Barriers and facilitators of readiness for hospital discharge in patients with myocardial infarction: a qualitative study: quality improvement study.

Background: Readiness for hospital discharge (RHD) in patients with myocardial infarction (MI) is a key concept in the discharge process. This study was conducted to explain the barriers and facilitators of preparation for discharge in patients with MI. Materials and methods: A qualitative study was conducted using conventional content analysis from April 2021 to 2022. Data collection was done in a targeted manner through semi-structured interviews until the data saturation stage. Nineteen participants (11 patients, 3 family members, and 5 healthcare team) were interviewed. Data analysis was done in eight steps according to the suggested steps of Graneheim and Lundman. MAXQDA18 software was used for coding. Results: From the interviews, 348 primary codes, 11 sub-categories, and 5 categories were extracted. Finally, after continuous analysis and comparison of interviews, codes, and categories, two themes including "supporting platform" and "caring atmosphere" were extracted, which were the result of the participants' experience and understanding of the barriers and facilitators of RHD. The supporting platform included "family support" and "social support" and the caring atmosphere included "care gaps" and "professional healthcare team performance". Conclusion: The results of this study indicate several factors affecting RHD in heart attack patients. According to the results of the study, the participation of the patient, family, healthcare team, and community in creating RHD is recommended. It is also suggested to pay attention to these factors in care and treatment planning to help improve health and control complications and prevent re-hospitalization in these patients.

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.

Factors Improving Oncology Nurse Role Performance in Providing Pediatric Palliative Care: A SWOT Analysis.

OBJECTIVE: Palliative care is provided by an interdisciplinary team in which, nurses play an important role, and improving their role performance can be effective in providing high-quality care. This study aimed to explore the factors related to improving oncology nurses' role performance in providing pediatric palliative care. METHODS: This qualitative study was conducted using semi-structured interviews with 22 nurses, physicians, hospital supervisors, children, and their parents from September 2022 to January 2023. Data analysis was performed based on conventional content analysis proposed by Elo and Kyngas using MAXQDA 2020. Finally, subcategories of each main category were summarized in the SWOT analysis matrix. RESULT: Data analysis led to the extraction of 1250 codes, three main categories (nurse-related factors, child and family-related factors, and organizational factors), five generic categories, and 32 subcategories that were ultimately classified in the SWOT analysis matrix. CONCLUSION: This study showed that oncology nurses' role performance in providing palliative care is influenced by many internal and external factors. In this regard, in order to improve their role performance, increasing knowledge among nurses, nursing students, and the community on integrating pediatric palliative care topics into the nursing curriculum, fair access to palliative care services, drug accessibility, financial support, and further research are recommended.

Effect of Topical Sesame Oil on the Severity of Pain in Patients With Limb Trauma: A Randomized Controlled Trial.

Objective: The purpose of this study was to investigate the effect of topical use of sesame oil on pain severity in patients with limb trauma. Methods: A placebo-controlled randomized controlled trial was conducted on 120 patients with nonpenetrating upper and lower limb traumas admitted to the trauma emergency department. The patients were allocated to either the sesame oil group or the placebo group using the stratified random sampling technique based on trauma size and age. Depending on the trauma area, sesame or placebo oil were poured on the trauma site and massaged for 5 to 7 minutes. The intervention was repeated twice a day for 3 days at home. Pain severity was measured using the numeric pain scale before intervention on the first day and 30 minutes after each intervention for 3 days, twice a day. Data were analyzed using descriptive and analytical tests including the independent t test, χ2 test, Fisher exact test, Mann-Whitney U test, Friedman test, and multiple linear regression analysis. The significance level was set at 0.05. Results: The decreasing trend of pain was significant in both the intervention and placebo groups (P < .001). Comparison of the trend of changes in pain scores between the 2 groups showed that the mean changes of pain severity were higher in the intervention group compared with the placebo group in all assessments. There was a significant difference in the rate of analgesic consumption in the intervention group compared with the placebo group (P < .001). However, there was no significant difference between the 2 groups regarding pain severity. Pain reduction was negatively associated with body mass index (b = -0.091, P = .003), amount of received pain medication (b = -0.001, P = .039), and area of trauma (b = -0.002, P = .039). Pain reduction was greater in male patients than female patients (b = 0.676, P = .015). The effect of sesame oil on pain changes was not significant. No adverse side effects were reported. Conclusion: This study showed that despite less use of analgesics in the intervention group than in the placebo group, sesame oil did not have any statistically significant effects on the severity of limb trauma pain. Further research is needed regarding the effect of topical sesame oil application on pain as a safe and uncomplicated intervention.