0.001). Conclusions According to the results of this study, the self-management education program can be considered an appropriate strategy for improving the QOL in people suffering from CHF by health care providers. Trial registration The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2015032021521N1. Funding The authors received financial support for the research, authorship, and/or publication of this article from Iran University of Medical Sciences (No: 107/105/94/D, date April 11, 2015).
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Comparing the effect of patients preferred music and Swedish massage on anticipatory anxiety in patients with burn injury: Randomized controlled clinical trial. Complement Ther Clin Pract 2018; 32:55-60. [PMID: 30057058 DOI: 10.1016/j.ctcp.2018.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 04/11/2018] [Accepted: 05/03/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Effective strategies should be considered for reducing pain and anxiety and improving burn patients' well-being. This study was aimed to compare the effect of preferred music and Swedish massage on pain anticipatory anxiety in burn patients. METHODS In this randomized controlled clinical trial 240 hospitalized burn patients were selected and assigned to Swedish massage, preferred music, combination of Swedish massage and preferred music and control groups through fixed blocking randomization. Interventions was offered before wound care one time for 20 min on patients' bedside. Patients in the control group only received routine care. The Persian version of Burn Specific Pain Anxiety Scale were used for data gathering. Data was analyzed using SPSS-PC (V.16.0). RESULTS There was a statistically significant difference between groups regarding mean changes of anticipatory anxiety (P < 0.001). The results indicated that patients in the group of combination of both interventions reported significantly lower anticipatory anxiety as compared to the preferred music (P = 0.015), Swedish massage (P = 0.002) and control (P < 0.001) groups. The mean changes of anticipatory anxiety score in the Swedish massage and preferred music groups had a statistically significant difference with the control group (P < 0.001). There was no difference between the mean changes of anticipatory anxiety in preferred music and Swedish massage groups. CONCLUSIONS According to the results, combining both Swedish massage and preferred music was more effective in reducing anticipatory anxiety in burn patients. Health care providers, particularly, nurses can provide these two noninvasive and economical interventions simultaneously and benefits the synergistic effect of them in burn patients.
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Comparing the effects of education using telephone follow-up and smartphone-based social networking follow-up on self-management behaviors among patients with hypertension. Contemp Nurse 2018; 54:362-373. [PMID: 29451091 DOI: 10.1080/10376178.2018.1441730] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Little is known about the benefits of social networks in the management of patients. OBJECTIVE The aim of this study was to compare the effects of self-management (SM) education using telephone follow-up and mobile phone-based social networking on SM behaviors among patients with hypertension. METHODS This randomized clinical trial was conducted with 100 patients. They were randomly allocated to four groups: (i) control, (ii) SM training without follow-up, (iii) telephone follow-up and (iv) smartphone-based social networking follow-up. The hypertension SM behavior questionnaire was used for data collection before and six weeks after the study. RESULTS Those patients who underwent SM education training (with and without follow-up) had statistically significant differences from those in the control group in terms of SM behaviors (p < .001). There was no statistically significant difference between different types of follow-up. CONCLUSION SM education using telephone follow-up and/or smartphone-based social networking follow-up influenced SM behaviors among patients with hypertension.
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The effect of nature sounds on physiological indicators among patients in the cardiac care unit. Complement Ther Clin Pract 2017; 29:147-152. [PMID: 29122253 DOI: 10.1016/j.ctcp.2017.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 09/12/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Environmental noises may create physiological and psychological disorders in patients hospitalized in the CCU. Therefore, this study was conducted to investigate the effects of nature sounds on physiological indicators among patients in the CCU. MATERIALS & METHODS This randomized clinical trial was conducted on 93 patients hospitalized in the cardiac care units of three teaching hospitals in 2016. The patients were selected using the convenient method with three randomized blocks. The patients were assigned into three groups as nature sounds, silence that received a set of headphones without playing sounds, and control groups. In addition to routine care, the patients in the intervention group listened to nature sounds for 30 min using a set of headphones for two days. The patients in the control group only received routine care. In addition to routine care, the patients in the silence group used a set of headphones for 30 min to block noises and no sound was played for them. Physiological indicators such as heartbeat rate, systolic and diastolic blood pressures, respiration rate, and arterial O2 saturation were assessed using monitoring devices. Descriptive and inferential statistics were used for data analysis via the SPSS software. FINDINGS Nature sounds and silence had no statistically significant effects on physiological indicators. However, a statistically significant difference was reported in the heart rate in the nature sound group before and after the intervention in the first day of the intervention (P = 0.046). In the second day of the intervention, there were statistically significant differences in the diastolic blood pressure in the nature sounds group (P = 0.028), heart rate (P = 0.001) and diastolic blood pressure (P = 0.013) in the silence group, and heart rate (P = 0.014) in the control group before and after the intervention. CONCLUSION Listening to nature sounds or the use of headphones blocked environmental noises and could influence mean arterial pressure. Future studies can examine the effects of this intervention implemented for a longer term using nature sounds by patients.
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Effect of Multimedia Self-Care Education on Quality of Life in Burn Patients. World J Plast Surg 2017; 6:292-297. [PMID: 29218277 PMCID: PMC5714973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Burn injuries can have adverse effects on quality of life of patients and can disturb their physiological, psychological, social and spiritual well-being. This study aimed to investigate the effect of multimedia self-care program on quality of life in burn patients. METHODS This Randomized controlled clinical trial was conducted from November 2015 to December 2016. The samples were hospitalized burn patients with 10% to 45% of 1st, 2nd and 3rd degree burns of total body surface area (TBSA). The patients were randomly allocated into experimental (n=50) and control (n=50) groups. Both groups received the routine in-person self-care trainings of the hospital and then the experimental group received self-care compact disks. The quality of life questionnaire in both groups were completed before intervention and after 3-months and statistically analyzed. RESULTS Accordingly, the changes in quality of life and the dimensions between both groups after 3 month of intervention were significant. The changes in quality of life in experiment group was significantly greater than control group for physical, psychological and social variables. CONCLUSION According to the findings, using multimedia self-care programs can improve burn patient's quality of life, so it is recommended for nurses and hospital staffs of burn injury wards to use multimedia self-care programs as a complementary therapy measure.
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Sleep Quality of Patients Admitted to the Coronary Care Unit: Pilot Study. JOURNAL OF CLIENT-CENTERED NURSING CARE 2017. [DOI: 10.32598/jccnc.3.3.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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The Effect of Massage on Anticipatory Anxiety and Procedural Pain in Patients with Burn Injury. World J Plast Surg 2017; 6:40-47. [PMID: 28289612 PMCID: PMC5339608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Pain related to burn injuries is one of the most troublesome pain intensity. This study aimed to investigate the effect of massage on anticipatory anxiety, procedural pain intensity, vital signs and relaxation level of patients with burn injury. METHODS In this quasi-experimental study, through convenience sampling, 60 hospitalized adult burn patients were selected from a specialized burn and reconstructive hospital. Subjects were assigned to massage and control groups through simple randomization. Massage was offered by using non aromatic oil about 10-15 minutes before wound care on intact part of the body once a day for 20 minutes on patients' bedside for 3 consecutive days. In the 3 days, the control group did not received any massage and were asked to stay at bed. Demographic and clinical characteristics and vital signs, Visual Analogue Scale and the Persian version of Burn Specific Pain Anxiety Scale were used to determine baseline and procedural pain, anxiety and relaxation levels and anticipatory anxiety. RESULTS No significant difference was noted between mean score of pain intensity, anxiety and relaxation level, and vital signs in massage and control groups after intervention following wound care. In massage and control groups, there was no significant differences between mean scores of anticipatory anxiety before and after intervention. There was no significant difference between the mean scores of anticipatory anxiety in massage and control groups after intervention prior wound care. CONCLUSION Massage was shown not to have any effect on anticipatory anxiety and procedural pain.
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The effects of patient-preferred music on anticipatory anxiety, post-procedural burn pain and relaxation level. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2016.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Review Paper: The Bed Incline and Prevention of Ventilator-Associated Pneumonia. JOURNAL OF CLIENT-CENTERED NURSING CARE 2016. [DOI: 10.32598/jccnc.2.3.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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The Effect of Self-Management Training Using CD on the Quality of Life in Patients with Chronic Heart Failure. JOURNAL OF CLIENT-CENTERED NURSING CARE 2016. [DOI: 10.32598/jccnc.2.1.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Effect of a multimodal training program and traditional lecture method on nurses' hand hygiene knowledge, belief, and practice: A brief report. Am J Infect Control 2015; 43:762-4. [PMID: 25997879 DOI: 10.1016/j.ajic.2015.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 03/15/2015] [Accepted: 03/18/2015] [Indexed: 11/16/2022]
Abstract
This study compared the effect of a multimodal training program and lecturing method on nurses' hand hygiene knowledge, belief, and practice. Two weeks and 3 months after the study, nurses' in both groups received significantly higher scores compared with the control group. Compared with the lecturing method, the multimodal training program is more effective in improving nurses' hand hygiene knowledge, belief, and practice 3 months after the study.
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The effect of shiatsu massage on pain reduction in burn patients. World J Plast Surg 2014; 3:115-8. [PMID: 25489534 PMCID: PMC4236994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 05/19/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Burn is a tragedy that follows multiple problems in a patient including pain, anxiety and lack of confidence into medical team. This study evaluated the effect of shiatsu massage on pain intensity of burn patients. METHODS A total of 120 burn patients from Motahhari Burn Hospital and of both genders were randomly divided into 4 groups of undergoing hand massage, leg massage, both hand and leg massages, and the control group. The effect of shiatsu massage in pain relief of burned patients was evaluated. The visual analog scale (VAS) was used to assess pain in burn patients. RESULTS Pain intensity in the control group before and after the intervention was not statistically significant (p=1). In all massage groups, the difference for pain intensity before and after the intervention was statistically significant. CONCLUSION According to our data, shiatsu method over both hands and legs were effective in pain reduction and can be recommended together with analgesics to decrease the dose.
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Strategies for recreating normal life: Iranian coronary heart disease patients' perspectives on coping strategies. J Clin Nurs 2013; 23:2151-60. [PMID: 24330453 DOI: 10.1111/jocn.12428] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2013] [Indexed: 01/30/2023]
Abstract
AIMS AND OBJECTIVES To identify coping strategies used by Iranian patients with coronary heart disease. BACKGROUND One of the most important nursing interventions is facilitating adjustment for patients. A deeper understanding of patients' coping strategies for controlling illness and its consequences is needed. DESIGN A qualitative design. METHODS Participants were hospitalised patients diagnosed with coronary heart disease, based on documented angiographic results. A qualitative study using semi-structured interviews was conducted, and purposive sampling was performed. The qualitative content analysis determined categories and subcategories for describing and understanding coping strategies. RESULTS The term 'coping strategies' refers to the strategies used by participants living with coronary heart disease as they attempt to understand and control their chronic condition and return to a social and physical state as similar to their predisease condition as possible. During the data analysis, six strategies emerged: searching for meaning and information; trying to achieve comfort and control; resting more, doing less and slowing down; motivating, prioritising and caring for self; turning to religion and spirituality; and expectations and receiving assistance and support. CONCLUSIONS This qualitative study describes the coping strategies of Iranian patients with coronary heart disease and the commonalities with strategies for others dealing with chronic illnesses in Iran. The patients were found to use a variety of coping strategies to deal with their illness and its impacts on their lives. RELEVANCE TO CLINICAL PRACTICE This study contributes to the existing body of knowledge about optimal nursing care strategies for patients with coronary heart disease. Through increasing awareness of coping strategies, nurses can help their patients employ the most effective tools and reinforce constructive successful coping styles for patients who are dealing with coronary heart disease.
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Coronary heart disease patients transitioning to a normal life: perspectives and stages identified through a grounded theory approach. J Clin Nurs 2013; 23:571-85. [PMID: 24175915 DOI: 10.1111/jocn.12272] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2013] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore how Iranian patients with coronary heart disease experience their lives. BACKGROUND Coronary heart disease is a leading cause of death in Iran and worldwide. Understanding qualitatively how patients experience the acute and postacute stages of this chronic condition is essential knowledge for minimising the negative consequences of coronary heart disease. DESIGN Qualitative study using grounded theory for the data analysis. METHODS Data for this study were collected through individual qualitative interviews with 24 patients with coronary heart disease, conducted between January 2009 and January 2011. Patients with angina pectoris were selected for participation through purposive sampling, and sample size was determined by data saturation. Data analysis began with initial coding and continued with focused coding. Categories were determined, and the core category was subsequently developed and finalised. RESULTS The main categories of the transition from acute phase to a modified or 'new normal' life were: (1) Loss of normal life. Experiencing emotions and consequences of illness; (2) Coming to terms. Using coping strategies; (3) Recreating normal life. Healthcare providers must correctly recognise the stages of transition patients navigate while coping with coronary heart disease to support and educate them appropriately throughout these stages. CONCLUSION Patients with coronary heart disease lose their normal lives and must work towards recreating a revised life using coping strategies that enable them to come to terms with their situations. RELEVANCE TO CLINICAL PRACTICE By understanding Iranian patients' experiences, healthcare providers and especially nurses can use the information to support and educate patients with coronary heart disease on how to more effectively deal with their illness and its consequences.
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