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The effects of Orem's self-care theory on self-care behaviors among older women with hypertension: A randomized controlled trial
Full text linkBackground: Lifestyle modification and self-care have potential effects on hypertension management among older women. Objectives: The aim of this study was to assess the effects of using Orem's Self-Care Deficit (OSCD) theory on self-care behaviors among older women with hypertension. Methods: This clinical trial was conducted in 2018-2019. A 70-year-old woman with hypertension were conveniently recruited from healthcare centers in Ramsar, Iran, and randomly allocated to a control and an intervention group. Participants in the intervention group received self-care education based on the OSCD theory. The control group received no intervention. Data were collected using a personal characteristics questionnaire, a researcher-made self-care need assessment checklist, and the Hypertension Self-Care Activity Level Effects questionnaire. The Wilcoxon and the Mann-Whitney U-tests were used to analyze the data. Results: There were no significant differences between the groups respecting the pretest mean scores of medication adherence, weight control, physical activity, and nutrition-related self-care behaviors (P > 0.05). However, after the intervention, the between-group difference respecting the mean scores of these behaviors were statistically significant (P < 0.001). Conclusion: The OSCD theory is effective in promoting self-care behaviors among women with hypertension. Therefore, its use is recommended to improve hypertension management and quality of life and reduce treatment-related costs in these patients
The effects of an interdisciplinary supportive educational program on anxiety among patients undergoing cataract surgery
Full text linkBackground: In most ophthalmic surgeries, patients are conscious or semi-conscious, and hence, they may experience varying levels of anxiety during surgery. Objectives: The aim of this study was to evaluate the effects of an interdisciplinary supportive educational program on anxiety among patients undergoing cataract surgery (CS). Methods: This quasi-experimental study was carried out in February-August 2019 using a two-group pretest-posttest design. Participants were 64 patients with cataract who were referred to Feiz Hospital, Isfahan, Iran, for undergoing CS. They were consecutively recruited and randomly assigned to either a control or an intervention group. Data were collected using a demographic questionnaire and Spielberger State-Trait Anxiety Inventory. Participants in the intervention group received an interdisciplinary supportive educational intervention, while their counterparts in the control group received routine care services. State anxiety and trait anxiety were assessed both on the sampling day and after regaining full postoperative consciousness. Data analysis was done via the independent and the paired samples t-, the Mann-Whitney U-, and the Chi-square tests. Results: There were no statistically significant differences between the intervention and the control groups respecting the pretest mean scores of state anxiety (35.25 ± 8.51 vs. 35.72 ± 9.43; P = 0.83) and trait anxiety (38.25 ± 7.002 vs. 39.16 ± 8.58; P = 0.64). However, there were statistically significant differences between the groups regarding the posttest mean scores of state anxiety (28.66 ± 10.39 vs. 34.84 ± 9.36; P = 0.02) and trait anxiety (31.76 ± 8.51 vs. 38.13 ± 10.29; P = 0.01). Conclusion: As a simple and inexpensive intervention, an interdisciplinary supportive and educational program through both face-to-face communication and telecommunication methods is effective in significantly reducing anxiety among patients undergoing CS
Emergency nurses attitudes toward interprofessional collaboration and teamwork and their affecting factors: A cross-sectional study
Full text linkBackground: The emergency department (ED) is a multidisciplinary department and seriously needs interprofessional collaboration (IPC). Objectives: The purpose of this study was to examine the emergency nurses attitudes toward IPC and teamwork and their affecting factors. Methods: A cross-sectional study was conducted on 138 emergency nurses working in teaching hospitals affiliated to Tabriz University of Medical Sciences, Tabriz, Iran, from January to April 2019. Data were collected using a three-part questionnaire including a demographic data sheet, the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration, and the Testing Team Attitude Questionnaire. The data were analyzed using descriptive statistics, Pearsons correlation coefficient, analysis of variance, and multivariate regression analysis. Results: The majority of the study participants were female (68.1), in the age range of 30-40 years old (44.2), and had a working experience of 1-5 years in the ED (63.8). The mean scores of nurses attitudes toward IPC and teamwork were 48.68 ± 5.14 and 96.15 ± 8.97, respectively. A direct and strong correlation was found between nurses attitudes toward IPC and teamwork (r = 0.594, P = 0.001). Regression analysis showed that, among all variables, only the participants employment status (compulsory governmental services, P < 0.031 and B = 2.356), overall work experience between 1 and 5 years (P < 0.001 and B = -3.769), and the attitude toward teamwork (P< 0.001 and B = 0.350) could significantly predict nurses attitude toward IPC. Conclusion:The attitudes of emergency nurses toward IPC and teamwork were at an optimal level. Nurses belief in IPC and especially belief in nurse physician collaboration plays an important role in providing quality care and keeping patient safety in ED. Joint in-service workshops on the philosophy and principles of IPC and teamwork for nurses and physicians working in EDs can further strengthen the IPC
The relationship of nursing students personality traits with their perceived stress in clinical environment
Full text linkBackground: Clinical education is the most stressful part of education for nursing students. This study investigated the relationship of nursing students personality traits with their perceived stress in clinical environment. Objectives: This study aimed at investigating the relationship of nursing students personality traits with their perceived stress in clinical environment. Methods: This cross-sectional study was conducted in October 2020 on 215 nursing students. Participants were selected through stratified random sampling from Zanjan University of Medical Sciences, Zanjan, Iran. Data collection instruments were a demographic questionnaire, the NEO Personality Inventory short form, and the Perceived Stress Scale. Data analysis was done through the independent-samples t-test, Pearson,s correlation analysis, and one-way analysis of variance. Results: The mean score of perceived stress was 43.74±10.25 out of 56, implying high level of stress. Neuroticism personality trait had significant positive correlation with perceived stress (P < 0.001), whereas extraversion and agreeableness personality traits had significant negative correlations with perceived stress (P < 0.05). Conclusion: Healthcare authorities need to employ strategies to identify nursing students who are at risk for stress and improve their psychological readiness for attending clinical environment
The effects of a care plan based on the roy adaptation model on depression among nursing home residents
Full text linkBackground: Depression is one of the most common mental disorders among nursing home residents. Nursing models are among the therapies with potential effects on depression. Objectives: This study aimed to determine the effects of a care plan based on the Roy's Adaptation Model (RAM) on depression among nursing home residents. Methods: This quasi-experimental study was conducted on sixty older adults selected from four nursing homes in Urmia, Iran. Participants were randomly allocated to a control and an intervention group. A care plan based on the RAM was designed and implemented for participants in the intervention group. The plan included individualized and group educations based on participants' maladaptive behaviors in the four modes of the RAM. During the intervention, participants' maladaptive behaviors and their stimuli were determined and measures were taken for their management. The intervention lasted for 1.5 months, followed by a 1-month supervision. Before and after the intervention, depression was assessed using the Geriatric Depression Scale. Data were analyzed through the independent- and the paired-sample t and the Chi-square tests. Results: The pretest and the posttest mean scores of depression were 5.78 ± 3.51 and 6.11 ± 3.64 in the control group and 6.81 ± 3.64 and 2.86 ± 2.50 in the intervention group. The between-group difference respecting the pretest mean scores of depression was not statistically significant (P = 0.21), whereas the posttest mean score of depression in the intervention group was significantly less than the control group (P < 0.001). Although the mean score of depression in the control group did not significantly change (P = 0.32), it significantly decreased in the intervention group (P < 0.001). Conclusion: The care plan developed in this study based on the RAM is effective in significantly reducing depression among nursing home residents. Therefore, it can be used for depression management in nursing homes
The outcomes of humanistic nursing for critical care nurses: A qualitative study
Full text linkBackground: Despite the importance and the necessity of humanistic approaches to care, there are limited studies into their outcomes for nurses. Objectives: The aim of this study was to explore the outcomes of humanistic nursing for critical care nurses (CCNs). Methods: This qualitative study was conducted through conventional content analysis. Data were collected through semi-structured interviews with 16 CCNs purposively selected from hospitals in Ahvaz, Iran. Trustworthiness of the data was ensured using Lincoln and Guba's criteria. Results: The outcomes of humanistic nursing were grouped into three main categories, namely personal growth and self-actualization, protection of personal dignity, and greater satisfaction and comfort. Each of these categories had three subcategories which were development of abilities, self-concept and self-worth, spiritual transcendence; greater popularity, improved social status of nursing, appreciation, respect, and support for nurses; and happiness, satisfaction, and motivation, respectively. Conclusion: Humanistic approaches to care help fulfill the needs of both patients and nurses. The findings of this study provide a deeper understanding about how to reinforce humanistic behaviors and can be used in nursing education and practice
Barriers to end-of-life care delivery to home-dwelling terminally-ill older patients: A qualitative content analysis
Full text linkBackground: In the last days of life, home-dwelling terminally-ill older patients have complex care needs. End-of-life (EOL) care for these patients is usually delivered at home. However, there is limited information about the barriers to EOL care delivery to home-dwelling terminally-ill older patients. Objectives: This study is aimed to explore the barriers to EOL care delivery to home-dwelling terminally-ill older patients. Methods: This qualitative study was conducted in 2017-2018. Ten family caregivers and ten health-care providers were purposively selected. The main inclusion criterion was the experience of EOL care delivery to home-dwelling terminally-ill older patients. Data were collected through semi-structured interviews and were analyzed through conventional content analysis. In total, 23 interviews were held with twenty participants. Results: The barriers to EOL care delivery to home-dwelling terminally-ill older patients were categorized into the following three main categories and ten subcategories: inappropriate community-based healthcare context (subcategories: lack of public home care services, lack of palliative/hospice care services, legal/ethical dilemmas, and wrong cultural beliefs leading to wrong EOL care), unsupportive healthcare providers (subcategories: limited preparation for EOL care delivery, negligence towards appropriate home care delivery, and indifference to patients' and their families' rights), and inappropriate family conditions (subcategories: families' lack of care-related knowledge and skills, families' poor financial status, and tension in families). Conclusion: There are different familial, financial, professional, organizational, and social barriers to EOL care delivery to home-dwelling terminally-ill older patients. Culturally-appropriate policies and strategies are needed for operationalizing EOL care, integrating it into the public health-care system, and preparing healthcare providers and family caregivers for its delivery
The effects of competency-based education on midwifery students knowledge, skills, and self-confidence for postpartum hemorrhage management
Full text linkBackground: Hemorrhage is a leading cause of maternal death in the perinatal period. New teaching methods have been recommended for promoting midwives competence in maternal care delivery. Objectives: This study was conducted to determine the effects of a competency-based education (CBE) program on midwifery students knowledge, skills, and self-confidence for postpartum hemorrhage (PPH) management. Methods: This experimental study was conducted in 2018 on 86 third-, fourth-, and fifth-semester midwifery students recruited from the Faculty of Nursing and Midwifery of Iran University of Medical Sciences, Tehran, Iran. They were randomly allocated to either a control (n = 43) or an intervention group (n = 43). Participants in the control group received routine formal midwifery education, while their counterparts in the intervention group received CBE in addition to routine formal midwifery education. Participants knowledge, skills, and self-confidence for PPH management were assessed at three time points, namely before, immediately after, and six weeks after the study intervention. Data were analyzed through performing the Chi-square and the independent-samples t-tests and the repeated measures analysis of variance. Results: There were no significant differences between the intervention and the control groups regarding the pretest mean scores of knowledge (4.87 ± 1.58 vs. 5.05 ± 2.07), skills (80.12 ± 5.72 vs. 82.30 ± 6.89), and self-confidence (7.05 ± 1.19 vs. 6.62 ± 1.47) (P > 0.05). In the intervention group, the mean scores of knowledge, skills, and self-confidence were significantly greater than the control group both at the first posttest (10.17 ± 1.31 vs. 5.20 ± 1.55, 301.15 ± 19.30 vs. 80.50 ± 5.12, and 9.47 ± 1.19 vs. 6.80 ± 0.91, respectively) and the second posttest (9.37 ± 2.21 vs. 5.32 ± 1.50, 299.67 ± 17.58 vs. 81.07 ± 5.69, and 9.72 ± 1.28 vs. 6.52 ± 1.44, respectively) (P < 0.05). Conclusion: CBE is effective in significantly improving midwifery students knowledge, skills, and self-confidence for PPH management, and hence, it is recommended for promoting their competence
The effects of an ethical empowerment program on nurses ability of ethical care delivery to patients with decreased level of consciousness in intensive care unit
Full text linkBackground: Nurses should be empowered for ethical care delivery (ECD) to patients with decreased level of consciousness (LOC) in the intensive care unit (ICU). However, there are limited data about the effects of ethical empowerment programs on nurses ECD ability. Objectives: The aim of this study was to evaluate the effects of an ethical empowerment program on nurses ability of ECD to patients with decreased LOC in ICU. Methods: This quazi experimental study was conducted in 2019 in Al-Zahra University Hospital, Isfahan, Iran. Seventy-two nurses were randomly recruited from the ICUs and randomly allocated to an intervention and a control group. Participants in the intervention group were provided with an ethical empowerment program. A researcher-made questionnaire was used to measure participants ability of ECD to patients with decreased LOC at three time points, namely before, immediately after, and 1 month after the workshop. Data were analyzed through the Chi-square test, the independent-samples t-test, and the repeated-measures analysis of variance. Results: The difference between the intervention and the control groups respecting the pretest mean score of ECD ability was not statistically significant (124 ± 5.88 vs. 126.17 ± 9.07; P = 0.10). However, the mean score of ECD ability in the intervention group was significantly greater than the control group both immediately after the workshop (142.58 ± 7.22 vs. 127.14 ± 8.13; P < 0.001) and 1 month after the workshop (147.57 ± 5.45 vs. 128.51 ± 9.52;P < 0.001). Conclusion: Ethical empowerment is effective in significantly improving nurses ability of ECD to patients with decreased LOC in ICU. This program is recommended for improving nurses ECD ability
Comparing the effects of hot compress and hot ginger compress on pain associated with breast engorgement
Full text linkBackground: Breast engorgement (BE) is a physiologic condition in the postpartum period characterized by painful swelling of the breasts. BE-associated pain is the second main cause of exclusive breastfeeding failure in the early weeks of childbirth. Objectives: This study aimed to compare the effects of hot compress and hot ginger compress on BE-associated pain. Methods: This randomized clinical trial was conducted in 2018 on 76 breastfeeding women with BE conveniently recruited from Imam Reza hospital, Mashhad, Iran. Participants were randomly allocated to a control group to receive hot compress (n = 38) and an intervention group to receive hot ginger compress (n = 38). Study intervention was implemented in both groups thrice daily for 2 consecutive days. A Visual Analog scale was used for the assessment of BE-associated pain before and after the study intervention. Data were analyzed using the Mann-Whitney U, the independent-samples t, the Wilcoxon, and the Chi-square tests as well as the analysis of covariance. Results: The mean score of BE-associated pain in the right and the left breasts significantly reduced by, respectively, 6.25 ± 1.76 and 6.06 ± 1.76 points in the intervention group (P 0.05). The decreases in the mean scores of the right and the left BE-associated pain in the intervention group were significantly greater than the control group (P < 0.05). Conclusion: Hot ginger compress is more effective than hot compress in reducing BE-associated pain among breastfeeding women