Mothers' efforts to overcome difficult twists and turns in living with children with cancer: a phenomenological study.

BACKGROUND: Child cancer impacts the entire family. However, those who identify as mothers may be most negatively affected due to the societal expectations placed upon them in primary caregiving. This study was conducted with the aim of exploring the lived experiences of mothers of children with cancer and their adaptation to their child's illness. METHODS: This study employed a qualitative and hermeneutic approach using Heideggerian phenomenology as a philosophical framework. Our sampling strategy was purposive. Mothers (n = 14) of children diagnosed with cancer participated in face-to-face semi-structured interviews. The seven-steps of critical hermeneutic analysis were used to summarize and interpret findings. RESULTS: Analysis revealed that participants' adaptation to their child's illness occurs through comprehensive support and the utilization of empowering beliefs. The theme of comprehensive support included sub-themes of seeking informational support, seeking psychological support, and seeking social support. The theme of utilizing empowering beliefs encompassed sub-themes of resilience against cultural misconceptions and reliance on spiritual beliefs. Furthermore, one constitutive pattern 'mothers' efforts to overcome difficult twists and turns in living with children with cancer' was identified.This related to participants' striving to navigate the twists and turns of life's hardships. CONCLUSIONS: Relationships and social context are vital and important features of this phenomena. Employing a team approach to provide comprehensive support to mothers of children with cancer involving physicians, nurses, and psychologists can be supportive in their adaptation to their child's cancer. Additionally, reductions in cultural taboos surrounding cancer could facilitate improved adaptation to childhood cancer for these mothers.

Nurses' perceptions of compassionate care in pediatric oncology: a qualitative interview study.

BACKGROUND: Compassion is a crucial aspect in the management of pediatric oncology patients as it has the potential to enhance nurse satisfaction levels, thereby further enhancing the quality and safety of the care they deliver. This study aimed to investigate nurses' understanding and experience of compassionate care when working in pediatric oncology departments. METHODS: This research utilized a qualitative descriptive design. Content analysis was used to make sense of data collected via individual and semi-structured interviews conducted with nurses (n = 32) working in pediatric oncology departments. RESULTS: Nurses' understanding of compassionate care for children with cancer was organized into two categories: Humanistic compassionate care and compassionate end-of-life care. The humanistic compassionate care category comprised of three subcategories: (1) empathy, (2) altruism, and (3) respect for the cultural values and beliefs of the family. The compassionate end-of-life care category comprised of two subcategories: (1) facilitating parents' presence at the child's bedside and (2) creating suitable conditions for accepting the death of a child. CONCLUSION: Compassionate care for children with cancer is marked by a strong emphasis on humanistic, cultural, and end-of-life considerations. Our findings further emphasize the paramount importance of taking families' presence, wishes and beliefs into consideration within this context.

Compassion and care at the end of life: oncology nurses' experiences in South-East Iran.

BACKGROUND: End of life (EOL) care is newly established in the Iranian context. Context, in this case, refers to the internal and external manifestation of the nurse values, norms and experiences that are learnt throughout life. AIM: The aim of this study was to explore nurses' experiences of caring for dying patients in Iran. METHODS: A phenomenological hermeneutic approach, influenced by the philosophy of Ricoeur, was used to analyse 10 oncology nurses' experiences of caring for dying persons. FINDINGS: Three themes emerged from the analysis: 1) seeing the patient as unique person, 2) being present and open to seeing patients as unique persons and 3) personal and professional development as a result of closeness between nurse and patient. Caring for dying persons means assisting them at the end of their lives. CONCLUSION: Caring relationships underlie professional palliative care and are essential in EOL care. Proper palliative education and professionally led supervision should be included in the Iranian nursing curriculum.

The effect of escape room clinical evaluation method on satisfaction, learning, and preparedness to practice as interns of nursing students: A quasi-experimental quantitative study.

BACKGROUND: Clinical evaluation utilizing the escape room game is recognized as a novel method for assessing the team-oriented performance of learners. It is a tool for evaluating teamwork skills in clinical settings, which can boost student motivation and learning. This study aimed to investigate the effect of clinical evaluation through escape rooms and feedback provision through the PEARLS (promoting excellence and reflective learning in simulation) approach on pre-internship nursing students' satisfaction, learning, and preparedness to practice as interns. MATERIALS AND METHOD: The current research is a quasi-experimental quantitative study conducted with a census sample of 42 sixth-semester undergraduate nursing students in 2022. The escape room method was utilized to evaluate entry preparedness into the clinical field. Reliable and valid researcher-made questionnaires were administered to assess the impact of the intervention on learning, satisfaction, and preparedness. The data were analyzed in SPSS version 26 using descriptive and inferential tests. The significance level was considered to be less than 0.05. RESULTS: Twenty-six males and 16 females constituted the 42 participants (mean age: 23.46 years). The clinical evaluation method of the escape room game was deemed satisfactory or highly satisfactory by 80% of students. From the perspective of 72% of students, escape rooms were definitely or highly effective in shaping their preparedness to enter the clinical field. Comparing the students' mean learning scores (self-assessment of clinical skills) before and after the test revealed that their post-test scores (55/16 ± 13/33) were significantly higher than their pre-test scores (45/58 ± 16/58) (P < 0.001). CONCLUSIONS: It appears that using the escape room evaluation method in conjunction with other student evaluation methods has helped improve students' interpersonal communication, problem-solving skills, critical thinking, and teamwork. The experience of working in a group not only improves these skills and is enjoyable to students but can also enhance their learning. Clinical education is dependent on teamwork. The escape room test can be viewed as a valuable tool for encouraging students to collaborate as a team. Therefore, it is suggested that students in all medical education groups be evaluated clinically using this test.

Operating room technologists' knowledge, attitude, and preparedness for disaster management of a Zahedan: Implications for nursing disaster education.

BACKGROUND: During the occurrence of accidents and disasters, the role of hospitals and healthcare centers is very sensitive and they are among the first units that with their quick, optimal, and timely healthcare services provision can reduce mortality and increase the number of survivors. For this purpose, this study was conducted to investigate the knowledge, attitude, and level of preparedness of operating room technologists of educational hospitals of Zahedan University of Medical Sciences in relation to disasters. MATERIALS AND METHOD: The present research is a cross-sectional descriptive study that was conducted with the participation of 60 operating room technologists of Zahedan educational hospitals from January 2022 to December 2022. The sampling was performed by the census method. The data collection tool was a demographic characteristic and a researcher-made questionnaire for the assessment of attitude, knowledge, and preparation against the occurrences of accidents and disasters was completed during 2 months by referring the researcher to the hospitals. For the data analysis, descriptive statistics and analytical statistical tests were used. The data were analyzed using IBM SPSS Statistics 26. Corp., Armonk, NY, USA. The significance level was considered P < 0.05. RESULTS: The results showed that the average scores of attitude, preparation, and knowledge are 9.3 ± 6.1, 75.8 ± 9.9, and 5.7 ± 4.1, respectively, and the majority of operating room technologists have a favorable level towards attitude and have relatively favorable level towards preparation and knowledge during the occurrence of disasters. The average score of knowledge and attitude of operating room technologists with work history had a significant difference from each other (P < 0.05). technologists with less work experience have more knowledge and a more positive attitudedisaster. CONCLUSION: Measuring the level of knowledge, attitude, and preparedness of surgical technologists to deal with disasters as one of the ways of receiving feedback from employee training can be a useful reflection of the success of training programs in creating the necessary capabilities in various fields of disaster preparedness, and it can be a powerful tool for increasing individual and group dynamics and organizing individual learning in coping training. Furthermore, disaster education should be incorporated into the operating room curriculum, which would play a seminal role in preparing them for future disaster management. It is also suggested to investigate the impact of intelligent training on the level of knowledge, attitude, and preparation of operating room personnel regarding disasters and obstacles in this regard in future research.

The Effect of Benson Relaxation Technique on Anxiety and Quality of Life in Patients with Thalassemia Major: A Clinical Trial.

Thalassemia major is the most common chronic blood disease in the world, especially in Asia and Iran, and it gives rise to anxiety and reduces quality of life [QOL] in patients. The purpose of this study was to determine the effect of Benson relaxation technique on anxiety and QOL in patients with thalassemia major. This semi-experimental clinical trial study was conducted on 140 patients with thalassemia major in two intervention groups [n = 70] and control group [n = 70] in Ali Asghar Hospital, Zahedan.The data were collected using a demographic information form, the Spielberger State-Trait Anxiety Inventory [STAI], and the World Health Organization Quality of Life-BREF [WHOQOL-BREF] and self-report checklist. The control group received routine care, whereas the intervention group, we first completed the questionnaires; then, Benson relaxation technique was taught to each patient in three one-hour sessions in the presence of a family member for three consecutive days. Finally, they were asked to practice this technique twice a day for 12 weeks. The questionnaires were completed again one and three months after the intervention. Data analysis showed no significant difference between the mean scores of anxiety and QOL and its dimensions in the two groups at baseline [P > 0.001]. One and three months after the relaxation technique, however, the intervention group experienced a statistically significant difference in the mean scores of anxiety and QOL and its dimensions [P < 0.001]. The results confirmed that Benson Relaxation Technique reduces anxiety and improves the QOL of patients with thalassemia major. Clinical Trials Registration: IRCT20200926048842N2.

Nurses' effort for providing end-of-life care in paediatric oncology: a phenomenological study.

BACKGROUND: Many children with cancer are hospitalised before the end of life and need special care. To improve the delivery of care for children, it is necessary to understand the insights, emotions and feelings of nurses. AIM: This study aimed to explore the lived experiences of nurses providing end-of-life care for children with cancer. METHODS: A phenomenological hermeneutic approach was used to analyse the experience of 14 oncology nurses working in a children's hospital who were caring for children with cancer. FINDINGS: Three themes and seven subthemes emerged from the analysis. The three main themes were: pain management (relieving physical pain and reducing the mental pain of the child and family); respect-based care (for the values and beliefs of the child and family and honesty in providing information to them); and negative reflections of care (psychological trauma, cultural challenges and futile care). CONCLUSION: The results of the present study showed that, despite the problems experienced by the nurses, they were still trying to provide life-sustaining care for children with cancer.

Comparison of self-, peer, and teachers' evaluation about the clinical skills of nursing students at the department of psychiatry.

BACKGROUND: Evaluating clinical performance is a challenge in nursing education. On the other hand, a single evaluation method cannot be used to judge different areas of interpersonal skills. Therefore, this study was conducted to compare the evaluation of teachers', peer, and self-evaluation of nursing students in the psychiatric ward of Baharan Hospital affiliated to Zahedan University of Medical Sciences. MATERIALS AND METHODS: In this analytical cross-sectional study, forty trainee students were selected by a census method in a time period and they were evaluated by three methods including self-, peer, and teachers' evaluation. Their clinical skills were assessed using a school-based clinical evaluation questionnaire containing 15 questions in the areas of taking history, examination of psychiatric health, and the ability to communicate with the patient. The analyses were performed by SPSS-22 software. RESULTS: The mean and standard deviation of the evaluation scores of clinical teachers as well as peer and self-evaluation in the areas of taking patient's history were 13.82 ± 2.74, 14.46 ± 2.68, and 15.75 ± 2.56, respectively. In addition, the outcomes in the areas of psychiatric examination were 8.11 ± 1.54, 9.25 ± 2.70, and 10.43 ± 2.65 and in the areas of clinical communication were 8.93 ± 2.03, 9.04 ± 2.25, and 10.21 ± 1.98, respectively. There was a significant correlation between the mean of teachers' evaluation and self-evaluation scores (P = 0.003) as well as comparing peer and self-evaluation (P = 0.048). However, no significant correlation was observed between teachers' and peer evaluation (P = 0.062). CONCLUSION: Due to the difference in scores of different methods of evaluation, self- and peer evaluation can be used as a complementary method with teachers' evaluation in measuring the clinical performance of clinical students.

The experience of family caregivers caring for a patient with chronic disorders of consciousness: a qualitative content analysis.

BACKGROUND: Management of a patient with chronic disorders of consciousness is a long-term and stressful situation for family caregivers. AIMS: The aim of this study was to describe the experiences of family caregivers of patients with chronic disorders of consciousness. METHODS: Purposeful sampling was used, data were collected through semi-structured, in-depth interviews at participants' homes. Data were analysed using qualitative content analysis. FINDINGS: Results indicated that family caregivers of patients with chronic disorders of consciousness face many difficulties in providing care to vegetative state (VS) and minimally conscious state (MCS) patients; they experience it as a challenging type of care, which influences their mental health. CONCLUSION: Family caregivers are faced with many challenges because of the high burden of care, round-the-clock concern, taking care of an alive but unresponsive patient without receiving enough support. They experience mental and inner turmoil because of social isolation and dealing with contradictory feelings in their daily life.

Ethical Challenges in Cancer Care: A Qualitative Analysis of Nurses' Perceptions.

Cancer is a growing problem in the world, meanwhile, the issue of providing care for cancer patients has been associated with multiple ethical challenges (ECs). This study aimed to investigate and explain the nurses' perceptions of ECs in caring for cancer patients in Iran. In this qualitative study, the participants consisted of 25 nurses working in cancer wards. The typical EC that the nurses are faced with while caring for cancer patients included categories such as "creating moral distresses" and "threat to patient's autonomy." The category of creating moral distress consisted of two subcategories, including "faulty communication process" and "provision of futile care." Also, the category of "threat to patient's autonomy" included subcategories of "individual factors" and "organizational factors." Since disregarding ethical principles in caring for patients with cancer will result in greater ECs in this respect, the healthcare administrators should make more effort to help establish transparent rules, and develop protocols needed to identify and eliminate these ECs.

The Effectiveness of Slow-Stroke Back Massage on Hospitalization Anxiety and Physiological Parameters in School-Age Children: A Randomized Clinical Trial Study.

BACKGROUND: The outcomes of hospitalization anxiety are mental health disorders. One of the methods of anxiety reduction is massage, which can cause reduction of pain and changes in physiological parameters. OBJECTIVES: This study aimed to investigate the effects of slow-stroke back massage (SSBM) on hospitalization anxiety and physiological parameters in school-age children. METHODS: This clinical trial study included 80 school-aged children from Ali Ebne Abi Taleb hospital, located in Zahedan, who were selected using sequential sampling and randomly divided into two groups: a massage group (40) and a control group (40). Data were collected using a demographic questionnaire and the state-trait anxiety inventory for children (STAIC). Subjects in the massage group received SSBM, using sesame oil, for 3 days. Massage was given three times a day, and each massage session lasted for 15 - 20 minutes. Physiological parameters and hospitalization anxiety were determined from the second to fifth days. T-test and Chi-square were used for analysis data. RESULTS: There was a statistically significant difference (P < 0.05) between the mean of systolic blood pressure (SBP), diastolic blood pressures (DBP), and pulse rate (PR) in the massage group prior to intervention (97.05 ± 20.7, 60.35 ± 16.69 and 95.45 ± 13.02 respectively) and on the fifth day (88.32 ± 16.58, 55.95 ± 12.7 and 90.45 ± 15.1 respectively). However, no difference was observed in mean respiratory rate (RR) in the massage group from the second day (17.55 ± 3.6) to fifth day (17.62 ± 3.27) (P = 0.096). The mean of state of anxiety, which was 36.4 ± 5.1 before intervention, was reduced by the fifth day to 31.2 ± 5.1 in the massage group (P < 0.0001, t = 5.2). CONCLUSIONS: The results suggest that massage reduced hospitalization anxiety, PR, and BP. Therefore, we propose that nurses can use massage to reduce anxiety in school-age children in hospital. This method has no side-effects and is easily applicable.