Spiritual care competence, moral distress and job satisfaction among Iranian oncology nurses.

BACKGROUND: Nurses have a crucial role in identifying spiritual needs and providing spiritual care to patients living with cancer. AIM: This study evaluated Iranian oncology nurses' spiritual care competence and its relationship with job satisfaction and moral distress. METHOD: This cross-sectional study was conducted on 280 Iranian oncology nurses in 2020 using four questionnaires: demographic questionnaires, the Spiritual Care Competence Questionnaire (SCCQ), the Minnesota Job Satisfaction Questionnaire (MSQ) and the nurses' Moral Distress Questionnaire (MDS-R). FINDINGS: The mean scores indicated a medium to high Spiritual Care Competence (SCC), mild to moderate moral distress and high job satisfaction. There was a positive correlation between SCC and external job satisfaction (r=184, p<0.05) and a negative correlation between SCC and moral distress (r=-0.356, p<0.05). CONCLUSIONS: SCC diminishes with decreasing external job satisfaction and increasing moral distress. To improve the SCC of nurses working with patients living with cancer, it is recommended that nursing managers and policymakers revise the organisational policies to tackle the obstacles and consider the related factors to provide an ethical climate, implement quality spiritual care and increase job satisfaction.

Evaluating the Use of Communication Board on Cortisol Level and Physiological Parameters in Mechanically Ventilated Patients.

Background: Mechanically ventilated patients experience a high level of anxiety due to their therapeutic condition. Anxiety is one of the strongest emotions that patients under mechanical ventilation experience due to their inability to communicate with others. The aim of this study was to investigate the effect of using a communication board on these patients' by assessing serum cortisol level and vital signs. Materials and Methods: This randomized clinical trial study was conducted in 2020. This study included 60 ventilated patients, who had been randomly assigned into two intervention and control groups. After blood sampling and evaluation of cortisol and physiological parameters, patients in the control group received routine communication by nurses, whereas those in the intervention group received communication using a communication board. Subsequently, the serum cortisol level and physiological parameters were measured again. Results: No significant difference was observed between the two groups in terms of demographic characteristics. There was a significant difference in blood cortisol levels before and after in the intervention group (t 29 = 15.52, p < 0.001). After the intervention, the intervention group's systolic blood pressure (t 58 = -3.78, p < 0.001), diastolic blood pressure (t 58 = -3.79, p < 0.001), and heart rate (t 58 = -2.09, p = 0.041) were significantly lower than the control group. Conclusions: Communication through a communication board in mechanically ventilated patients leads to decreased cortisol levels and physiological parameters. It is recommended to do more studies about communication boards' content and use this tool for more prolonged periods.

Ways To Enhance Blood Transfusion Safety: A Systematic Review.

AIM: Blood product administration is a vital and possibly life-threatening issue that may increase the risk of clinical damage in patients. This review aims to provide a comprehensive review of the ways to improve blood transfusion safety. METHOD: In order to conduct this systematic review, electronic databases, including PubMed/MEDLINE, EMBASE, Web of Science, Cochrane CENTRAL, Scopus, and Google Scholar, were searched for data of the last 30 years using keywords including patient safety, blood transfusion, risk management, safety management, and transfusion reaction. The inclusion criteria set for the selection of quantitative articles were articles written in English and published in peer-reviewed journals during the mentioned period. In this study the publications are reviewed in line with the PRISMA guide checklist. RESULTS: Among 6105 articles found during the initial search, 16 articles were finalized for further investigation. Fifty percent of the included articles discussed the use of modern technology including patient identification system, barcode technology, portable computer systems, and databases. Moreover, 31% of the studies evaluated the use of alternative methods for transfusion of blood products including mediastinal blood transfusion, the use of autologous blood in adult patients, the use of cord blood in children, the use of hemoglobin-based oxygen carrier-201, and the injection of fresh whole blood. About 18% of articles drew attention to indications and thresholds as an essential factor increasing patient safety. CONCLUSION: It was concluded from this study that the use of technology leads to fewer human errors and complications caused by these errors. In addition, some alternative methods can be used in a cost-effective way to reduce serious adverse events caused by common strategies.

Effect of cancer treatment on sleep quality in cancer patients: A systematic review and meta-analysis of Pittsburgh Sleep Quality Index.

BACKGROUND: Sleep problems are one of the most common symptoms experienced by cancer patients. The causes of poor sleep quality might be due to treatment and its side effects. Thus, we conducted this systematic review and meta-analysis with the aims of investigating sleep quality during treatment in cancer patients. METHODS: Comprehensive search strategy was conducted in the following original databases: PubMed, Web of Science (ISI), Scopus, Embase, PsycINFO, and Ovid, from 1950 to 15th February 2021. Studies that investigated the sleep quality during treatment in cancer patients were included. Two investigators extracted all relevant data, independently. For deriving mean difference, random-effects meta-analyses were used. We assessed quality of studies by Newcastle-Ottawa Scale (NOS). RESULTS: A total of 27 studies (1884 participants) were included in the syntheses on sleep quality. The mean global Pittsburgh Sleep Quality Index (PSQI) in cancer patients before the initiation of treatment was 7.11 (95% CI: 6.48, 7.74), during 8.31 (95% CI: 6.34, 10.27), after the treatment 7.10 (95% CI: 6.54, 7.66), and finally, the mean global PSQI in the time of follow-up was estimated 7.33 (95% CI: 6.27, 8.39); all the results were meaningful (P < 0.001). The mean difference showing the quality of sleep was better before the initiation of treatment compared to after the treatment. CONCLUSION: Cancer patients who underwent cancer treatment face lots of problems and adverse effects caused by treatment. Our results revealed that cancer patients experience poor quality of sleep during the whole trajectory of cancer even after a year from the initiation of treatment. After the end of treatment, sleep quality got better compared to during the treatment and returned to before the treatment level, but it is still poor and needs more sleep-related interventions to improve.

Clinical manifestation, laboratory and radiology finding, treatment and outcomes of COVID-19: A systematic review and meta-analysis.

BACKGROUND: Since December 2019, coronavirus (COVID-19) spread throughout the world. The high rate of infection and its unknown nature led specialists to report the condition of patients. The aim of this study is to systematically review of symptoms, laboratory and radiologic findings, treatment, and outcomes of patients with COVID-19. MATERIALS AND METHODS: Databases such as PubMed, Embase, Scopus, Web of Science, Google Scholar, and Cochrane were searched. Finally, 46 articles were appropriate for the aim of the study. After quality evaluation, the necessary data were extracted and meta-analysis was performed. RESULTS: 4858 articles were retrieved until March 30, 2020. After screening, the full-text of 46 articles was assessed. Of the reported cases, 31.7% had no comorbidities, 21.4% had high blood pressure, 70.6% had fever, and lymphopenia was reported in 55.2% of patients. For 16% bilateral patchy shadowing in radiography and for 51% ground-glass opacity was reported. Outcomes were remarkable for recover to death. CONCLUSION: COVID-19 leads to healthcare problems for countries. Nonspecific symptoms have made it difficult for differential diagnoses without computed tomography-scan or corona Test, but they are not available in many countries. Therefore, this systematic review can help health care staff to make decisions based on symptoms, treatments, and outcomes..