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The effects of virtual-augmented reality training on anxiety among operating room students attending coronary artery bypass graft surgery
Full text linkBackground: Operating room (OR) students experience varying levels of anxiety during their internship program in the OR. Educational technology has the potential for reducing anxiety. Objectives: This study aimed at assessing the effects of training based on virtual-augmented reality (VAR) on anxiety among OR students attending coronary artery bypass graft (CABG) surgery. Methods: This randomized controlled trial was conducted in 2020. Thirty-six OR students were conveniently recruited and randomly allocated to an intervention (n = 18) and a control (n = 18) group. Participants in the control group received conventional training, whereas their counterparts in the intervention group received VAR training through watching a 360-degree VAR video of CABG surgery in addition to conventional training. The State-Trait Anxiety Inventory was used for anxiety assessment in both groups at three time points, namely before entering the OR on the first day of the internship program, after entering the OR but before scrub, and on the last day of the program. The data were analyzed through the independent-samples t-test, the Chi-square test, and the repeated-measures analysis of variance. Results: There was no significant difference between the intervention and the control groups regarding the pretest mean scores of state anxiety (40.61 ± 7.63 vs. 41.59 ± 5.09; P = 0.66) and trait anxiety (39.17 ± 7.39 vs. 39.29 ± 6.05; P = 0.96). However, the mean scores of state and trait anxiety in the intervention group were significantly less than the control group at both the first posttest (33.17 ± 6.16 vs. 45.06 ± 8.69 and 33.56 ± 6.19 vs. 42.59 ± 6.62; P < 0.001) and the second posttest (32.39 ± 4.62 vs. 42.35 ± 6.14 and 32.94 ± 5.20 vs. 41.0 ± 5.58; P < 0.001). Conclusion: VAR training is effective in significantly reducing anxiety among OR students attending CABG surgery
The effect of local warming before vascular access on vascular access indicators in adult patients receiving chemotherapy: A systematic review
Full text linkBackground: Intravenous (IV) cannulation is difficult, especially in patients undergoing chemotherapy due to frequent exposure to venous catheterization as well as the destructive effects of chemotherapy drugs on the vessel wall. Therefore, an easy, accessible, and fast method is needed to facilitate venous cannula insertion.
Objectives: This study aimed to systematically review studies on the effects of local warming before insertion of peripheral venous cannulas on vascular access in adult patients receiving chemotherapy.
Methods: This systematic review was conducted by searching databases including PubMed, Scopus, Cochrane, Embase, CINAHL, and ProQuest. The full search of information sources was conducted from the inception of the databases up to December 7, 2020, using the keywords namely warming, heat, chemotherap, cancer, vein score, catheterization, visibility, and palpability. All randomized and nonrandomized trials that were in English language and full text were included. The search was based on the PRISMA guidelines, and finally, six articles were selected for the review. The 8-item JADAD scale was used to evaluate the quality of the included articles.
Results: After a complete search, 244 articles were recovered and reviewed. Finally, six articles, including 516 samples, met the criteria for entering the study. Findings indicated that local warming at the IV insertion site increased insertion success rate at the first attempt, increased vein score, increased patient satisfaction and relaxation and reduced the catheterization time, reduced pain intensity, reduced pain perceived by the nurse, and reduced the number of pricks.
Conclusion: Findings suggest that using local warming at the IV insertion sites in patients receiving chemotherapy is an effective, easy, and cost-effective method that can be performed using very simple tools and is recommended for all health care providers
The effect of H7 acupressure on amniocentesis anxiety in pregnant women: A randomized controlled trial
Full text linkBackground: Amniocentesis is the most common invasive procedure for diagnosing fetal abnormalities. Most pregnant women are anxious about fetal abnormalities and screening tests. Objectives: This study was conducted to determine the effect of H7 acupressure on amniocentesis anxiety in pregnant women. Methods: This clinical trial was conducted on 56 pregnant women candidates for amniocentesis. In the intervention group, acupressure was performed at H7 acupoint for 5 min in each hand, 30 min before amniocentesis, and then daily for 10 days. The control group did not receive any intervention. Data collection was done using a demographic questionnaire, the Spielberger state-trait anxiety inventory, and a daily acupressure recording checklist. Data were analyzed using the independent samples t-test, Chi-square test, repeated measures analysis, Bonferroni post hoc test, and paired t-test. Results: The mean state anxiety scores in the intervention group were 38.70 ± 5.64 and 30.22 ± 6.70 immediately and 10 days after amniocentesis. However, at the same times, the mean state anxiety scores in the control groups were 49.03 ± 2.30 and 50.86 ± 2.01, respectively, which were significantly higher than the intervention group (P < 0.001). The mean scores of trait anxiety were significantly lower in the participants of the acupressure group than the control group 10 days after amniocentesis (P < 0.001). Conclusion: The H7 acupressure could be effective in reducing state and trait anxiety in pregnant women during amniocentesis and when they are waiting for the test results
Iranian nurses self-reported mastery and use of musculoskeletal assessment skills
Full text linkBackground: Nurses are the key members of the health-care team and play an important role in the assessment of the patients, problems. Objectives: This study aimed to investigate Iranian nurses, self-reported mastery and use of musculoskeletal assessment skills. Methods: This cross-sectional study was conducted from October 2018 to January 2019 on 200 nurses in Shahid Beheshti Hospital of Kashan, Iran. Data were collected using a two-part questionnaire including a demographic data form and 16 self-report items on nurses, mastery in the assessment of the musculoskeletal system. The levels of self-reported mastery and use of the musculoskeletal assessment skills in patient care were assessed. Data analysis was done using descriptive statistics, independent samples t-tests, analysis of variance, and the Pearson correlation analysis. Results: Nurses obtained 83.25 of the score in the area of using health history taking skills, while they obtained 86.94 of the score of mastery in this field. Furthermore, nurses gained 33.77 of the score in the area of using physical examination skills, while they gained 44.53 of the score of mastery in this area. The most commonly used musculoskeletal assessment skills were checking the range of motion of the joints and checking muscle strength that were used in 20.5 of cases. However, nurses rarely used specific tests such as the Patrick,s, ballottement, and Lasegue tests. A significant direct correlation was found between nurses self-reported mastery in musculoskeletal assessment skills and the use of these skills (r = 0.44, P = 0.001). Conclusion: Despite the desirable levels of nurses, self-reported mastery and use of history taking skills, the level of their self-reported mastery and use of musculoskeletal assessment skills are not satisfactory
Being with and for mother: From perceived difficulties to rebalancing the mothering role in women with breast cancer
Full text linkBackground: Breast cancer is the most common cancer and the 5-th leading cause of death in Iranian women. Many of these women are at the age of fertility and have dependent children. Objectives: This study aimed to explore the experiences of mothers with breast cancer of the support they receive for playing and rebalancing their mothering role. Methods: This qualitative content analysis study was conducted from 2018 to 2019. Participants were 22 mothers with breast cancer purposively recruited from Shahid Ghazi Tabatabaee Hospital in Tabriz, Iran. Data were collected through semi-structured interviews and analyzed through a conventional content analysis method. Results: Participants experiences were categorized into three main categories, namely, perceived difficulties, being with and for mother, and rebalancing family functions. The four subcategories of the first category were the physical limitations in performing the mothering role, the psychological burden of the disease, role strain in playing the mothering role, and childrens social difficulties. The second category included five subcategories, namely, assistance with the mothering role, emotional attachment to the mother, provision of family expenses and medical costs, normalization of appearance following cancer-induced changes, and social support resources. Finally, the third category included two subcategories, namely, the stability of the mothers roles and promoting a health-oriented perspective in the family. Conclusion: Mothers with breast cancer face difficulties in performing their role as mothers. Identifying and providing supportive interventions for them by the health-care providers not only can be effective in achieving role stability for the mother but also in rebalancing family functions
Job burnout among nurses in Iran: a systematic review and meta-analysis
Full text linkBackground: Job burnout is a major problem among nurses. The three dimensions of job burnout include emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA). Objectives: The aim of this study was to determine the mean of job burnout among nurses in hospitals affiliated to Medical Sciences Universities in Iran. Methods: This was a systematic review and meta-analysis. An online search was performed in the PubMed, Web of Sciences, Scopus, Google Scholar, Scientific Information Database, Medlib, Iranmedex, Magiran, Civilica, Noormags, and Irandoc databases. The search keywords were burnout,job burnout, occupational burnout, nurses, nursing staff, and Iran. Critical appraisal of eligible studies was performed using the Critical Appraisal Skills Program checklist. The first author's name, publication year, sample size, and the mean scores and standard error values of the different dimensions of job burnout were extracted from each included study. The random-effects and the fixed-effect models were used for the meta-analysis. The Cochran's Q test, the I2 index, and the Egger's regression analysis were used. Results: Nineteen studies with a total sample of 3926 nurses were included in the meta-analysis. The overall means of the EE, DP, and low PA dimensions of job burnout were 21.19 (95 confidence interval CI: 19.28-23.11), 7.85 (95% CI: 6.26-9.43), and 28.89 (95% CI: 27.10-30.67), respectively. The I2 index values of these dimensions were, respectively, 96.6%, 99.4%, and 97.8%, indicating high heterogeneity among the studies. The Egger's regression analysis showed that there was no evidence of publication bias in the studies (P = 0.08). Conclusion: Job burnout among nurses in Iran is moderate in the EE and the DP dimensions and high in the low PA dimension. Strategies are needed to improve nurses' work conditions, fulfill their needs, and thereby, reduce their job burnout
The consequences of child,s congenital heart disease for parents: A qualitative study
Full text linkBackground: Affliction of a child by a chronic disease can significantly affect the whole family. Identifying the consequences of a child,s congenital heart disease (CHD) for parents can help health-care providers provide better care services to them. Objectives: This study aimed at exploring the consequences of a child,s CHD for parents. Methods: This study was conducted in 2020 using conventional content analysis. The 30 parents of 15 children afflicted with CHD were purposively recruited from a hospital and a physician,s private office in Sanandaj, Iran. Data were collected via semi-structured interviews and continued up to data saturation. Data analysis was performed via conventional content analysis suggested by Graneheim and Lundman. Results: The consequences of a child,s CHD for parents were grouped into three main categories, namely threatened family integrity (with three subcategories), psychological turmoil (with five subcategories), and being in limbo (with three subcategories). The 11 subcategories of these three categories were the effects of CHD on parents, neglectful parenting for other family children, reluctance to have another child, anxiety, maternal depression and somatization, helplessness, fear over treatment failure, acceptance of an unchangeable reality, uncertain future, concern over hiding or not hiding a child,s CHD, and a heart full of pain, respectively. Conclusion: A child,s CHD can threaten family integrity, cause parents psychological turmoil, and put them in limbo. Health-care providers, particularly nurses, need to assess the needs of these parents and provide them with professional counseling and need-based emotional, informational, and financial support in order to reduce the negative effects of CHD on them
The Effects of Education through Role-Playing on Self-Concept among Older Adults
Full text linkBackground: Self-concept (SC) is one the psychological characteristics affected by aging. Objectives: This study aimed to assess the effects of education through role-playing on SC among elderly people. Methods: This quasi-experimental study was conducted in 2018 using a two-group pre- and posttest design. Participants were 72 older adults randomly recruited from retirement centers in the East of Guilan province, Iran, and randomly allocated into control group and intervention group. Participants in the intervention group received education through role-playing in six-weekly sessions. Participants' SC was assessed before the intervention onset and 1.5 months after its end using the Rogers Self-concept Questionnaire. The independent sample t-test, the Mann-Whitney U test, and the Chi-square test were used for the data analysis. Results: There was no statistically significant difference between the intervention and the control groups respecting the pretest mean score of SC (10.69 ± 2.21 vs. 9.77 ± 2.59; P = 0.11). However, the posttest mean score of SC in the intervention group was significantly less than the control group (8.44 ± 2.70 vs. 9.69 ± 2.40; P = 0.046). The pre- and posttest mean difference of SC in the intervention group was also significantly greater than the control group (2.25 ± 2.43 vs. 0.10 ± 1.58; P<0.001). Conclusion: Education through role-playing is effective in significantly improving older adults' SC. Therefore, health-care providers can use this method for SC improvement among older adults
The Effect of Motivational Interview on Puberty Knowledge and Practice among Adolescent Girls
Full text linkBackground: Adolescence is a critical stage of life with a significant role in reproduction and fertility. Interventions are needed to promote the health of adolescent girls as prospective mothers. Objectives: This study aimed to investigate the effects of motivational interviewing on adolescent girls' puberty knowledge and practice. Methods: This quasi-experimental study was conducted in 2018 on 240 eighth-grade female students recruited through multistage sampling from ten high schools in Shahroud, Iran. Schools were allocated into an intervention group and a control group through simple randomization. Participants in the intervention group received a five-session puberty-related motivational interviewing intervention. Puberty knowledge and practice in both groups were assessed before, immediately after, and 1 month after the intervention. Data were analyzed through the Chi-square and the independent-samples t-tests and the repeated-measures analysis of variance. Results: Participants' age was 14.47 ± 0.51 years, on average. About 70 of them had poor or moderate puberty knowledge. Although there was no statistically significant between-group difference respecting the mean scores of puberty knowledge and practice at pretest (P> 0.05), the mean scores of puberty knowledge and practice in the intervention group were significantly higher than the control group at both posttests (P = 0.001). Conclusion: Motivational interviewing is effective in improving adolescent girls' puberty knowledge and practice
The association of Shift Work and Effort-Reward Imbalance with Gastrointestinal Symptoms among Female Nurses
Full text linkBackground: Shift work impacts workers' health, mainly by disrupting the circadian rhythm, and gastrointestinal (GI) disturbances are among the health effects of shift work. Objectives: The objective of this study was to assess the association between shift work, work stress, and GI disturbance among nurses. Methods: In July 2018, a cross-sectional study was conducted in Dammam Medical Complex, Saudi Arabia. A total of 250 nurses were selected through convenience sampling from several departments. They completed a validated questionnaire, which included questions about their demographic data, GI symptoms, and effort-reward imbalance (ERI). Work stress was classified into two groups based on the ERI ratio. GI symptoms were categorized into three indices: total, upper, and lower GI. The sampling plan was designed to cover most of the shifts in the included departments throughout nonspecified dates. The daytime nurses' group was selected from the same hospital as a comparison group to the shift workers. Means and standard deviations were calculated for continuous variables and frequencies and percentages were calculated for categorical variables. The associations were assessed using the Chi-squares and analysis of variance. Results: Work stress among nurses, as measured by the ERI scale, was strongly associated with both upper and lower GI symptoms, with odds ratios of 5.7 (CI: 3.3-7.9) and 2.2 (CI: 1.8-4.3), respectively. The total GI symptom score of the shift workers was greater than that for the daytime workers, with means of 7.8 ± 6.9 and 5.4 ± 5.1, respectively (P = 0.005). Multivariable regression analysis showed that ERI was associated with both lower and upper GI symptoms after adjusting for shift work and years on the job. Conclusions: Shift work was associated with the high prevalence of GI symptoms. Stress (ERI) increased the risk for GI disturbance. Controlling work stress is necessary because it affects nurses' physical and social health, as well as their performances at work and the quality of care they provide