The Lived Experiences of Iranian Patients with Rheumatoid Arthritis: A Qualitative Research.

Background: Rheumatoid Arthritis (RA) is a chronic inflammatory disease that affects various systems of the body. The present study was conducted with the aim to explain the lived experiences of Iranian patients with RA. Materials and Methods: According to the research question, the phenomenological research approach was used. The participants were selected through purposive sampling, and sampling was continued until data saturation was achieved. The data was collected by conducting unstructured interviews and using an audio recorder. To interpret the data, an interpretive/hermeneutic approach was implemented using Van Manen's method. In addition, Lincoln and Guba's criteria were used to evaluate data robustness. Results: A total of 24 participants participated in the study. Overall, 145 basic concept codes were extracted which were classified into the four main themes of self-management with the participation of the family, spiritual resilience in the face of existing problems, the tendency to hide the disease, and the fear of an uncertain future. Conclusions: It is recommended that care providers use the findings of this study to develop care plans in the various aspects of the physical, mental, social, and spiritual needs of patients with RA based on their concerns and deep experiences. It is also suggested that other qualitative research approach methodologies such as grounded theory for explaining the process of patient care and providing an appropriate model, or action research for solving the problems of hospitalized patients through suitable care at home be implemented.

The effect of eye care protocol on the prevention of ocular surface disorders in patients admitted to intensive care unit.

Eye care is one of the most critical tasks of intensive care unit (ICU) nurses. Patients in this unit are exposed to potential ocular problems due to critical conditions. This study aimed to establish a new eye care protocol for preventing ocular surface disorders in patients admitted to ICU. This was a clinical trial study performed on patients admitted to ICU in 2019. The data gathering tools included the demographic questionnaire, the Schirmer test for dry eye, fluorescein staining and slit lamp manual for examining corneal ulcers, and slit lamp manual to check keratitis and conjunctivitis. A type of eye care protocol was performed on the patient's eyes. After five consecutive days of executing the protocol, the data were analyzed using SPSS software version 18. The use of eye care protocol reduced the risk of keratitis (P=0.027), conjunctivitis (P=0.012), eye dryness (P=0.001), and corneal ulcer (P=0.003) in patients admitted to ICU in the intervention group compared to the control group. Ophthalmology protocols reduced the incidence of keratitis, conjunctivitis, dry eye, and corneal ulcers in ICU patients. Therefore, using this method in ICU patients can improve nursing care.

Effect of Family Presence on the Success of Weaning in Intensive Care Units.

Background: Weaning of the patient from mechanical ventilator is one of important stages of treatment in patients undergoing mechanical ventilation. Therefore, this study was done to determine the effect of family presence on weaning success in patients admitted to intensive care units (ICUs). Materials and Methods: The present interventional quasi-experimental study was performed on 154 patients undergoing mechanical ventilation who were selected through available sampling method and based on inclusion criteria and were randomly divided into intervention and control groups. For the intervention group, the presence of one of the family members was used in process of weaning from the mechanical ventilator. A questionnaire of patients' demographic information, family satisfaction of patients admitted to ICU, and a checklist of recording the patient's vital signs were used to collect the required information. Results: Based on the results, After the intervention, the patients in the intervention group were in a better condition than the control group in terms of vital signs, time spent for intubation and number of re-intubation, as well as family satisfaction (P<0.05). Conclusion: The results showed that the presence of family in the process of weaning of patients admitted to the intensive care unit is effective in improving vital signs and physiological indicators and reduces the time spent for intubation and the number of re-intubation in these patients while promoting family satisfaction. Therefore, the use of this method can be used in coordination with members of the treatment team to help patients admitted to the intensive care unit.

The Persian validation of the Coronary Artery Disease Education Questionnaire Short Version for education of patients undergoing cardiac rehabilitation.

BACKGROUND: Coronary artery disease (CAD) is a leading cause of cardiovascular death worldwide. Therefore, assessing knowledge in patients with CAD needs a specific tool. This study aims to carry out the Persian validation of the Coronary Artery Disease Education Questionnaire Short Version (CADE-Q SV) for education of patients undergoing cardiac rehabilitation (CR). METHODS: This study was a cross-sectional study. First, the original version of the CADE-Q SV was translated from English into Farsi using the standard approach. The face validity and content validity were measured using quantitative and qualitative approaches. The confirmatory factor analysis (CFA) was done to examine the construct validity. The reliability of the questionnaire was investigated through test-retest reliability and by calculating Cronbach's alpha coefficient. SPSS software was used to analyze the data, and the R package lavaan, to approve the CFA. RESULTS: The result of quantitative face validity showed that the minimum score was 4.42. The minimum scores for quantitative content validity were 0.83 for content validity index (CVI) and 0.66 for content validity ratio (CVR); therefore, all the items were approved. According to the results of the CFA, the comparative fit index (CFI) was reported to be 0.969, indicating a good fit for the items. The Cronbach's alpha coefficient for the whole instrument was 0.679, and the test-retest correlation was measured to be > 0.4, after a 2-week interval. CONCLUSION: In total, it can be concluded that the CADE-Q SV has good psychometric properties and proper reliability. It can be utilized in medical and CR centers.

Development and Psychometric Properties Evaluation of a Care Needs Questionnaire in Phase 1 Cardiac Rehabilitation for Patients with Coronary Artery Disease: CNCR-Q.

Introduction: Cardiovascular diseases (CVDs) are one of the most common chronic illnesses and the leading cause of mortality worldwide. This study aimed to design and assess the psychometric properties of questionnaire to examine the care needs of patients with coronary artery disease (CAD) in phase 1 of cardiac rehabilitation (CR). Methods: This sequential exploratory study used a mixed method with two phases. In the first phase, qualitative study was performed by analyzing the concept of Schwartz-Barcott-Kim hybrid model; and in the second phase, quantitative data were obtained and analyzed for the psychometric parameters of the designed tool. Results: The questionnaire for care needs was based on the indicators of measurement, which was identified in the qualitative phase of the study, as a tool with 40 items. After conducting face validity qualitatively, all tool items were considered important and were retained for the next steps. After completing the steps for determining the content validity ratio (CVR) and content validity index (CVI) of 40 items, they were preserved for decision making at a later stage. The results of exploratory factor analysis revealed four factors; the factor analysis of three items was eliminated and the final version of the questionnaire CNCR-Q (Care Needs Cardiac Rehabilitation-Questionnaire) with 37 items remained. Conclusion: The findings indicated that the questionnaire with properties, such as simple scoring, reliability and validity, is an appropriate tool for assessing care needs in Iranian patients with CAD. Moreover, the CNCR-Q is an effective instrument for assessing patient needs before discharge.