The Effect of Spiritual Group Therapy on the Quality of Life and Empowerment of Women with Breast Cancer: A Randomized Clinical Trial in Iran.

This randomized clinical trial was carried out on 74 women with breast cancer between May 2015 and April 2016 in the south of Iran. The patients were selected using a simple sampling method and randomly divided into an intervention (n = 30) and a control (n = 37) group. Five spiritual therapy sessions were conducted for the intervention group. Each session lasted one hour. The quality of life and empowerment of the patients were measured before and one month after the intervention. To collect data, four instruments were used, including a demographic information form, the European Organization for Research and Treatment of Cancer QOL questionnaire Cancer-30 (EORTC QLQ C-30), EORTC QLQ Breast-23 (EORTC QLQ-BR23), and the Cancer Empowerment Questionnaire (CEQ). After the intervention, a difference was observed between the groups concerning the mean score of general health (P = 0.016) and emotional function (P = 0.029), but there was no significant difference between the groups concerning the mean score of empowerment (P = 0.62). Thus, it appears that spiritual group therapy can improve the quality of life of this group of patients.IRCT registration number: IRCT 2014050417546N2.

The effects of mobile-based education on nurse self-concept among nursing students: an embedded mixed methods study / Los efectos de la educación basada en el móvil en el autoconcepto de las enfermeras entre los estudiantes de enfermería: un estudio de métodos mixtos integrados / Os efeitos da educação baseada em dispositivos móveis no autoconceito dos enfermeiros entre os estudantes de enfermagem: um estudo integrado de métodos mistos

Objective. This study evaluates the effects of mobile-based education (MBE) on nurse self-concept (NSC) among nursing students. Methods. This embedded mixed methods study was conducted in 2020­2021 in a main quantitative phase and a supplementary qualitative phase. In the quantitative phase, a quasi-experimental study with the Solomon four-group design was conducted on 117 second-year nursing students of Shiraz University of Medical Sciences, Shiraz, Iran. 70 students in the first (C1: n=37) and the second (C2: n=33) semesters of the 2020 academic year were respectively considered as the control groups, and 40 students in the first semester of the 2021 academic year considered as the experimental groups (I1: n=20 and I2: n=20). Participants in the experimental groups received NSC-related MBE through an Android application, while their counterparts in the control groups received no NSC-related MBE. Cowin's Nurse Self-Concept Questionnaire was used to assess the NSC. In the qualitative phase, six students from the experimental groups were purposively selected and interviewed through face-to-face semi-structured interviews. Moreover, two focus group discussions were held with a six-person and a five-person group of students from the experimental groups. Results. While the mean scores of NSC and its dimensions did not significantly change in the C1 group, the posttest mean scores of them in the E1 group were significantly greater than the corresponding pretest values (p<0.05), expect for the care dimension (p=0.586). Moreover, except for the care dimension (p>0.05), the posttest means scores of NSC and its other dimensions in the E1 and the E2 groups were significantly greater than the C1 and the C2 groups, respectively (p<0.05). Analysis of the qualitative data resulted in the generation of the main theme of multidimensional growth and development with three main categories, namely development of coping strategies, knowing professionalization strategies, and development of managerial potentials. Conclusion. NSC-related MBE is effective in improving nursing students' NSC.

Objetivo. Este estudio evalúa los efectos de la educación basada en el móvil (EBM) en el autoconcepto enfermero (ACE) entre los estudiantes de enfermería. Métodos. Estudio de métodos mixtos realizado entre los años 2020-2021 tuvo una fase cuantitativa principal y una fase cualitativa complementaria. En la fase cuantitativa se llevó a cabo un estudio cuasi-experimental con el diseño de cuatro grupos de Salomón en los que se asignaron 117 estudiantes de segundo año de enfermería de la Universidad de Ciencias Médicas de Shiraz, Irán. Participaron en los grupos de control 70 estudiantes: 37 del primer (C1) y 33 del segundo (C2) semestres del año académico 2020 y 40 estudiantes del primer semestre de 2021 como los grupos de intervención (I1: n=20, e I2: n=20). Los participantes de los grupos de intervención recibieron EMB relacionados con el CNS a través de una aplicación Android, mientras que sus homólogos de los grupos de control no recibieron este tipo de educación. Se utilizó el Cuestionario de Autoconcepto de Enfermería (ACE) de Cowin. En la fase cualitativa, se seleccionaron intencionadamente seis estudiantes de los grupos experimentales a quienes se les realizaron entrevistas semiestructuradas cara a cara. Además, se hicieron dos grupos de discusión con un grupo de seis y otro de cinco estudiantes de los grupos experimentales. Resultados. Mientras que las puntuaciones medias del ACE y sus dimensiones no cambiaron significativamente en el grupo C1, las puntuaciones medias pos-test de las mismas en el grupo I1 fueron significativamente mayores que los correspondientes valores pre-test (p<0.05), excepto para la dimensión de cuidado (p=0.586). Además, con excepción de la dimensión de atención (p>0.05), las puntuaciones medias pos-test de ACE y sus otras dimensiones en los grupos I1 y I2 fueron significativamente mayores que las de los grupos C1 y C2, respectivamente (p<0.05). El análisis de los datos cualitativos dio como resultado la generación del tema principal de crecimiento y desarrollo multidimensional con tres categorías principales: el desarrollo de estrategias de afrontamiento, el conocimiento de estrategias de profesionalización y el desarrollo de potenciales de gestión. Conclusión. La intervención EBM es eficaz para mejorar el ACE de los estudiantes de enfermería.

Objetivo. Avaliar os efeitos da educação baseada em dispositivos móveis (EBM) no autoconceito de enfermagem (ACE) entre estudantes de enfermagem da Shiraz University of Medical Sciences, Irã. Métodos. Estudo de métodos mistos que teve uma fase principal quantitativa e uma fase qualitativa complementar. Na fase quantitativa, foi realizado um estudo quase-experimental com o desenho de quatro grupos Solomon. 70 alunos participaram dos grupos de controle: 37 do primeiro (C1) e 33 do segundo (C2) semestre do ano letivo de 2020 e 40 alunos do primeiro semestre de 2021 como grupos de intervenção (I1: n=20, e I2: n=20). Apenas os participantes dos grupos de intervenção receberam EMBs relacionados à ACE por meio de um aplicativo Android. A escala de Cowin foi utilizada para avaliar o ACE. Na fase qualitativa, foram selecionados intencionalmente seis alunos dos grupos experimentais aos quais foram realizadas entrevistas semiestruturadas face a face. Além disso, foram feitos dois grupos de discussão (um de seis e outro de cinco) com alunos dos grupos experimentais. Resultados. Enquanto as pontuações médias do ACE e suas dimensões não mudaram significativamente no grupo C1, as pontuações médias pós-teste no grupo I1 foram significativamente maiores do que os valores pré-teste correspondentes (p<0.05), exceto para a dimensão do cuidado (p=0.586). Além disso, com exceção da dimensão atenção (p>0.05), as pontuações médias pós-teste do ACE e de suas outras dimensões nos grupos I1 e I2 foram significativamente maiores do que nos grupos C1 e C2, respectivamente (p<0.05). A análise dos dados qualitativos resultou na geração do tema principal crescimento e desenvolvimento multidimensional com três categorias principais: o desenvolvimento de estratégias de enfrentamento, o conhecimento de estratégias de profissionalização e o desenvolvimento de potenciais de gestão. Conclusão. A intervenção EBM foi eficaz em melhorar o ACE de estudantes de enfermagem.

Lived Experience of Iranian Family Caregivers of Person with Tuberculosis: A Qualitative Study / Experiencia vivida de los cuidadores familiares de personas con tuberculosis: Un estudio cualitativo / Experiência vivida de cuidadores familiares de pessoas com tuberculose: um estudo qualitativo

Objective. To investigate the lived experience of family caregivers of persons with tuberculosis. Methods.In this study, the method of hermeneutic phenomenology. Data were collected through online in-depth semi-structured interviews with nine family caregivers of TB patients. The obtained data were thematically analyzed to explain the concept of home care for TB patients through van Manen's 6-step methodology. Results. After the thematic analysis, three main themes of caregivers' mental distresses, quality care stasis, and facilitated care were obtained from 944 primary codes and 11 categories. Conclusion.Family caregivers of these patients suffer from mental distress. This issue affects the quality and ease of caregiving for these patients. Therefore, policymakers of this area should pay attention to the family caregivers of these patients and attempt to provide support; they should try to improve their quality of life.

Objetivo. Investigar la experiencia vivida por los cuidadores familiares de personas con tuberculosos. Métodos. En este estudio se utilizó el método de la fenomenología hermenéutica. Los datos se recogieron mediante entrevistas semiestructuradas en línea con nueve cuidadores familiares de pacientes con tuberculosis. Los datos obtenidos se analizaron temáticamente para explicar el concepto de atención domiciliaria a los pacientes con TB mediante la metodología de 6 pasos de van Manen. Resultados. Tras el análisis temático, se obtuvieron tres temas principales: angustia mental de los cuidadores, estancamiento de la atención de calidad y facilitación de la atención, a partir de 944 códigos primarios y 11 categorías. Conclusión.Los cuidadores familiares de estos pacientes sufren de distrés sicológico. Este problema afecta la calidad y la facilidad con que se brinda el cuidado. Por lo tanto, los responsables de la política en salud deben prestar atención a los cuidadores familiares de estos pacientes para proporcionarles más apoyo, lo que redundará en una mejoría de su calidad de vida.

Objetivo.Investigar a experiência vivida por cuidadores familiares de pessoas com tuberculose.Métodos.Neste estudo foi utilizado o método da fenomenologia hermenêutica. Os dados foram coletados por meio de entrevistas semiestruturadas online com nove cuidadores familiares de pacientes com tuberculose. Os dados obtidos foram analisados tematicamente para explicar o conceito de atenção domiciliar aos pacientes com TB utilizando a metodologia de 6 etapas de van Manen. Resultado S. Após a análise temática, três temas principais ­ sofrimento mental dos cuidadores, estagnação do cuidado de qualidade e facilitação do cuidado ­ foram derivados de 944 códigos primários e 11 categorias. Conclusão. Os cuidadores familiares desses pacientes sofrem de sofrimento psíquico. Essa questão afeta a qualidade e a facilidade com que os cuidados são prestados a esses pacientes. Portanto, os responsáveis pela política de saúde devem estar atentos aos cuidadores familiares desses pacientes para dar-lhes mais suporte, o que resultará em uma melhora em sua qualidade de vida.

Patient's Dignity: Viewpoints of Patients and Nurses in Hospitals.

Much of the available research on perceptions of patient dignity either is qualitative in type or explores them in specific patient groups, such as elderly patients, cancer patients, terminally-ill patients, and adolescent patients. The present study addresses nurses' and adult patients' views on patient dignity. A total of 400 individuals (200 nurses and 200 patients) from 39 internal and surgical units from four hospitals affiliated to Shiraz University of Medical Sciences participated in the study. The collected data were analyzed using descriptive, t-test, one-way ANOVA, and Pearson's correlation coefficient using SPSS v. 23.0. A significant difference between nurses' and patients' points of view was identified in relation to four domains: the importance of privacy (p < 0.001); attention to patient autonomy (p < 0.001); respect for patients (p < 0.001); and communication between nurses and patients (p < 0.001). In order to maintain patients' dignity in practice, nurses must become better acquainted with patients' expectations. The questionnaire assessing respect for patient's dignity developed in the present study is a reliable and valid instrument for this purpose.

Spiritual needs of mothers having children with cancer: A qualitative study.

BACKGROUND: Diagnosing cancer, as a life-threatening event, in children and adolescents stops the normal course of life for all family members. Spirituality, which plays an essential role in coping with illness and death, can increase resistance against psychological crises induced by cancer diagnosis and treatment. This study aims to discover the spiritual needs of mothers having children with cancer aged 1-12 years old. MATERIALS AND METHODS: In this qualitative study, the conventional content analysis approach was used. The research environment was three pediatric oncology wards of Amir Hospital in Shiraz, Iran. Data were collected from September 2019 to March 2020 through face-to-face semi-structured in-depth interviews. Fifteen participants including 12 mothers and 3 nurses were interviewed through purposive method considering maximal variation. The interviews were recorded, transcribed, and subjected to a qualitative analysis. Credibility, dependability, confirmability, and transferability of data were confirmed. RESULTS: The mean (± standard deviation) age of the mothers was 35.76 (±5.96) years old. The spiritual needs of the mothers were classified into three categories, including religious well-being, existential well-being, and growth and excellence as well as seven subcategories. Religious well-being included subcategories of direct and indirect connection with God, existential well-being included subcategories of need for hope, multifaceted support, and rethinking, growth, and excellence consisted of subcategories of devoting yourself and surrender. CONCLUSION: Mothers of children with cancer face important spiritual needs. Therefore, it is necessary for the treatment team to identify these needs and use them to provide appropriate spiritual care.

Anxiety in Relatives of Patients Admitted to Cardiac Care Units and its Relationship with Spiritual Health and Religious Coping

Objective. This work sought to determine the level of anxiety in relatives of patients admitted to CCUs and its relationship with spiritual health and religious coping. Methods. This cross-sectional study was conducted on 300 relatives of Cardiac Care Units patients in Jahrom, Iran. Required data was collected using the Spielberger State-Trait Anxiety Inventory (STAI), the Paloutzian-Ellison Spiritual Well Being Scale (SWBS), and the Pargament Brief RCOPE questionnaire. Results. The results showed that both levels of state and trait anxiety were moderate and the level of total spiritual health was high. Anxiety score had an inverse relationship with spiritual health (r=-0.52) and a direct relationship with negative religious coping score (r=0.25). However, no significant relationship was found between total anxiety score and positive religious coping (p>0.05). There was a direct relationship between spiritual health and positive religious coping (r=0.19), and an inverse relationship between spiritual health and negative religious coping (r=-0.36). Conclusion. According to the findings of the study, it is suggested to paying attention to the reinforcement of spiritual attitudes, beliefs, and religious coping strategies to reduce their anxiety in CCU patients.

Objetivo. Este trabajo buscó determinar el nivel de ansiedad en familiares de pacientes ingresados en Unidades de Cuidados Cardíacos -UCC- y su relación con la salud espiritual y el afrontamiento religioso. Métodos. Este estudio transversal se llevó a cabo en 300 familiares de pacientes hospitalizados en UCC en Jahrom, Irán. Los datos requeridos se recopilaron utilizando el Inventario de Ansiedad ­ Estado - Rasgos (STAI) de Spielberger, la Escala de Bienestar Espiritual de Paloutzian-Ellison (SWBS) y el cuestionario RCOPE en versión breve de Pargament. Resultados. Los hallazgos mostraron que tanto los niveles de ansiedad del estado como de los rasgos eran moderados y el nivel de salud espiritual total era alto. La puntuación de ansiedad tuvo una relación inversa con la salud espiritual (r=-0.52) y una relación directa con la puntuación de afrontamiento religioso negativo (r=0.25). Sin embargo, no se encontró una relación significativa entre la puntuación total de ansiedad y el afrontamiento religioso positivo (p>0.05). Hubo una relación directa entre la salud espiritual y el afrontamiento religioso positivo (r=0.19), y una relación inversa entre la salud espiritual y el afrontamiento religioso negativo (r=-0.36). Conclusión. De acuerdo con los hallazgos del estudio, se sugiere prestar atención al refuerzo de las actitudes espirituales, creencias y estrategias de afrontamiento religiosas para reducir su ansiedad en los pacientes con CCU.

Objetivo. Este trabalho buscou determinar o nível de ansiedade em familiares de pacientes internados em Unidades de Cuidados Cardíaco - UCC- e sua relação com a saúde espiritual e o enfrentamento religioso. Métodos. Este estudo transversal foi realizado em 300 familiares de pacientes internados na UCC em Jahrom, no Irão. Os dados necessários foram coletados usando o Spielberger Trait Anxiety Inventory (STAI), a Escala Paloutzian-Ellison de Bem-estar Espiritual (SWBS) e o questionário RCOPE de Pargament. Resultados. Os resultados mostraram que tanto os níveis de ansiedade do estado como os traços eram moderados e o nível geral de saúde espiritual era alto. A pontuação de ansiedade teve uma relação inversa com a saúde espiritual (r=-0.52) e uma relação direta com a pontuação de afrontamento negativo religioso (r=0.25). No entanto, não foi encontrada relação significativa entre a pontuação total de ansiedade e o afrontamento religioso positivo (p>0.05). Houve relação direta entre saúde espiritual e enfrentamento religioso positivo (r=0.19), e relação inversa entre saúde espiritual e enfrentamento religioso negativo (r=-0.36). Conclusão. De acordo com as descobertas do estudo, sugere-se colocar atenção para o reforço de atitudes espirituais, crenças e estratégias religiosas de enfrentamento para reduzir sua ansiedade em pacientes com CCU.

Nursing Student Experiences of Caring for Burned Patient: From Fearfulness to Normalization

Objective. To describe the care experiences of students in burn units. Methods. Qualitative research of the phenomenological descriptive type which was conducted with the participation of eight senior nursing students in Shiraz College of Nursing and Midwifery, Iran. The method used for gathering data about Student experiences in Care Services for Burn Cases was the individual semi-structured interview. The Colaizzi method was used for analysing and interpreting the data. Results. Three main themes emerged: the attractive but stressful experience, trying to adjust and metamorphosis in attitude. Taking care of burned patients led to metamorphosis and adaptation to the requirements of burn care due to the students' improved attitudes, awareness and potentials. This finally turned the stressful nature of taking care of a burn patient into an attractive experience for them. Conclusion. Students with little clinical experience of stressful working situations in burn units faced different challenges. Due to the specific nature of taking care of burned patients, the clinical experiences of nursing students who offer these services are unique.

Objetivo. Describir las experiencias de atención de los estudiantes en las unidades de quemados. Métodos. Investigación cualitativa del tipo descriptivo fenomenológico que se realizó con la participación de ocho estudiantes senior de enfermería en el Shiraz College of Nursing and Midwifery en Irán. El método utilizado para reunir datos sobre las experiencias de los estudiantes en los servicios de atención de pacientes quemados fue la entrevista individual semiestructurada. El método Colaizzi se utilizó para analizar e interpretar los datos. Resultados. Emergieron tres temas principales: la experiencia atractiva pero estresante, tratando de adaptarse, y la metamorfosis en actitud. El cuidado a los pacientes quemados condujo a la metamorfosis y a la adaptación a los requerimientos del cuidado de las quemaduras, debido a que los estudiantes mejoraron las actitudes, mostraron mayor conciencia y desarrollaron potencialidades. Esto finalmente convirtió la naturaleza estresante de cuidar a un paciente quemado en una experiencia atractiva para ellos. Conclusión. Los estudiantes con poca experiencia clínica de situaciones laborales estresantes pueden enfrentar diversos desafíos en las unidades de quemados. Debido a la naturaleza específica del cuidado de este tipo de pacientes, las experiencias clínicas son únicas para los estudiantes de enfermería.

Objetivo. Descreva as experiências de atenção do aluno em unidades de queimados. Métodos. Pesquisa qualitativa, do tipo descritivo fenomenológico, realizada com a participação de oito estudantes seniores de enfermagem da Faculdade de Enfermagem e Obstetrícia Shiraz, no Irã. O método utilizado para coletar dados sobre as experiências dos estudantes nos serviços de queimados foi a entrevista individual semiestruturada. O método Colaizzi foi utilizado para analisar e interpretar os dados. Resultados. Surgiram três temas principais: a experiência atraente, porém estressante, tentando se adaptar e a metamorfose na atitude. Cuidar de pacientes queimados levou à metamorfose e adaptação às exigências do cuidado com queimaduras, porque os alunos melhoraram atitudes, mostraram maior consciência e desenvolveram potencialidades. Isso finalmente transformou a natureza estressante de cuidar de um paciente queimado em uma experiência atraente para eles. Conclusão. Alunos com pouca experiência clínica em situações estressantes de trabalho podem enfrentar vários desafios em unidades de queima. Devido à natureza específica do atendimento a esses pacientes, as experiências clínicas são únicas para os estudantes de enfermagem.

Post-Traumatic Growth among Family Caregivers of Cancer Patients and Its Association with Social Support and Hope.

BACKGROUND: Cancer not only is a traumatic experience for the patients, but also can affect the family caregivers. Post-traumatic growth (PTG) refers to positive psychological changes experienced by people as a result of a struggle in dealing with traumatic events in life. Both the patients and their caregivers may experience PTG. The present study aimed to assess the extent of PTG in caregivers of patients with gastrointestinal cancer and to examine the relationship between the PTG dimensions and both the social support (SS) and hope. METHODS: The present descriptive correlational study was conducted during May-August 2018 in Shiraz, Iran. The target population included 112 caregivers who visited hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Data collection instruments included a demographic information form, post-traumatic growth inventory, social support appraisals scale, and Miller hope scale. The data were analyzed using the SPSS software (version 23.0). P<0.05 was considered statistically significant. RESULTS: The mean score for PTG, hope, and SS was 75.41±16.49, 190.95±24.20, and 89.10±12.84, respectively. A significant positive correlation was found between PTG and both SS (P<0.001, r=0.59) and hope (P<0.001, r=0.70). The results of the multiple regression analysis showed a significant relationship between PTG, SS, and hope (P<0.001). Hope had a higher effect on PTG (ẞ=0.62) compared to SS (ẞ=0.27). CONCLUSION: The results showed a good level of PTG among the caregivers and the experience of stressful situations positively affected their psychological condition. The positive change was associated with the perceived SS and hope.

Quality of Nurses' Communication with Mechanically Ventilated Patients in a Cardiac Surgery Intensive Care Unit.

OBJECTIVES: To describe the quality of the relationship between nurses and patients under mechanical ventilation. METHODS: This observational study, performed in a cardiac surgery intensive care unit in Iran, selected 10 nurses and 35 patients through simple random and convenience sampling, respectively. One of the researchers observed 175 communications between nurses and patients in different work shifts and recorded the results according to a checklist. Nurse and patient satisfaction with the communication was assessed by using a six-item Likert scale, 8 to 12 h after extubation. RESULTS: Most of the patients were male (77.1%), while most of the nurses were female (60%). Patients started over 75% of the communications observed. The content of the communication was related mostly to physical needs and pain. Besides, the majority of patients used purposeful stares and hand gestures, and head nod for communication. Most of the communications between patients and nurses were satisfied 'very low' (45.7% in nurses, versus 54.3% in patients). However, 'complete satisfaction' was lower in nurses (0%), compared with patients (5.7%). No statistically significant correlation was found between patients' and nurses' satisfaction and demographic variables. CONCLUSIONS: The results showed that communication between nurses and mechanically ventilated patients was built through traditional methods and was based on the patients' requests. This issue might be the cause of an undesirable level of their satisfaction with the communication, given that effective communication can lead to understanding and meeting the needs of the patients.

Quality of Nurses' Communication with Mechanically Ventilated Patients in a Cardiac Surgery Intensive Care Unit

Objetivo. Describir la calidad de la relación entre las enfermeras y los pacientes sometidos a ventilación mecánica. Métodos. Estudio observacional realizado en una Unidad de Cuidados Intensivos de Cirugía Cardíaca en Irán. Se seleccionaron 10 enfermeras y 35 pacientes mediante muestreo aleatorio simple y de conveniencia, respectivamente. Se observaron 175 comunicaciones entre las enfermeras y los pacientes en diferentes turnos de trabajo. Los resultados se registraron de acuerdo con una lista de verificación. La satisfacción con la comunicación de las enfermeras y de los pacientes se evaluó mediante una escala Likert de 6 ítems, de 8 a 12 horas después de la extubación del paciente. Resultados. La mayoría de los pacientes eran hombres (77.1%), mientras que en las enfermeras predominó el sexo femenino (60%). El 75% de las comunicaciones observadas las iniciaron los pacientes. El contenido de la comunicación estaba relacionado principalmente con las necesidades físicas y el dolor. La mayoría de los pacientes usaron las miradas intencionadas, los gestos con las manos y los movimientos de la cabeza para comunicarse. La mayoría de las comunicaciones fueron 'ligeramente satisfactorias' (45.7% para enfermeras versus 54.3% para pacientes). Sin embargo, la satisfacción general fue menor en las enfermeras (0%) en comparación con los pacientes (5.7%). No se encontró correlación estadísticamente significativa entre la satisfacción de los pacientes y de las enfermeras con las variables demográficas estudiadas. Conclusión. Los resultados mostraron que la comunicación entre las enfermeras y los pacientes con ventilación mecánica se construyó a través de métodos tradicionales y se basó en las solicitudes de los pacientes. Esta situación puede ser el motivo del nivel indeseable de satisfacción con las comunicaciones, las cuales son esenciales para comprender y satisfacer las necesidades de los pacientes.

Objective. To describe the quality of the relationship between nurses and patients under mechanical ventilation. Methods. This observational study, performed in a cardiac surgery intensive care unit in Iran, selected 10 nurses and 35 patients through simple random and convenience sampling, respectively. One of the researchers observed 175 communications between nurses and patients in different work shifts and recorded the results according to a checklist. Nurse and patient satisfaction with the communication was assessed by using a six-item Likert scale, 8 to 12 h after extubation. Results. Most of the patients were male (77.1%), while most of the nurses were female (60%). Patients started over 75% of the communications observed. The content of the communication was related mostly to physical needs and pain. Besides, the majority of patients used purposeful stares and hand gestures, and head nod for communication. Most of the communications between patients and nurses were satisfied 'very low' (45.7% in nurses, versus 54.3% in patients). However, 'complete satisfaction' was lower in nurses (0%), compared with patients (5.7%). No statistically significant correlation was found between patients' and nurses' satisfaction and demographic variables. Conclusion. The results showed that communication between nurses and mechanically ventilated patients was built through traditional methods and was based on the patients' requests. This issue might be the cause of an undesirable level of their satisfaction with the communication, given that effective communication can lead to understanding and meeting the needs of the patients.

Objetivo. Descrever a qualidade da relação entre as enfermeiras e os pacientes submetidos a ventilação. Métodos. Estudo observacional realizado em uma Unidade de Tratamento Intensivo de Cirurgia Cardíaca no Irã. Se selecionaram 10 enfermeiras e 35 pacientes mediante amostra aleatória simples e de conveniência, respectivamente. Se observaram 175 comunicações entre as enfermeiras e os pacientes em diferentes turnos de trabalho. Os resultados se registraram de acordo com uma lista de verificação. A satisfação com a comunicação das enfermeiras e dos pacientes se avaliou mediante uma escala Likert de 6 itens, de 8 a 12 horas depois da extubação do paciente. Resultados. A maioria dos pacientes eram homens (77.1%), enquanto que nas enfermeiras predominou o sexo feminino (60%). 75% das comunicações observadas foram iniciadas pelos pacientes. O conteúdo da comunicação estava relacionado principalmente com as necessidades físicas e a dor. A maioria dos pacientes para comunicar-se usavam as olhadas intencionadas, os gestos com as mãos e os movimentos da cabeça. A maioria das comunicações foram 'ligeiramente satisfatórias' (45.7% para enfermeiras versus 54.3% para pacientes). Porém, a satisfação completa foi menor nas enfermeiras (0%) em comparação com os pacientes (5.7%). Não se encontrou correlação estatisticamente significativa entre a satisfação dos pacientes e das enfermeiras com as variáveis demográficas. Conclusão. Os resultados mostraram que a comunicação entre as enfermeiras e os pacientes com ventilação mecânica se construiu através de métodos tradicionais e se baseou nas solicitações dos pacientes. Esta situação pode ser o motivo do nível indesejável de satisfação com as comunicações, as quais são necessárias para compreender e satisfazer as necessidades dos pacientes.

The Effect of Group Reflection on Nursing Students' Spiritual Well-being and Attitude Toward Spiritual Care: a randomized controlled trial

Objective. To investigate how group reflection about spiritual care affects nursing students' spiritual wellbeing and attitude toward spirituality and spiritual care. Methods. This was a randomized controlled trial conducted on 63 second-year nursing students who were studying at Nursing and Midwifery Colleges in Shiraz and Jahrom, both located in south of Iran. The students were randomly divided into an intervention (n=30) and a control (n=33) group. The study data were collected using the Spiritual Well-Being Scale and Spirituality and Spiritual Care Rating Scale before and after the intervention. The intervention consisted in four sessions of group reflection based on the scenarios related to spiritual care. The control group was given a related lecture in one session. Results. A significant difference was found between the two groups' means in spiritual well-being scores after the interventioncompared to before that. Likewise, a significant difference was observed in the intervention group students' total scores of attitude before and after the intervention. Conclusion. Group reflection improved the nursing students' spiritual well-being and their attitude toward spirituality and spiritual care compared with control group.

Objetivo. Investigar cómo la reflexión grupal sobre el cuidado espiritual afecta el bienestar espiritual y la actitud de los estudiantes de enfermería hacia la espiritualidad y el cuidado espiritual. Métodos. Este fue un ensayo controlado aleatorio realizado en 63 estudiantes de segundo año de dos escuelas de enfermería y partería en Irán. Los estudiantes se dividieron aleatoriamente en los grupos de intervención (n=30) y de control (n=33). Los datos del estudio se recopilaron utilizando la Escala de Bienestar Espiritual y la Escala de Calificación de Espiritualidad y Cuidado Espiritual antes y después de la intervención. La intervención consistió en cuatro sesiones de reflexión grupal basadas en escenarios relacionados con el cuidado espiritual. El grupo de control recibió solamente una conferencia relacionada con el tema. Resultados. Se encontró una diferencia significativa entre las medias de los dos grupos en cuanto a las puntuaciones de bienestar espiritual después de la intervención en comparación con la de la preintervención. Asimismo, se observó una diferencia significativa en las puntuaciones totales de actitud de los estudiantes del grupo de intervención antes y después de la intervención. Conclusión. La reflexión grupal mejoró el bienestar espiritual de los estudiantes de enfermería y su actitud hacia la espiritualidad y el cuidado espiritual en comparación con el grupo de control.

Objetivo. Investigar como a reflexão grupal sobre o cuidado espiritual afeta o bemestar espiritual e a atitude dos estudantes de enfermagem para a espiritualidade e o cuidado espiritual. Métodos. Este foi um ensaio controlado aleatório realizado em 63 estudantes de segundo ano de duas escolas de enfermagem e de parteiras no Irã. Os estudantes se dividiram aleatoriamente nos grupos de intervenção (n=30) e de controle (n=33). Os dados do estudo se recopilaram utilizando a Escala de Bemestar Espiritual e a Escala de Qualificação de Espiritualidade e Cuidado Espiritual antes e depois da intervenção. A intervenção consistiu em quatro sessões de reflexão grupal baseadas em cenários relacionados com o cuidado espiritual. O grupo de controle recebeu somente uma conferência relacionada com o assunto. Resultados. Se encontrou uma diferença significativa entre as médias dos dois grupos em quanto às pontuações de bem-estar espiritual depois da intervenção em comparação com a da pré-intervenção. Assim mesmo, se observou uma diferença significativa nas pontuações totais de atitude dos estudantes do grupo de intervenção antes e depois da intervenção. Conclusão. A reflexão grupal melhorou o bem-estar espiritual dos estudantes de enfermagem e sua atitude à espiritualidade e o cuidado espiritual em comparação com o grupo de controle.

Causes of medical errors and its under-reporting amongst pediatric nurses in Iran: a qualitative study.

OBJECTIVES: To explore the causes of medical errors (ME) and under-reporting amongst pediatric nurses at an Iranian teaching hospital. DESIGN: A qualitative study, based on individual, in-depth, semi-structured interviews and content analysis approach. SETTINGS: The study was conducted at the Pediatric Department of the largest tertiary general and teaching hospital in Shiraz, southern Iran. PARTICIPANTS: The study population was all pediatrics nurses who work at Pediatric Department and they had been trained on ME, as well as methods to report them through the hospital's ME reporting system. Purposive sampling was used by selecting key informants until data saturation was achieved and no more new information was obtained. Finally, 18 pediatric nurses were interviewed. MAIN OUTCOME MEASURE(S): Pediatrics nurses' views on the causes of ME and under-reporting. RESULTS: We found five main factors causing ME and under-reporting: personal factors, workplace factors, managerial factors, work culture and error reporting system. These factors were further classified into proximal and distal factors. Proximal factors had direct relationship with ME and distal factors were contextual factors. CONCLUSION: Causes of ME and under-reporting amongst pediatric nurses are complex and intertwined. Both proximal and distal factors need to be simultaneously addressed using context-specific approaches. Further research on other groups of healthcare workers and using a quantitative approach will be beneficial to elucidate the most appropriate interventions.

Evaluating the Effectiveness of a Continuing Education Program for Prevention of Occupational Exposure to Needle Stick Injuries in Nursing Staff Based on Kirkpatrick's Model.

BACKGROUND: Nurses are the most vulnerable group that are faced with occupational injuries caused by exposure to needle stick injuries. This study evaluated the effectiveness of a continuing education program about the prevention of occupational exposure to needle stick injuries in the nursing staff, based on the Kirkpatrick model. METHODS: In this study, 120 nurses were selected in the experimental and control groups. A continuing education program for experimental group was performed. After the education program, its effectiveness has been evaluated across four levels (Reaction, Learning, Behavior, Results) of the Kirkpatrick model. Data analysis was conducted using Pearson's correlation coefficient, chi-square test, paired t-test, independent samples t-test, and descriptive statistics. The data were analyzed using the SPSS statistical software (V. 22). RESULTS: The mean score for knowledge in the experimental group improved significantly from 8.32 ± 2.17 to 13.98 ± 1.2 (p < 0.05). The experimental group of 24 nurses (40%) were exposed to needle stick injury before education, but this number was reduced to 9 (15%) after intervention. The chi-square test showed a significant difference (P = 0.013). However in the experimental group, 15 nurses (25%) were exposed to blood and body fluids before intervention, but again it was reduced to 6 (10%) after education. The chi-square test showed a significant difference (P = 0.002). CONCLUSION: The results from the execution of continuing education program showed that through designing training programs and raising awareness in nursing personnel, we can reduce occupation exposure to needle stick injuries.

The effect of massage therapy by patients' companions on severity of pain in the patients undergoing post coronary artery bypass graft surgery: a single-blind randomized clinical trial.

BACKGROUND: Pain on mid sternotomy incision site after Coronary Artery Bypass  Graft  Surgery (CABG) is a common problem that causes sleep disturbance, delayed wound healing, and increased use of analgesic drugs. Massage therapy which is mostly performed by healthcare providers is a non-pharmacological approach for managing this pain. The present study aimed to determine the effect of massage therapy by patient's companion on the severity of pain in post CABG patients. METHODS: In this randomized single-blind clinical trial, 70 post CABG patients were randomly divided into an intervention and a control group. The intervention group received massage by one of their relatives who was trained by an expert nurse. The control group, on the other hand, received routine care. The pain intensity was assessed by Visual Analogue Scale (VAS) before and immediately, 30, 60, and 120 minutes after the intervention. Then, the data were entered into the SPSS statistical software (version 16) and analyzed using repeated measures ANOVA and post-hoc test (Scheffe). RESULTS: At the beginning of the study, no significant difference was found between the two groups regarding the pain severity. In the intervention group, the pain severity significantly decreased in all the four time points after the intervention (P=0.001). However, no significant difference was observed in this regard in the control group. CONCLUSION: Massage therapy by patient's companion trained by a nurse was an effective strategy for pain management in post CABG patients. This could also promote the patient's family participation in the process of care. TRIAL REGISTRATION NUMBER: IRCT201208218505N3.