Designing and validating of a questionnaire measuring perceived self-care ability (PSCA) in chronic stroke patients at home.

BACKGROUND: Patients with a stroke often cannot care for themselves after hospital discharge. Assessment of their self-care ability is the first step in planning post-discharge home care. This study aimed to design and validate a measure of perceived self-care ability (PSCA) in stroke patients. METHODS: A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2020-2021. The qualitative phase involved in-depth semi-structured interviews with 12 participants. Transcripts were content analyzed. The results guided the development of 81 items. psychometric properties such as face validity (Impact Score > 1.5), content validity ratio (CVR > 0.63), content validity index (Item Content Validity Index: ICVI > 0.78, Scale Content Validity Index/Average: SCVI/Ave > 0.8) and Kappa value (Kappa > 0.7), internal consistency (Cronbach's alpha > 0.7), relative reliability (ICC: inter class correlation coefficient), absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0.4-0.7), interpretability, responsiveness, feasibility, and ceiling and floor effects were assessed. RESULTS: Content analysis of the qualitative interviews yielded 5 major categories and 9 subcategories that reflected "Perceptual stability", "Cognitive fluctuations", "Sensory, Motor and Physical health"," The subjective nature" and "The dynamic nature" of PSCA. Results of face and content validity reduced the number of items to 32, capturing three dimensions of PSCA in chronic stroke patients; these dimensions included perceptual ability, threatened health status, and sensory, motor, and cognitive ability. The findings supported the reliability and validity of the measure. CONCLUSIONS: The PSCA questionnaire was developed and validated within the Iranian culture. It is useful in assessing the self-care of patients with stroke and in informing practice.

Factors influencing support provision to the family caregivers of elderly patients with cancer: A qualitative study.

PURPOSE: Family caregivers (FCs) play a significant role in providing care to elderly patients with cancer (PWC). Meanwhile, they face a wide range of challenges and are considered hidden patients who require special attention and support. Nonetheless, they do not receive adequate support. This study aimed at exploring the factors influencing support provision to the FCs of elderly PWC. METHOD: This descriptive qualitative study was conducted in 2020-2022. Thirty-one FCs and family members of elderly PWC and healthcare providers were purposefully recruited from various healthcare centers in Tehran, Iran. Data were collected through semi-structured interviews and analyzed using Graneheim and Lundman's conventional content analysis approach. Trustworthiness was ensured through Lincoln and Guba's criteria. RESULTS: Factors influencing support provision to the FCs of elderly PWC came into three main categories, namely the potential for supporting elderly PWC and FCs, complexity of family and social support, and support-related challenges of the healthcare system. CONCLUSIONS: Identifying the factors influencing support provision to the FCs of elderly PWC can assist healthcare policymakers and authorities in developing more effective strategies to support these groups.

Confusion at the beginning of sexual intercourse, the challenge of patients after coronary artery bypass graft surgery in Iran: A qualitative study.

BACKGROUND: Many patients suffer from sexual dysfunction after coronary artery bypass graft surgery, but they refuse to propose and follow up on the problem due to the cultural structures prevailing in Iranian society. Untreated sexual dysfunction will disturb the quality of life of these patients. This study was performed to explain the experiences of male patients from sexual problems after coronary artery bypass graft surgery. MATERIALS AND METHODS: This qualitative study was performed with the approach of conventional content analysis in Tehran in 2020. The data were collected through semi-structured interviews with 12 men after coronary artery bypass graft surgery at the hospital's cardiac surgery clinic, as well as the surgeon's clinic. Participants were selected by the targeted sampling method. After obtaining informed consent, the collected data were written word by word, and the content analysis approach was used to name the data, create analytical codes, and determine subcategories and categories. The data were analyzed by MAXQDA 10 software. RESULTS: The findings of this study show that the dimensions of confusion in patients' sexual intercourse after coronary artery bypass graft surgery in four subcategories of challenges of the first intercourse after surgery, ambiguity in how to obtain information, the ambiguity of sexual issues after surgery, and spouse are concerned about having sexual intercourse. CONCLUSION: The results of this study show that male patients who have undergone coronary artery bypass graft surgery have many ambiguities in the process of sexual intercourse, which passes the beginning of sexual intercourse with fear and avoidance of intercourse. Postoperative patients do not propose these problems with the medical staff when they suffer from sexual dysfunction or ambiguity due to the taboo of talking about sexual intercourse. Eventually, the patient and his or her partner become confused about sexual intercourse after surgery. Therefore, it is recommended that policymakers in the field of health create the culture and planning for solving the ambiguities created in the path of sexual intercourse of these patients.

Iranian nurses' experience of "being a wrongdoer": A phenomenological study.

BACKGROUND: Patient safety, which is a patient's right, can be threatened by nursing errors. Furthermore, nurses' feeling of "being a wrongdoer" in response to nursing errors can influence the quality of care they deliver. RESEARCH OBJECTIVES: To explore the meaning of Iranian nurses' experience of "being a wrongdoer." RESEARCH DESIGN: A phenomenological approach was used to explore nurses' lived experiences. Nurses were recruited purposively to take part in semistructured interviews, and the data collected from these interviews were analyzed using Van Manen's thematic analysis. Participants and research context: Eight nurses working in three private or governmental hospitals in Tehran, Iran. Ethical consideration: The research design was approved in each participating hospital, and all interviews were carried out at a predetermined time in a private place. FINDINGS: Five themes were extracted from the data: "wandering in unpleasant feelings" (with two subthemes: "unpleasant physical feelings" and "unpleasant emotions"), "wandering in the conscience court" (with three subthemes: "being the accused," "being the victim," and "being the judge"), "being arrested in time," "time for change" (with three subthemes: "promoting accountability," "promoting learning," and "strengthening supportive relationships"), and "spiritual exercise." DISCUSSION: Some of our results are supported by the model of self-reconciliation and the recovery trajectory of "second victims" theory. CONCLUSION: The meaning of "being a wrongdoer" has positive and negative aspects. Feelings of wandering provide nurses the opportunity to reflect on and re-embrace the professional and moral responsibility of nursing. Nursing managers can convert their "defeats" into a prelude to learning, increase their accountability, and improve the quality of nursing care.

Nursing error: an integrated review of the literature.

Nursing errors are complex and take place frequently in the care of patients. However, despite their significance, they have not been properly defined or addressed in the literature. This integrative review of the literature explored the concept of nursing error, explained its definitions and described its attributes and measurements. The databases of Medline, CINAHL, Google Scholar and SID were searched using a number of keywords, including malpractice, adverse events and mistake, with and without the word nurse. The aim was to determine the definition of nursing error, regardless of the contextual aspects, in various scientific systems. After reviewing the relevant literature, content analysis (in MAXQDA) was applied to classify the definitions, attributes and measurements obtained on the basis of their similarities and differences. Ultimately, a definition was established for the concept of nursing error.

The effect of a preoperative spiritual/religious intervention on anxiety in Shia Muslim patients undergoing coronary artery bypass graft surgery: a randomized controlled trial.

BACKGROUND: Coronary artery bypass grafting (CABG) is associated with anxiety. Preoperative anxiety is considered a predictor for a range of suboptimal postsurgical outcomes. OBJECTIVE: To evaluate the effect of a spiritual/religious training intervention on anxiety in Shia Muslim individuals scheduled for CABG. METHODS: A randomized controlled trial of a preoperative spiritual/religious training intervention, congruent with Islamic supplication (Zikr), was administered in five sessions of 45 minutes duration to test the impact on anxiety in comparison with standard care. Seventy participants were selected based on inclusion criteria and randomly allocated to treatment and control groups. Baseline levels of anxiety and the impact of the intervention were assessed using the Persian version of the Hamilton Anxiety Scale. RESULTS: Baseline characteristics were comparable between the intervention and control groups. Following the intervention, there was a statistically significant difference in anxiety mean scores between intervention (19.48 ± 2.03) and control groups (43.27 ± 5.49), p < .001. CONCLUSIONS: This study demonstrates that preoperative spiritual/religious training can reduce anxiety in Muslim patients undergoing CABG. Further evaluation of this intervention in other population groups is warranted and the study underscores the importance of culturally appropriate and interventions.