Effect of needles distance of arteriovenous fistula cannulation on hemodialysis adequacy based on KT/V: a randomized controlled trial.

Background: This study aims to assess the effect of needle distance of arteriovenous fistula (AVF) cannulation on haemodialysis adequacy based on KT/V. Materials and methods: This study was a parallel-group, randomized controlled trial. Patients who met the inclusion criteria were divided into two groups with 3 and 6 cm needle distances using block randomization. Data acquisition transpired through a comprehensive checklist encompassing demographic variables such as age and sex, alongside clinical metrics comprising actual weight, dry weight, average dialysis duration, fistula longevity, and KT/V rate. Results: A total of 42 haemodialysis patients were enroled in this investigation, with 21 allocated to the 3 cm needle distance group and another 21 to the 6 cm needle distance group. The mean post-haemodialysis KT/V values for the 3 cm and 6 cm needle distance groups were 1.25 (SD=0.25) and 1.42 (SD=0.24), respectively, demonstrating a statistically significant difference (P<0.001). While there was no significant difference in the average pre-haemodialysis and post-haemodialysis KT/V values within the 3 cm needle distance group (t=1.93, P=0.068), the corresponding values for the 6 cm needle distance group exhibited a notable discrepancy (t=9.66, P<0.001). Conclusion: In general, a needle distance of 6 cm between arteriovenous points yielded superior enhancements in dialysis adequacy compared to a 3 cm needle distance following haemodialysis. Consequently, health administrators and policymakers may consider instituting efficacious interventions to scrutinize the care and therapeutic protocols for haemodialysis patients, involving the development of policies and applications.

The Relationship Between Spirituality and Religiosity with Death Anxiety Among Cancer Patients: A Systematic Review.

This systematic review aimed to summarize the evidence regarding the relationship between spirituality and religiosity with death anxiety (DA) among cancer patients. This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) checklist. An extensive search was conducted on electronic databases such as Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) via keywords extracted from Medical Subject Headings from the earliest to February 9, 2022. The quality of the included studies was assessed using the appraisal tool for cross-sectional studies (AXIS tool). Fifteen studies were selected for inclusion in this systematic review. Nine and six studies assessed the relationship between spirituality and religiosity with DA in cancer patients, respectively. Most studies had a negative relationship between spirituality (n = 8) and religiosity (n = 4) with DA. In sum, most studies showed that religion and spirituality are negatively related to DA in patients with cancer.

Effect of family-centered care on the anxiety levels among family members of patients undergoing cardiac surgery: a randomized controlled trial.

Background: The present study aims to determine the effect of family-centered care on anxiety levels among family members of patients undergoing cardiac surgery. Materials and methods: This study was a randomized clinical trial study that was conducted on the families of Iranian cardiac surgery patients. In the intervention group, family-centered care was implemented, and the content of the intervention included providing informational and emotional support to the family member and the family member's participation in patient care according to the set framework. Results: A total of 144 family members of patients undergoing cardiac surgery were included in this study. Among the 144 family members, 71 were in the intervention group, and 73 were in the control group. The changes in the state anxiety score before and after the intervention were significant between the two groups, and the changes were higher in the control group (P=0.043). Also, there was no significant difference in the changes in trait anxiety before and after the intervention between the two groups (P>0.05). Conclusion: In general, the high prevalence of anxiety in patients' families has negative functional consequences on both patients and their families. To reduce the level of anxiety, special attention should be paid to knowing the effective factors and appropriate coping methods. Nevertheless, it is important to note that additional research is warranted to delve deeper into this matter in future studies.

Psychometric evaluation of the heart failure somatic perception scale in Iranian heart failure patients: a cross-sectional study.

Background: This study aimed to evaluate the psychometric evaluation of heart failure somatic perception scale (HFSPS) in Iranian heart failure patients. Materials and methods: A total of 220 heart failure (HF) patients were enroled in the study. Data gathering was conducted via consecutive sampling from August 2022 to April 2023. Face validity, content validity, construct validity, and internal consistency were used to evaluate the validity and reliability of the Persian version of the HFSPS. Construct validity was done through confirmatory factor analysis and convergent validity. Convergent validity between HFSPS and symptom status questionnaire-heart failure was measured using Pearson's correlation coefficient. Cronbach's alpha and Macdonald's omega coefficient were used to evaluate the reliability of instruments. Results: A total of 220 HF patients participated in this study. Their mean age was 66.46 (SD=11.40). Among the participants, 70% were men. The results of the confirmatory factor analysis evaluation showed the goodness of fit indices of the final HFSPS model after modification was within an acceptable range (χ2=306.18 P<0.001, Minimum Discrepancy Function Divided by Degrees of Freedom=2.47, Comparative of Fit Index=0.91, Tucker-Lewis index=0.90, Adjusted goodness of fit index=0.81, Parsimonious norm fit index=0.70, root mean square error of approximation=0.082). Convergent validity between HFSPS and symptom status questionnaire-heart failure indicated a positive and significant correlation. Cronbach's alpha coefficient in the HFSPS was 0.868, and McDonald's omega coefficient in the HFSPS was 0.832. Conclusion: Overall, the Persian version of the HFSPS was determined to be a reliable and valid scale among Iranians with HF.

Prevalence of surgical wound infection and related factors in patients after long bone surgery: A systematic review and meta-analysis.

The goal of this systematic review and meta-analysis is to provide an overview of the prevalence of surgical wound infection and related factors in patients after long bone surgery. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Prevalence", "Surgical wound infection", "Surgical site infection" and "Orthopedics" from the earliest to the May 1, 2023. The appraisal tool for cross-sectional studies (AXIS tool) evaluates the quality of the included studies. A total of 71 854 patients undergoing long bone surgery participated in 12 studies. The pooled prevalence of surgical wound infection in patients who underwent long bone surgery reported in the 12 studies was 3.3% (95% CI: 1.5%-7.2%; I2 = 99.39%; p < 0.001). The pooled prevalence of surgical wound infection in male and female patients who underwent long bone surgery was 4.6% (95% CI: 1.7%-11.7%; p < 0.001; I2 = 99.34%) and 2.6% (95% CI: 1.0%-6.3%; I2 = 98.84%; p < 0.001), respectively. The pooled prevalence of surgical wound infection in patients with femur surgery sites reported in nine studies was 3.7% (95% CI: 2.1-6.4%; I2 = 93.43%; p < 0.001). The pooled prevalence of surgical wound infection in open and close fractures was 16.4% (95% CI: 8.2%-30.2%; I2 = 95.83%; p < 0.001) and 2.9% (95% CI: 1.5%-5.5%; I2 = 96.40%; p < 0.001), respectively. The pooled prevalence of surgical wound infection in patients with diabetes mellitus (DM), hypertension (HTN) and cardiovascular disease (CVD) was 4.6% (95% CI: 2.3%-8.9%; I2 = 81.50%; p < 0.001), 2.7% (95% CI: 1.2%-6.0%; I2 = 83.82%; p < 0.001) and 3.0% (95% CI: 1.4%-6.4%; I2 = 69.12%; p = 0.006), respectively. In general, the different prevalence of surgical wound infection in patients undergoing surgical treatment after long bone fracture may be caused by underlying factors (gender and co-morbidity) and fracture-related factors (surgery site and type of fracture).

Risk predictions of hospital-acquired pressure injury in the intensive care unit based on a machine learning algorithm.

Pressure injury (PI), or local damage to soft tissues and skin caused by prolonged pressure, remains controversial in the medical world. Patients in intensive care units (ICUs) were frequently reported to suffer PIs, with a heavy burden on their life and expenditures. Machine learning (ML) is a Section of artificial intelligence (AI) that has emerged in nursing practice and is increasingly used for diagnosis, complications, prognosis, and recurrence prediction. This study aims to investigate hospital-acquired PI (HAPI) risk predictions in ICU based on a ML algorithm by R programming language analysis. The former evidence was gathered through PRISMA guidelines. The logical analysis was applied via an R programming language. ML algorithms based on usage rate included logistic regression (LR), Random Forest (RF), Distributed tree (DT), Artificial neural networks (ANN), SVM (Support Vector Machine), Batch normalisation (BN), GB (Gradient Boosting), expectation-maximisation (EM), Adaptive Boosting (AdaBoost), and Extreme Gradient Boosting (XGBoost). Six cases were related to risk predictions of HAPI in the ICU based on an ML algorithm from seven obtained studies, and one study was associated with the Detection of PI risk. Also, the most estimated risksSerum Albumin, Lack of Activity, mechanical ventilation (MV), partial pressure of oxygen (PaO2), Surgery, Cardiovascular adequacy, ICU stay, Vasopressor, Consciousness, Skin integrity, Recovery Unit, insulin and oral antidiabetic (INS&OAD), Complete blood count (CBC), acute physiology and chronic health evaluation (APACHE) II score, Spontaneous bacterial peritonitis (SBP), Steroid, Demineralized Bone Matrix (DBM), Braden score, Faecal incontinence, Serum Creatinine (SCr) and age. In sum, HAPI prediction and PI risk detection are two significant areas for using ML in PI analysis. Also, the current data showed that the ML algorithm, including LR and RF, could be regarded as the practical platform for developing AI tools for diagnosing, prognosis, and treating PI in hospital units, especially ICU.

Caregivers' knowledge with burned children and related factors towards burn first aid: A systematic review.

This systematic review aimed to examine the caregivers' knowledge with burned children and related factors towards burn first aid. A comprehensive, systematic search was performed in different international electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Knowledge", "First aid", "Caregiver", "Burn", and "Child" from the earliest to the December 1, 2022. The quality of the studies included in this systematic review was evaluated by using the appraisal tool for cross-sectional studies (AXIS tool). A total of 11 763 caregivers of children with burns were enrolled in 14 studies. Of the participants, 78.81% were female and 41.15% had a university education. The mean score of caregivers' knowledge with burned children towards burn first aid was 51.44 out of 100. The knowledge of caregivers of burned children towards burn first aid had a significant positive relationship with the level of education, first aid training, age of caregivers, history of burn, number of children, monthly income, social status, and attitude. In addition, caregivers' knowledge had a significant negative relationship with the number of children. Furthermore, there was a significant relationship between caregivers' knowledge and level of education, monthly income, smoking, and previous knowledge of first aid. The level of caregivers' knowledge with burned children towards burn first aid was moderate. Therefore, health managers and policymakers can improve the knowledge of caregivers of burned children towards burn first aid by creating suitable platforms for face-to-face training as well as online training using websites.

A systematic review of social support and related factors among burns patients.

Burn injuries, as a major public health problem, can lead to high morbidity and mortality. Burns is considered as one of the most devastating injuries globally and the fourth most common injury after traffic accidents, falls and interpersonal violence. Burn injuries can affect human life, such as physical and mental health, functional skills, and performance. Changes in appearance, social isolation, stress, anxiety, depression, low self-esteem, unemployment, financial burden and family problems can occur in these patients. These burn complications can be exacerbated without adequate social support. This systematic review evaluated burn patients' social support and related factors. A systematic search was performed on the international electronic databases such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as 'Burns', 'Social support', 'Perceived social support' and 'Social care' from the earliest to 30 April 2022. The quality of the included studies in this review was assessed using the appraisal tool for cross-sectional studies (AXIS tool). A total of 1677 burn patients were included in this review from 12 studies. Mean score of social support in burn patients based on multidimensional scale of perceived social support, Phillips's social support questionnaire, social support questionnaire, social support scale and Norbeck social support questionnaire were 5.04 (SD = 1.59) of 7, 22.06 (SD = 3.05), 78.20 (SD = 15.00) of 95, 82.24 (SD = 13.70) and 4.14 (SD = 0.99), respectively. Factors such as income, educational attainment, burn surface area, reconstructive surgery, quality of life, self-esteem, socialisation, posttraumatic growth, spirituality, and ego resilience had a significant positive relationship with social support of burns patients. Social support in patients with burn had a significant negative relationship with factors such as psychological distress, having children, life satisfaction, neuroticism and post-traumatic stress disorder. Overall, patients with burns had moderate levels of social support. Therefore, it is recommended that health policymakers and managers make it easier for burn patients to adapt to burns by providing psychological intervention programs and the social support needed by burn patients.

A systematic review of self-esteem and related factors among burns patients.

Introduction: The present systematic review was conducted to examine self-esteem and related factors in burns patients. Methods: A comprehensive search was conducted from the first to the April 1, 2022 at the international electronic databases such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Burns", "Self-confidence", "Self-perception", "Self-esteem", and "Self-concept". Results: A total of 762 burn patients were included in this review from ten cross-sectional studies. The mean score of self-esteem in burn patients based on Rosenberg Self-Esteem Scale, State Self-Esteem Scale, Cooper Smith's self-esteem questionnaire, and Rifai's self-esteem scale were 17.77 (SD = 5.55) out of 30, 65.91 (SD = 5.49) out of 100, 56.68 (SD = 5.49) out of 100, and 109.77 (SD = 9.55) out of 145, respectively. Factors associated with self-esteem in burns patients were gender, occupation, the location of the burn, type of burn, site of burn, burn scar, and quality of life had a significant relationship with burn patients' self-esteem. Factors such as social support, family support, friends support, and supporting others, had a significant positive relationship with self-esteem of burns patient. However, self-esteem in patients with burn had a significant negative relationship with grade of burn injury, percentage of burn, depth of burn, facial burn, post-traumatic stress disorder, psychiatric morbidity, major depressive, and suicidality factors. Conclusion: Overall, patients with burns had moderate levels of self-esteem. Therefore, it is recommended that health professionals use interdisciplinary approaches to better manage burn patients.