Caregivers' demands: caring atmosphere expected by cancer patients' caregivers-a qualitative content analysis.

PURPOSE: Family caregivers play a critical role in providing care for patients with cancer. However, the quality of their caregiving can be greatly impacted if the demands and expectations they experience are not identified. Therefore, this study aimed to explore the demands and perceived expectations of caregivers while caring for cancer patients. METHODS: This qualitative study was conducted from June 2022 to September 2023. Face-to-face and in-depth semi-structured interviews were conducted to collect the experiences of 19 Iranian family caregivers of patients with cancer. Purposive sampling was used to select the participants. The interviews were analyzed using conventional content analysis and the rigor of the study was ensured by employing Lincoln and Guba's criteria. RESULTS: Three main themes and six subthemes were identified through data analysis. The themes that emerged from the caregivers' experiences included the following: (1) ambiguity in the healthcare system, (2) need for empathetic communication, and (3) forgotten caregivers in the healthcare system. CONCLUSION: Caregivers often feel overlooked, resulting in unfulfilled needs and expectations. It is imperative to explore potential solutions that provide caregivers information, empathetic communication, and support. Nurses, as key members of the healthcare team, should play a significant role in addressing this problem.

Behind the scenes of caregiving in patients with advanced cancer: A qualitative study on family caregivers.

Objective: Family caregivers may have concerns that they do not want to disclose to others. This study aims to delve into the concealed facets of care provided by family caregivers to patients with advanced cancer. Methods: A qualitative approach was conducted in Iran from June 2022 to February 2023. Face-to-face, in-depth semi-structured interviews were carried out with 16 Iranian family caregivers of patients with advanced cancer, employing purposive sampling. The gathered data were analyzed using conventional content analysis, and Lincoln and Guba's criteria for rigor were applied to ensure the study's trustworthiness. Results: The analysis of the data resulted in the identification of three main themes with nine subthemes. The key themes derived from the experiences of family caregivers encompassed (1) chaotic mentalities, (2) troubling interdependence, and (3) desperational emotions. Conclusions: Caregivers of patients with advanced cancer commonly experience a highly fragile psychological state and are profoundly impacted by their concerns for the patient. Healthcare systems should prioritize ensuring that caregivers receive sufficient support and care.

Support Experiences for Novice Nurses in the Workplace: A Qualitative Analysis.

Introduction: Since novice nurses need support at the beginning of their work, knowing workplace support resources can help them to experience fewer challenges at the beginning of their work and improve the quality of patient care. Objectives: The present qualitative study aimed to explore novice nurses' experiences of supporting the workplace at the beginning of their work. Design: This qualitative study was performed using a content analysis method. Methods: This qualitative study was conducted with 14 novice nurse participants using the conventional content analysis method, unstructured in-depth interviews were used to collect data. All data were recorded, transcribed, and analyzed based on the Graneheim and Lundman method. Results: Two major categories and four subcategories were extracted during data analysis as follows: (1) An intimate work environment with subcategories of cooperative work atmosphere and empathetic behaviors, (2) Educational support available for improvement contains subcategories conducting orientation courses and holding retraining courses. Conclusion: The present study showed that such experiences as an intimate work environment, and educational support help novice nurses to have a supportive workplace and improve their performance. A welcoming and supportive atmosphere should be created for newcomers to ease their anxiety and frustration. Furthermore, they can improve their performance and provide quality care by giving themselves the motivation and spirit of improvement. Relevance to Clinical Practice: This research highlights the need for new nurses to have support resources in the work environment, and healthcare managers can improve the quality of care by allocating sufficient support resources to this group of nurses.

Effect of motivational interviewing on treatment adherence and self-efficacy of adolescents with asthma: A randomized controlled trial.

AIMS: This study examined the short-term effect of motivational interviewing on treatment adherence and self-efficacy of adolescents with asthma. DESIGN: The randomized controlled trial. METHOD: In this study, 72 adolescents with asthma were recruited and assigned to experimental and control groups randomly. In the experimental group, the motivational interviewing was performed for five weekly sessions lasting 80-90 min. The treatment adherence and self-efficacy questionnaires were completed before the intervention, 2 weeks and 3 months after the intervention in both groups. Data were analysed by Chi-Square test, independent samples T-test, repeated measures of Wilcoxon and generalized estimating equation. RESULTS: The treatment adherence was found to be significantly higher 2 weeks (p = 0.006) and 3 months after the intervention (p = 0.04) in the experimental group than the control group. In addition, the degree of self-efficacy was significantly more in the experimental group 2 weeks (p < 0.001) and 3 months later (p < 0.001) than the control group. The result of generalized estimating equation showed that the intervention group had an average of 14.44 more self-efficacy points than the control group (p < 0.001). Also, treatment adherence in the intervention group was significantly higher than the control group (ß = 6.14, p = 0.05(. CONCLUSION: This study adds to the evidence for the effectiveness of motivational interviewing in treatment of adolescents with asthma.

Explaining Novice Nurses' Experience of Weak Professional Confidence: A Qualitative Study.

Introduction: The majority of newly graduated nurses are not prepared to work at the bedside; therefore, they may not have the appropriate self-confidence. Objectives: The present qualitative study aimed to explain the novice nurses' experience of weak professional confidence. Design: This qualitative study was performed using a content analysis method. Methods: Content analysis was utilized to identify themes from interview transcripts. They were included in the study by purposeful sampling. Participants were interviewed through face-to-face and unstructured interviews. All data were recorded, transcribed, and analyzed based on the Graneheim and Lundman method. Results: Thirteen nurses participated in interviews. After data collection, all interviews were implemented and reviewed and the categories and subcategories were extracted. Three main categories containing turbulence in working life, unpleasant interactions, and lack of knowledge were extracted. Conclusion: According to the study findings, most novice nurses experienced turbulence in their working life, unpleasant interactions, and a lack of knowledge that affected their self-confidence. Therefore, educational and support programs are suggested to improve novice nurses' professional confidence. Relevance to Clinical Practice: According to the results of the study, the lack of self-confidence in novice nurses reduces the quality of care. Therefore, taking into account the experiences of the participants, nursing education managers should plan in such a way as to improve the self-confidence of the graduates. In addition, novice nurses need to be supported by their managers and colleagues to develop their professional confidence to provide more effective care.

Iranian Men's Sexual Life Issues After Their Wives' Burn: A Qualitative Content Analysis Study.

Physical and psychological complications of burn injuries reduce the victims' sexual quality of life and challenge their partners' sexual satisfaction. There is no information about men's sexual issues and behaviors. Previous studies did not address the impact of women's burns on their husbands' sexual lives. Therefore, this qualitative study aimed to characterize the sexual experiences of Iranian men after their wives' burns. The study was performed on 16 men with surviving spouses of major burn using criterion-based purposive sampling. Semistructured interviews were analyzed using a qualitative content analysis approach. The results showed men's sexual issues with three main themes and eight subthemes: 1) sexual desire restrictors (annoying scars, imposing roles, and wives' sexual coldness), 2) degradation of marital sex (reduced frequency of sexual intercourses, temptation of extramarital affairs), and 3) effort to maintain sex (sexual self-sacrifice, sexual pretending, sexual precautions). According to men's experiences, female sexual coldness, temptation for extramarital affairs, and sexual pretense were related to couples' poor knowledge of sexual discourse. Thus, health professionals can use context-oriented educational program to promote the couples' sexual knowledge and health after burns.

Exploring the Emotional Concerns of Oncology Nurses: A Qualitative Study.

Background: Nursing care for patients with cancer is related to the nurses' ability to manage their emotions and having appropriate behaviors in the clinical setting. Oncology nurses are emotionally influenced by their communication with cancer patients. Thus, this qualitative study was conducted to explore nurses' emotional concerns in oncology wards. Materials and Methods: This qualitative content analysis was performed among 14 oncology nurses in the oncology wards of cancer hospitals in the east and southeast of Iran (South Khorasan and Sistan and Baluchestan Provinces). The study participants were selected through purposeful sampling. Data were collected through face-to-face, semi-structured interviews until data saturation was reached from January to September 2020. The interviews were analyzed after being typed word by word, based on Graneheim and Lundman (2004). Results: The themes and subthemes that emerged from the data were related to the emotional concerns of oncology nurses. The main themes included emotional involvement and attachment (feeling of frustration in nurses, nurses' suffering from painful experiences, and nurses' emotional dependence), emotional ambiguity (nurses' uncertainty emotions, avoidance of expressing real emotions, and having a positive mindset to maintain the patient's positive mood), and emotional exhaustion (persistent chronic stress, excessive worrying about possible harms, and feelings of mental and physical exhaustion). Conclusions: Based on the study results, cancer patient nursing care can be distressing and stressful for nurses. Oncology nurses have many emotional concerns in caring for cancer patients. The experiences of oncology nurses provide new insight into how to manage their emotional concerns.

Metabolic engineering of the diosgenin biosynthesis pathway in Trigonella foenum-graceum hairy root cultures.

Diosgenin as a triterpene with numbers of pharmaceutical applications has been identified in Trigonella foenum-graceum. In this survey, in order to scale up the amount of diosgenin in Fenugreek as a promising alternative of yam, ∆24-reductase as a rate limiting enzyme in diosgenin biosynthesis pathway has been overexpressed by utilizing pBI121 expression plasmid in hairy roots culture platform. The recombinant binary vector pBI121-∆24-reductase was transformed into R. rhizogenes strain ATCC 15834 to induce transgenic hairy roots in "Hamedan" as a low-diosgenin production genotype. In the transgenic hairy roots, the ∆24-reductase expression level was significantly 8.15 times overexpressed comparing to the non-transgenic hairy roots, Nonetheless the Sterol-methyltransferase, as a competitive enzyme, was 6 times downregulated. Furthermore, the expression rate of Squalene synthase, Cycloartenol synthase, C26-Hydroxylase were also increased 1.5, 1.7, 2.9 times higher than those of the non-transgenic hairy roots, respectively. The diosgenin content in the transgenic hairy root was raised 3 times up comparing to the non-transgenic hairy roots, besides it was scaled up 25-fold comparing to the diosgenin amount in "Hamedan" Leaf. As a result, the first metabolic engineering on this pathway was clearly revealed the impact of ∆24 -reductase gene in diosgenin content enhancement.

A concept analysis of Watson's nursing Caritas process.

AIM: The main objective of this analysis is to give an understanding of Watson's nursing Caritas as a concept. DESIGN: Watson's nursing Caritas is an abstract concept, and difficult to define and operationalize because of its philosophical nature. Watson's nursing Caritas develops a clear relationship between care, caring factors, and the processes of human life. METHODS: We used Walker and Avant's method. PubMed, Scopus, Ovid, EBSCO, Science Direct, Web of Science, Google Scholar, and ProQuest were searched. "Caritas process" and "Watson's caring theory" were searched. In the primary search, 883 articles were found, but eventually, 25 articles were included in the study. RESULTS: We define Watson's nursing Caritas as the process based on caring consciousness, engaging in reliable human caring relationships for healing support, integrity, and development of humanity that alters the concept of caring into a higher ethical commitment inspired by responsibility for others, and different meanings, including kindness, compassion, joyfulness, and peacefulness and leads to the establishment of caring behavior in clinical Watson's nursing Caritas, thus leading to improving performance. CONCLUSION: Clinical nursing Caritas enables nurses to develop an effective human being relationship between nurse-client-family, and ultimately achieve a common experience and perception of caring.

Concerns of parents about children's overweight and obesity during the COVID-19 pandemic: A qualitative study.

BACKGROUND AND AIMS: Since the end of 2019, the world has been dealing with a new crisis caused by the widespread and global outbreak of the coronavirus that has affected various aspects of life. The stay-at-home orders issued to prevent the virus from spreading have caused many problems for families, such as obesity and overweight, particularly among children. As parents play a key role in the prevention of childhood obesity, the present qualitative study aimed to examine the experiences of parents regarding the obesity or overweight of their children during the outbreak of coronavirus. DESIGN AND METHODS: This study was performed using a qualitative descriptive approach. The sampling method was purposeful, and the required data were collected through in-depth, unstructured, and face-to-face interviews with 16 parents of children with obesity or overweight. The interviews were digitally recorded, transcribed verbatim, and analyzed using Graneheim and Lundman conventional content analysis approach. RESULTS: The findings were divided into five main themes, including overeating while stuck at home, leading to the sedentary life, disturbed sleep-wake rhythm of the children, indifference of the children towards their appearance, and the inability of parents to control the obesity of their children. CONCLUSIONS: The COVID-19 pandemic has affected families of children with obesity in various ways. The experiences of such parents provide new insight into parental struggles around managing their child's obesity particularly during such stressful times. IMPLICATIONS: An in-depth study of the experiences of the parents and perception of their challenges and concerns about childhood obesity during the COVID-19 pandemic can lead to the development of useful and effective strategies for the control of childhood obesity.

Diplomatic activities of Iranian Nursing Organization: A qualitative study.

BACKGROUND: Nursing organizations play an important role in fulfilling the professional demands of nurses. The Iranian Nursing Organization (INO) is also using diplomatic activities in this direction. AIM: This study was conducted to explain the diplomatic activities of INO. METHODS: A descriptive qualitative study was conducted using conventional content analysis. A purposive sampling approach was used. Data were collected via in-depth, unstructured, face-to-face interviews with 21 nurses at various INOs in different cities from March to July 2020. The data collection process continued until data saturation. Interviews were analyzed using Graneheim and Lundman's (2004) guidelines. The MAXQDA software (v. 10) was used. FINDING: The results showed that the diplomatic activities of INO comprise professional (three categories), social (two categories), and diplomacy in power network (two categories). CONCLUSION: INO carries out diplomatic activities at organizational, national and international levels and pursues its professional nursing goals through diplomacy. INO also uses social diplomacy and political diplomacy to influence decision-makers in the community and network of power.

The effect of rosemary essential oil inhalation on sleepiness and alertness of shift-working nurses: A randomized, controlled field trial.

BACKGROUND: Sleepiness during the night shift is a common complaint of shift workers, including the nurses. This study investigated the effects of inhaled rosemary oil on sleepiness and alertness of shift-working nurses. METHODS: Eighty shift-working nurses were selected and assigned randomly into control (n = 40) and intervention (n = 40) groups. Both groups completed the Karolinska Sleep Questionnaire and Epworth Sleepiness Survey before the intervention. The intervention group received one drop of rosemary essential oil using a mask. The control group received a drop of distilled water instead, after which the questionnaires were completed for a second time. RESULTS: The sleepiness mean score in the intervention group reduced from 12.15 to 8.3, while it increased from 11.41 to 13.76 in the control group (P < 0.001). The alertness mean scores changed from 4.45 to 3.25 and from 4.41 to 5.34 in intervention and control groups, respectively (P < 0.001). CONCLUSION: Rosemary aroma decreased sleepiness and increased alertness in shift-working nurses.

Factors affecting the emergence of diplomacy in Iranian nurse managers: a qualitative study.

AIM: To explore the factors affecting the emergence of diplomacy in Iranian nurse managers. BACKGROUND: Today, with the development of complex health systems, diplomacy in health care can take place at organizational, national and international levels. INTRODUCTION: Diplomacy's role is to convince others peacefully to achieve goals. Diplomacy in nursing can facilitate professional development and direct policy and decision-making process towards the development of a healthcare system. METHODS: The study used a qualitative descriptive approach. The sampling method was purposeful, and data were collected via in-depth, unstructured and face-to-face interviews with 16 participants. The interviews were digitally recorded, transcribed verbatim and analysed through conventional content analysis based on Graneheim and Lundman's work. RESULTS: In total, 212 codes were generated, which were grouped into three main categories, namely paradigmatic socio-political changes (two subcategories), nurses' dissatisfaction with their status in healthcare system (two subcategories) and multidimensional development of the nursing profession (four subcategories). DISCUSSION/CONCLUSIONS: Socio-political changes, development of the nursing profession and nurses' dissatisfaction with the health system have led to the emergence of diplomacy roles in nurse managers, the recognition and development of which can improve the effectiveness of nurse managers in policymaking. IMPLICATIONS FOR NURSING & HEALTH POLICY: The recent COVID-19 pandemic outbreak has demonstrated the urgent need to use diplomacy to solve health problems and adjust or develop policymaking at the national and international levels. Strengthening their role in diplomacy, nurse managers can play an important role as diplomats at various levels of policymaking and in health crisis management.

Spousal sexual life issues after gynecological cancer: a qualitative study.

PURPOSE: Sexual life is a multidimensional issue that can be affected negatively after gynecological cancer. The aim of this study was to reveal what sexuality life difficulties Iranian women with gynecological cancers experience. METHODS: A qualitative approach was conducted through face-to-face semi-structured interviews with 16 Iranian women with gynecological cancer and then analyzed with conventional content analysis. RESULTS: Three themes emerged from the data: (1) participant's struggle to maintain the sexual monopoly of the husband, (2) deterioration of intimacy, and (3) unpleasant bed-life experiences. Most women are ashamed to talk about their sexual relationships problems, and on the other hand, nurses and physicians ignore to talk about their sexual problems, so these women are alone in the face of this problem. CONCLUSION: Although women with gynecological cancer experience sexual problems such as reluctant to have sex and lack of enjoyment, they struggle to maintain sexual life with their husbands. These women do not have enough support. They believe that sexuality is a shameful issue, and they are reluctant to ask questions about it. Health professionals need to talk about the possibility of sexual problems due to changes in their bodies caused by cancer. These women need to be encouraged to talk about these problems, with consideration to their religious and cultural differences.

The effect of peer counseling on breastfeeding behavior of primiparous mothers: A randomized controlled field trial.

OBJECTIVE: To assess the impact of peer counseling on breastfeeding behavior of primiparous mothers. DESIGN AND SAMPLE: A randomized controlled field trial was conducted with 80 mother-child pairs, who referred to health centers in 2018. The samples were recruited via convenience sampling method and were randomly assigned into experimental and control groups. MEASUREMENTS: World Health Organization B-R-E-A-S-T-Feed Observation form was used at baseline, immediately, 1, 2, and 3 months after the intervention. INTERVENTION: The experimental group received support during the first 3 months after childbirth from 10 peers with successful breastfeeding experiences and similar characteristics to those of the participants, while the controls benefited from the routine education provided by their health centers. RESULTS: Baseline breastfeeding behavior mean scores were not different in the two groups (p > .05). Mean score changes after the intervention were significantly higher in the experimental group than in the control group at different time points, including immediately after the intervention (p < .001), 1 month (p < .001), 2 months (p < .001), and 3 months after the intervention (p < .001). CONCLUSION: Use of peer counseling program to correct the breastfeeding behaviors of primiparous mothers can improve their performance of breastfeeding techniques.

Aromatherapy massage with lavender essential oil and the prevention of disability in ADL in patients with osteoarthritis of the knee: A randomized controlled clinical trial.

BACKGROUND: Knee osteoarthritis is considered as one of the most prevalent musculoskeletal disorders which leads to joint degeneration and consequently disability in activities of daily living. This study aimed to evaluate the effects of aromatherapy massage with lavender essence on activities of daily living of patients with knee osteoarthritis. METHODS: This is a single-blinded, randomized clinical trial. A total of 90 patients with osteoarthritis of the knee referring to the outpatient rheumatology clinics affiliated to Birjand University of Medical Sciences were selected via convenience sampling method. The participants were randomly assigned into three groups: intervention group (aromatherapy massage with lavender essential oil), placebo group (massage with almond oil) and control group (without massage). The activities of daily living of patients was evaluated according to the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) at baseline, immediately after the intervention, 1 week, and 4 weeks after the intervention. Data were analyzed using SPSS statistical software version 16. RESULTS: The activities of daily living of patients were significantly improved immediately and 1 week after the intervention in the intervention group compared with their initial status (p < .001) and that of the control group (p < .001 and p = .03 respectively). However, 4 weeks after the intervention, there was no significant difference between the groups according to the Western Ontario and McMaster Universities Osteoarthritis index (p = .95). CONCLUSION: Aromatherapy massage with lavender essential oil may reduce the incidence of activities of daily living disability in patients with osteoarthritis of the knee. However, further studies are required to confirm findings of this study.

Inter-professional Relationships Issues among Iranian Nurses and Physicians: A Qualitative Study.

INTRODUCTION: Nurse-physician inter-professional relationship is an important issue in health care system that can affect job satisfaction and patient care quality. The present study explores the major issues of nurse-physician inter-professional relationships in Iran. MATERIALS AND METHODS: In this in-depth qualitative content analysis study conducted in 2014, 12 participants (5 physicians and 7 nurses) were recruited from two educational hospitals. The data were collected from deep, open, and unstructured interviews, and analyzed based on content analysis. RESULTS: The participants in this study included 12 individuals, 6 females and 6 males, with the age ranging 27-48 years and tenure ranging 4-17 years. Four themes were identified, namely, divergent attitudes, uneven distribution of power, mutual trust destructors, and prudence imposed on nurses. CONCLUSIONS: The results revealed some major inter-professional issues and challenges in nurse-physician relationships, some of which are context-specific whereas others should be regarded as universal. It is through a deep knowledge of these issues that nurses and physicians can establish better collaborative inter-professional relationships.

Effect of aromatherapy massage with lavender essential oil on pain in patients with osteoarthritis of the knee: A randomized controlled clinical trial.

BACKGROUND: Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly people. The purpose of this study was to investigate the effect of aromatherapy massage with lavender essential oil on pain in patients with osteoarthritis of the knee. METHODS: In this single-blinded, randomized clinical trial, 90 patients with osteoarthritis of the knee who referred to the outpatient rheumatology clinics affiliated with Birjand University of Medical Sciences were selected through convenience sampling method. They were randomly assigned to three groups: intervention (aromatherapy massage with lavender essential oil), placebo (massage with almond oil) and control (without massage). The patients were evaluated at baseline, immediately after the intervention, 1 week, and 4 weeks after the intervention in terms of pain via visual analogue scale. The data were analyzed in SPSS (version 16) using the repeated measure ANOVA, one-way ANOVA, and chi-squared test. RESULTS: Pain severity of the patients in the intervention group was significantly different immediately and 1 week after the intervention compared with their initial status (p < 0.001) and that of the control group (p < 0.001 and p = 0.009 respectively). However, at the third phase of follow-up (i.e., 4 weeks after the intervention), there was no significant difference between the groups according to the visual analogue scale (p = 0.67). CONCLUSION: Aromatherapy massage with lavender essential oil was found effective in relieving pain in patients with knee osteoarthritis. However, further studies are needed to confirm findings of this study.

The Effect of Aromatherapy on Anxiety in Patients.

BACKGROUND: Anxiety is the most common mental disorder in end-stage renal disease patients. The use of aromatherapy as a treatment for anxiety has increased substantially in most countries. OBJECTIVES: This study aimed to investigate the effect of inhaling rose water aromatherapy on anxiety in hemodialysis patients. METHODS: This randomized controlled clinical trial was carried out in the hemodialysis ward of Birjand Vali-Asr hospital on 46 patients who were randomly divided into control and experimental groups. The standard state-trait anxiety inventory of Spielberger was used to investigate the anxiety level of the samples. The experimental group inhaled rose water for 4 weeks, but the control group did not undergo any intervention. At the end of week 2 and week 4, the participants' anxiety was measured, and the results were statistically analyzed. RESULTS: Mean scores of state and trait anxiety in the experimental group before intervention were 47/47 ± 7/6 and 49/56 ± 13/8, respectively; those after week 4 following the intervention were reduced to 37/1 ± 6/5 and 42/9 ± 10/1; inhalation of rose water fragrance in the experimental group caused a significant decrease (P < 0.001) in the state and trait anxiety levels compared with controls (P = 0.43). CONCLUSIONS: According to the present study, rose water noticeably reduces the anxiety of hemodialysis patients. Therefore, inhalation of rose water can improve the patient's emotional and spiritual condition during hemodialysis treatment.