Factors associated with the quality of dying and death and missed nursing care.

BACKGROUND: Patients in intensive care units need full nursing care due to the high mortality rate. However, some aspects of nursing care can be forgotten. AIMS: To investigate the quality of death and dying and its association with aspects of missed nursing care, alongside the overall perception of nurses in intensive care units about factors associated with missed nursing care. METHODS: This cross-sectional study used a census sampling method of 105 nurses working in intensive care units. In order to collect data, the Quality of Dying and Death Questionnaire (QODD), missed nursing care (MISSCARE survey) and factors associated with missed nursing care questionnaire were used. Data analysis was performed by using SPSS 16. FINDINGS: The quality of death and dying, as perceived by nurses, was found to be lower than the average (Range score: 0 to 100). The range of missed nursing care was average (Range of score: 24 to 96) and the most noticeable reason for this missed nursing care was the shortage of nursing staff. CONCLUSION: Managers should ensure that nurses provide complete nursing care for terminally ill patients in intensive care units and eliminate factors that lead to aspects of nursing care being missed, such as staffing levels, material resources and communication between staff members.

Blinding and Its Quality in Clinical Trials Conducted on Patients with Breast Cancer: A Systematic Review.

Background: Blinding is one of the critical criteria of clinical trials that prevents probable bias. Judgment regarding results of an intervention significantly depends on the quality of such studies, one of which is blinding. This study aimed to investigate blinding and its quality in clinical trials in patients with breast cancer. Materials and Methods: A systematic review was conducted on the online databases of PubMed, ScienceDirect and ProQuest using keywords, MeSH terms and grey literature. Articles were screened by predefined inclusion and exclusion criteria. They were evaluated based on the checklists introduced by Cochrane database. Results: From 22519 articles obtained at the initial stage, 20 articles remained after screening for the inclusion and exclusion criteria. Fifteen articles had used single, five: double and none had used triple or quadruple blinding. Seventeen studies had described the details of blinding. Of the 15 single blind articles, the blinded subjects were patients in five, patients and research assistants in three, research assistants in five studies, and two had not given any details. Conclusions: The majority of researchers had used the single blind method, though using double, triple or quadruple blinding increases the trustworthiness of results and increases the quality of clinical trials. The details of blinding should be explained to other researchers and for a better understanding of the method if it is to be repeated. Thereafter, nurses can apply new interventions and earn their patients' trust and help those with breast cancer by relieving them of their disease symptoms and its treatment complications.

Struggle Turning Back to Professional Nursing Practice in Iran: A Qualitative Study.

BACKGROUND: Current nursing shortage is becoming more complicated because of turnover intention among nurses. Most of the inactive nurses in Iran after a long time for various rations Returned To Professional Nursing Practice (RTPNP). Because the RTPNP program does not exist in Iran to prepare inactive nurses returning to practice, this study aimed to explore the strategies that contribute to preparing nurses for RTPNP. MATERIALS AND METHODS: The present study was a part of the findings of a larger grounded theory study that lasted about 9 months from April 2019 to December 2019. The data were collected through semi-structured interviews with participants after signing an informed consent form. The average interview duration was 40 minutes. The study participants were selected through purposeful sampling from both public and private hospitals affiliated to Iran University of Medical Sciences. Participants included eight nurses, two education supervisors, two matrons, and two head nurses. Interviews were verbatim transcribed and analyzed using a constant comparative analysis method. RESULTS: Struggle turning back to PNP was the main category that emerged from four categories of "seeking learning resources," "return to practice support," "getting used to a practice," and "building a new family life" from the data analysis process. CONCLUSIONS: Returners struggle to get prepared for providing PNP to clients if there is no definite process of RTPNP. Organizational support and RTPNP programs are efficient strategies and could help these returners get prepared for PNP.

Androgen Deficiency in Aging Males: Translation and Validation Study of the Iranian Version.

BACKGROUND: Considering the importance of psychometric evaluation of the male sex hormone deficiency questionnaire by Iranian nurses, this study aimed to determine the translation and validation of the Iranian version of the Androgen Deficiency in Aging Males (ADAM) questionnaire. MATERIALS AND METHODS: This study was cross-sectional. After obtaining permission from the instrument maker, translating it into Farsi, retranslated it into English, and determining validity and reliability. The study population was 200 Iranian men who admitted to hospitals affiliated with Iran University of medical science and were older than 50 years and selected by convenience sampling method. They were evaluated and monitored based on the Iranian version of the ADAM questionnaire. Sensitivity and specificity were assessed and analyzed by Rock Chart analysis. Descriptive and analytical statistical tests were used at a significant level of 0.05. RESULTS: Findings showed that the Iranian version of the ADAM questionnaire had good face validity. Results showed that Cronbach's alpha in this questionnaire was 0.93, which indicates high reliability, and all the valid questionnaires were reported for the Scale-Content Validity Index (SCVI) calculation. Hence, the questionnaire has good content validity. The Iranian version of the ADAM questionnaire has a sensitivity of 93.85% and a specificity of 77.14% at the cut-off point of 2.2, indicating high sensitivity and specificity. CONCLUSIONS: The Iranian version of the ADAM questionnaire is valid and reliable and has high sensitivity and specificity. Nurses can also use it as an adjunctive scale to screen andropause men over 50 years of age.

Investigating the effect of educational intervention based on the Pender's health promotion model on lifestyle and self-efficacy of the patients with diabetic foot ulcer: A clinical trial.

BACKGROUND: This study aimed to investigate the effect of educational intervention based on the Pender's health promotion model (HPM) on lifestyle and self-efficacy of the patients with diabetic foot ulcer. MATERIALS AND METHODS: In this clinical trial conducted in 2019, 74 patients based on inclusion criteria were selected through convenience sampling and allocated to two groups of intervention (n = 37) and control (n = 37) using the randomized permuted block method. In this study, Demographic characteristics and localized Diabetes Foot Care Self-Efficacy Scale and Health-Promoting Lifestyle Profile Questionnaire for diabetic foot care were completed by two groups. The obtained data were analyzed using SPSS 16 and through descriptive and comparative statistics, independent t-test, paired t-test, and ANCOVA. RESULTS: After the intervention, the mean score of the intervention group significantly increased in all lifestyle dimensions (P < 0.001). Furthermore, the mean score of self-effcacy increased in the intervention group after the intervention (P < 0.001). Comparing the change in the mean scores of lifestyle and self-efficacy in both the groups 50 days after the intervention, an increase was observed in the mean scores of self-efficacy (P < 0.001) as well as those of lifestyle and its dimensions in the intervention group compared to those in the control group (P < 0.001). CONCLUSION: Educational intervention based on the Pender's HPM can promote the self-efficacy, lifestyle, and its dimensions in the patients with diabetic foot ulcers. The results of this study can be used in educational interventions aiming at patients with diabetic foot ulcers to change their lifestyle and improve their self-efficacy.

Exploring the process of turning back to professional nursing practice in Iran: A grounded theory.

BACKGROUND: The current nursing shortage is complicated because of turnover intention among nurses. Most of the inactive nurses returned to professional nursing practice. Returned to professional nursing practice program was low attrition rates and a more cost-effective strategy that prepared inactive nurses returning to practice. This study aimed to explain the process of returned to professional nursing practice. MATERIALS AND METHODS: This study was a grounded theory study, which lasted from about 2018 to 2020. Data were collected through semi-structured interviews and observations with participants after signing an informed consent form. The average interview duration was 45 min. The study participants were selected through purposeful sampling from both public and private hospitals affiliated to Iran University of Medical Sciences. Interviews were verbatim transcribed and analyzed using a constant comparative analysis method. RESULTS: In this study, 16 participants were selected, including ten nurses, two educational supervisors, two head nurses, and two matrons. The "transformed competence" as the core concept and the four main concepts of "feeling alienated with the new environment," "getting prepared for restart," "gradual maturity in clinical practice," and "components of organizational culture" were extracted from the data analysis process. CONCLUSION: The process of returned to professional nursing practice in the context of the organizational culture of incentive learning leading to a high level of competence, and in the context of the organizational culture of inhibiting learning, is leading to deficiency incompetence.

The Effect of Self-Management Training on Anxiety and Comfort of Burn Patients Candidate for Skin Grafting.

BACKGROUND: Self-management programs on needs of burn patients are still essential. So this study determined the effect of self-management training on anxiety and comfort of burn patients who were candidate for skin grafting. METHODS: In a continuous sampling method in Shahid Motahari Burn Center affiliated to Iran University of Medical Sciences, 80 burn patients candidate for skin grafting were divided into equal groups of intervention and control. Educational intervention was undertaken in the form of booklet during two sessions before and after skin grafting. Visual comfort scale questionnaire and Spiel Berger state-trait anxiety inventory were completed by patients before training and one month after intervention. RESULTS: There was a significant difference between the frequency of comfort level in both groups before and after the intervention. The level of comfort in the intervention group increased more than control group. The mean level of patients' anxiety showed a significant difference between groups and scores in intervention group were significantly more than control group. CONCLUSION: Attention and control of anxiety and comfort in burn patients are one of the essential elements of their care. It can be suggested that self-management training can reduce anxiety and increase burn patients' comfort.

Upper limb amputation; Care needs for reintegration to life: An integrative review.

BACKGROUND AND AIMS: Upper limb amputations cause numerous physical and psychosocial challenges including disruptions to quality of life as well as limitations in participation in society. While there is a great deal of literature on patients undergoing lower limb amputation, information on upper limb amputation is limited. This study aimed, therefore, to explore care needs in patients undergoing upper limb amputation. MATERIALS AND METHODS: An integrative review was conducted. The five-stage framework introduced by Whittemore and Knafl was used: problem identification, literature search, data evaluation, data analysis and presentation of results. Searches were performed based on predefined inclusion and exclusion criteria for online and unpublished research between 2008 to 2018. Data was extracted using CASP and STROBE checklists and analyzed using conventional inductive content analysis. RESULTS: Conventional content analysis method, applied to the full texts of the final articles, included 21 articles (4 qualitative articles and 17 quantitative articles). The care needs identified included 33 care needs in 6 domains: social needs, health care system, rehabilitation program, necessity of self-care, assisting in timely and correct decision-making and patient and family education. CONCLUSION: Rehabilitation plans should be made for all patients, with special attention to male workers. This should begin at the time of admission and continue after their discharge. Routine follow up after discharge is essential. Care must be provided by a multidisciplinary team with timely and accurate referral and with consideration of culture and individual factors.

The Effect of Short-Term Training Course by Nurses on Body Image in Patients with Burn Injuries.

BACKGROUND: Burn is the fourth most common cause of trauma worldwide and is the fourth among the injuries and surgeries requiring medical care. This study was designed to determine the effect of a short-term training course by nurses on body image in patients with burn injuries. METHODS: This study was a semi-experimental single-group survey assessing before and after interventions. Totally, 130 subjects (65 women and 65 men) were enrolled. The training course was held in 3 sessions of two hours. The contents of the group training course (a group of 5 people) were in relation to the body image and the factors affecting it, and the ways to improve the body image. The data collection instrument was the satisfaction with appearance scale (SWAP). RESULTS: The mean scores of the body image of patients before and after the intervention were 49.44±11.39 and 41.63±11.89, respectively. There was a significant difference between the mean scores of body image before and after educational interventions (T=6.013, P≤0.001). The mean score of body image in women before and after intervention was 49.2±10.9 and 41.2±11.65, respectively (T=4.51, P≤0.000). The mean score of body image in men before and after intervention was 49.6±11.89 and 42.07±12.19, respectively (T=4.51, P≤0.000). CONCLUSION: Short-term courses held by nurses were shown to have a significant role in improving the body image of burn patients.

Exploratory Study of Andropause Syndrome in 40-65 Years in Arak: A Cross Sectional Study.

Objective: Andropause syndrome is caused due to the deficiency in sex hormones and brings about symptoms of physical, psychological, and sexual nature. This study aims at investigating the prevalence of andropause syndrome in 40-65-year-old men in the central city of Iran (Arak). Materials and methods: This study is a descriptive cross-sectional research conducted on 600 men living in the city of Arak in 2017. The subjects were selected through cluster sampling and qADAM was used for collecting data including three areas (level of energy, psychological and sexual). The data were analyzed through descriptive and inferential statistics (independent t-test and ANOVA) and using SPSS 16. Results: The results showed that the average questionnaire score increased with an increase in age up to 50 years and above. Correlation test for the three subscales of physical, psychological, and sexual showed that the psychological subscale had the highest correlation with andropause score (p < 0.05). Among the items related to the subscales, the statement" I feel my sex drive has decreased" with mean and standard deviation of 3.62 ± 1.06 had the highest correlation with andropause and the statement "I feel I have no value for society" with mean and standard deviation of 1.7 ± 0.86 had the lowest correlation with andropause. Conclusion: Andropause age in Arak is 50 years and above. Average questionnaire score showed a positive direct relation with age. Decreased sex drive had the highest correlation and losing social value had the lowest correlation with andropause state.

Nurses empathy and family needs in the intensive care units.

INTRODUCTION: The patients' families in intensive care units (ICUs) experience excessive stress which may disrupt their performance in daily life. Empathy is basic to the nursing role and has been found to be associated with improved patient outcomes and greater satisfaction with care in patient and his/her family. However, few studies have investigated the nursing empathy with ICU patients. This study aimed to assess nursing empathy and its relationship with the needs, from the perspective of families of patients in ICU. METHODS: In this cross-sectional study, 418 subjects were selected among families of patients admitted to ICUs in Tabriz, Iran, by convenience sampling, from May to August 2012. Data were collected through Barrett-Lennard Relationship inventory (BLRI) empathy scale and Critical Care Family Needs Intervention (CCFNI) inventories and were analyzed using descriptive and inferential statistical tests. RESULTS: Findings showed that most of the nurses had high level of empathy to the patients (38.8%). There was also statistically significant relationship between nurses' empathy and needs of patients' families (p < 0.001). CONCLUSION: In this study we found that by increasing the nurse's empathy skills, we would be able to improve providing family needs. Through empathic communication, nurses can encourage family members to participate in planning for the care of their patients. However, further studies are necessary to confirm the results.