Effects of a peer education on cardiac self-efficacy and readmissions in patients undergoing coronary artery bypass graft surgery: a randomized-controlled trial.

AIM: This study aimed to investigate the effects of a peer education on cardiac self-efficacy (CSE) and readmission of the patients undergoing bypass surgery. BACKGROUND: Self-efficacy is an antecedent vital factor in both initiating and maintaining healthy behaviours. It significantly improves after effects of heart attacks, anxiety and diminishes the possibility of readmission. DESIGN: This study is a randomized-controlled trial. METHOD: Sixty patients undergoing bypass surgery were chosen and assigned equally into the control and intervention groups. While routine education was presented to the patients in the control group, intervention group were taught using the peer education in two sessions. CSE of all the selected patients was assessed orderly in 5 days, 4 weeks and 8 months after surgery. Moreover, their readmission was investigated after 8 months from surgery. Data was collected using demographic and the CSE scale. Data were also analysed by using χ2 , Kolmogorov-Smirnov and repeated measures analysis of variance tests. RESULTS: The mean score of CSE in the intervention group was significantly different from the corresponding number in the control group in all three stages of data collecting (p < 0·001). Compared to the control group, a smaller number of the patients in the intervention group were readmitted to the hospitals after 8 months (p = 0·011). CONCLUSIONS: Implementation of peer education has positive effects on CSE in patients who have bypass surgery and reduces their hospital readmission. It can be beneficial to apply this method as an educative-supportive approach in cardiac surgery fields. RELEVANCE TO CLINICAL PRACTICE: Implementation of peer education has positive effects on CSE in these patients and reduces their hospital readmission.

Cardiac patients' perception of patient-centred care: a qualitative study.

AIM: The aim of this study was to explore cardiac patients' perception of patient-centred care. BACKGROUND: Despite patient's importance in the process of care, less attention has been paid to experiences and expectations of patients in definitions of patient-centred care. As patients are an important element in process of patient-centred care, organizing care programs according to their perceptions and expectations will lead to enhanced quality of care and greater patient satisfaction. DESIGN: This study is a descriptive qualitative study. METHODS: Content analysis approach was performed for data analysis. Participants were 18 cardiac patients (10 women and 8 men) hospitalized in coronary care units of teaching hospitals affiliated to Tehran University of Medical Sciences. We collected the study data through conducting personal face-to-face semi-structured interviews. FINDINGS: The participants' perceptions of patient-centred care fell into three main themes including managing patients uncertainty, providing care with more flexibility and establishing a therapeutic communication. The second theme consisted of two sub-themes: empathizing with patients and having the right to make independent decisions. CONCLUSIONS: Receiving patient-centred care is essential for cardiac patients. Attention to priorities and preferences of cardiac patients and making decisions accordingly is among effective strategies for achieving patient-centred care. IMPLICATIONS FOR PRACTICE: Cardiac care unit nurses ought to be aware that in spite of technological developments and advances, it is still important to pay attention to patients' needs and expectations in order to achieve patient satisfaction. In planning care programs, they should consider accountability towards patients' needs, flexibility in process of care and establishing medical interactions as an effective strategy for improving quality of care.

Factors influencing patients' dignity: A qualitative study.

Dignity represents the essence of nursing care; hence, nurses are professionally responsible for promoting understanding about the promotion, provision, and preservation of every patient's dignity, while considering contextual differences. The aim of this study was to explore the factors that influence, promote, or compromise patient dignity. A purposeful sample of 14 participants with hospitalization experience was chosen, and individual in-depth semi-structured interviews were conducted for data collection. Using inductive content analysis, the themes and subthemes related to factors influencing patients' dignity were explored: "persona" ("personal beliefs" and "personal characteristics"), "communication behaviors" ("verbal interaction," "body language," "compassionate behavior," and "devoting enough time"), and "staff conduct" ("professional commitment," "adequate human resources," and "staff's proficiency and competency"). The findings revealed that it is essential to expand nurses' insights and knowledge about preserving patients' dignity and the factors that influence these. Recognizing and focusing on these factors will help nurses to establish practical measures for preserving and promoting patients' dignity and providing more dignified care at the bedside.

Human dignity in religion-embedded cross-cultural nursing.

BACKGROUND: Although human dignity is an unconditional value of every human being, it can be shattered by extrinsic factors. It is necessary to discover the authentic meaning of patients' dignity preservation from different religious perspectives to provide professional cross-cultural care in a diverse setting. RESEARCH OBJECTIVE: This article identifies common experiences of Iranian Muslim and Armenian Christian patients regarding dignified care at the bedside. RESEARCH DESIGN: This is a qualitative study of participants' experiences of dignified care elicited by individual in-depth semi-structured interviews. PARTICIPANTS AND RESEARCH CONTEXT: A purposeful sample of 10 participants (five Iranian Muslims and five Iranian Armenians) from various private and governmental hospital settings was chosen. ETHICAL CONSIDERATIONS: This study was approved by the ethics committee of Tehran University of Medical Sciences. All the participants were provided with information about the purpose and the nature of the study, the voluntary condition of their participation in this study, and the anonymous reporting of recorded interviews. FINDINGS: The common experiences of Christian and Muslim patients regarding dignity preservation emerged as "exigency of respecting human nobility" and "providing person-centered care." DISCUSSION AND CONCLUSION: It is essential to recognize the humanness and individuality of each patient to preserve and promote human dignity in diverse cross-cultural settings. The findings support and expand current understanding about the objective and subjective nature of dignity preservation in cross-cultural nursing.

Ethical advocacy in the end-of-life nursing care: A concept analysis.

AIM: This concept analysis was conducted to identify and define the features and functions of ethical advocacy in the end-of-life nursing care. BACKGROUND: Ethical advocacy is key to the role of the nurse in delivering quality and competent care. Despite this, the dimensions of this concept are poorly understood. DESIGN/DATA SOURCE: Databases such as Google Scholar, Scopus, Web of Science, Science Direct, and PubMed were searched systematically. To search these databases, the following keywords were used: "patient advocacy," "nursing," "ethics," "end-of-life care," and their combinations. REVIEW METHODS: Walker and Avant's method was utilized as a comprehensive review of the literature to explore how ethical advocacy in nursing can be used to improve the quality of care. RESULTS: The defining attributes of the concept of ethical advocacy included adhering to ethical principles of nursing, championing social justice in the provision of healthcare, safeguarding and defending patient's rights by applying collective wisdom, and involving hospital ethics committees. Antecedents are organizational and personal power and ethical leadership. The optimal consequence of ethical advocacy can be getting the best ethical governance. CONCLUSION: Based on this analysis, the concept of ethical advocacy is one of the most important roles for nurses which requires their awareness of this concept.

Concept analysis of the Four-Season-Symphony of Intellectuality-Spirituality-Ethics-Esthetics (FSS: I SEA) in nursing research.

BACKGROUND: The Four-Season-Symphony of intellectuality, spirituality, ethics, and esthetics (FSS: I SEA) in nursing research is a new concept that has not been addressed in previous nursing theories and studies. AIM: This study was conducted to clarify the concept of the FSS: I SEA in nursing research. DESIGN: Wilson's method of concept analysis was used. DATA SOURCE: Empirical and conceptual literature. REVIEW METHOD: This study has been conducted based on Wilson's 11-step approach by searching keywords with Symphony, Rationality, Intellectuality, Spirituality, Ethics, Esthetics, and Nursing research in databases including Google Scholar, PubMed, Scopus, CINAHL, Sid, Oxford Dictionary, Dehkhoda Dictionary, and nursing theory textbook. RESULTS AND CONCLUSION: Richness and elegance of the symphony in nursing research cannot be achieved by a single-tool benchmark; rather, a more integrated assessment can be achieved with the use of a tool combining different intellectuality, spirituality, ethics, and esthetics tools. This symphony contains a philosophical and deep understanding of the meanings of researcher, research problem, research process, and symphonic product. Through identifying the facilitators and barriers of this concept, nursing researchers, professors, and practitioners will be able to design and implement their research activities on FSS basis to pave the way for the continued transcendence of comprehensive nursing care.

Nursing portal; a nursing informatics solution for iran, lessons learned from a comparative study.

The nursing portal is an informatics solution in which services and capabilities supports the nursing staff in their practices and professional development with respect to the existing challenges for use of Internet by nurses at work. It can be considered as a creditable gateway for quick access to research-based evidence provided by reliable resources. Also it provide interactive virtual environment for knowledge exchange with experts or colleagues in different geographical area. Through a comparative study on specialized nursing portals in Iran and other three countries, the aim of this paper is defining desired content and structural specifications of nursing portals which support the practice of nurses in the workplace. Based on results of the present study, a set of recommendations provide for development of a comprehensive nursing portal in Iran.

Factors influencing the clinical preparation of BS nursing student interns in Iran.

Amalgamation of nursing education into universities has raised many questions about the nursing students' clinical preparation. Despite increased academic input into nursing education in Iran in recent years, the public and the government have criticized Iranian nurses regarding the poor quality of patient care. Using grounded theory methodology, in-depth individual interviews were conducted with a theoretical sample of nine participants to better understand the perceptions of factors influencing the clinical preparation of BS nursing student interns. Three main clinical themes emerged from this study: (i) educator incompetency; (ii) nursing staff technical ability; and (iii) a non-conducive learning environment.