Qualitative exploration of sexual dysfunction and associated coping strategies among Iranian prostate cancer survivors.

OBJECTIVE: Our understanding of the experiences of prostate cancer survivors regarding their sexual life and related issues remains limited. Therefore, this study aimed to explore sexual dysfunction and associated coping strategies among Iranian prostate cancer survivors. METHODS: A qualitative study was undertaken. Participants were 15 Iranian prostate cancer survivors chosen using purposeful sampling. Data collection involved conducting in-depth semi-structured interviews, followed by the utilization of the conventional qualitative content analysis method for data analysis. RESULTS: Three themes were developed: (a) suspension of sexual life-treatment for prostate cancer significantly impacted participants' sexual lives; (b) emotional resilience and psychological coping strategies-various psychological strategies were used to tackle sexual dysfunction; (c) efforts to regain sexual function-several strategies were applied to enhance sexual performance. CONCLUSION: Our study findings provide insights into the experiences of prostate cancer survivors and subsequent shifts in their sexual dynamics and coping with the disease. Healthcare providers should actively identify patients' concerns and develop culturally tailored care strategies to address sexual challenges and improve coping among prostate cancer survivors.

Development and psychometric evaluation of perceived clinical nurses' professional dignity scale: a sequential-exploratory mixed-method study.

BACKGROUND: In recent years, one of the concepts that has received attention in the nursing profession is professional dignity. On the other hand, there was no proper scale to evaluate this concept. This study aimed to develop and evaluate the psychometric properties of perceived clinical nurses' professional dignity scale (PCNPDS). METHODS: This exploratory sequential mixed method was developed and implemented in Iran. The study was conducted in two phases; (a) item generation by hybrid concept analysis and (b) item reduction by psychometric evaluation including validity and reliability of the developed scale. Also, the interpretability (ceiling and floor effect), stability (intraclass correlation coefficient), and absolute stability (standard error of measurement) were calculated. RESULTS: 68 items in the primary item pool were finally reduced to 22 items after evaluating the validity (face, content, and construct validity) and reliability. Exploratory factor analysis revealed three factors (organizational dignity, dignity-based competency, and dignity-based appreciation) and explained 47.55% of the total extracted variance. Confirmatory factor analysis showed that the model had a good fit. Finally, Cronbach's alpha coefficient, McDonald's omega, ICC, and SEM were calculated as 0.90, 0.89, 0.96, and 1.91, respectively. CONCLUSION: The 22-item developed scale is valid and reliable for professional dignity measurement among Iranian clinical nurses.

Development and validation of the shared governance feasibility instrument in nursing schools in Iran.

ABSTRACT: To develop and validate a shared governance feasibility instrument in schools of nursing in Iran with respect to the nature of the profession and the sociocultural context of the Iranian community. BACKGROUND: Nursing schools are liable to the application of shared governance due to the presence of various expert educational groups within the school that necessitates reciprocal cooperation. Since the concept of shared governance is culture-based and given that no full-fledged study has been conducted on shared governance in Iran, the development of a suitable shared governance feasibility instrument is rendered as mandatory. METHODS: This sequential exploratory mixed-method study consisted of two qualitative and quantitative parts was accomplished 2016-2019. First, the primary items were extracted through an extensive review of the literature, qualitative interviews and underwent psychometric validation using a methodological approach. Face, content, construct validity and reliability of the instrument was established and completed. RESULTS: One hundred fifty items were distilled from the first stage of the study, was reduced to 70 after establishing face, content validity and primary reliability. Exploratory factor analysis resulted in 52 items covering the two factors "shared atmosphere and culture" and "infrastructural prerequisites". These two factors accounted for 78.6% of the total variance of the questionnaire. In calculating the final reliability coefficient of the instrument, Cronbach's alpha and Omega were 0.981 and 0.805, respectively. The results showed an ICC of 0.91 indicating high reliability of the developed instrument with a standard error of measurement (SEM) of 10.43. Finally, the items underwent weighting via scoring by considering item weights due to differences between the two methods. CONCLUSION: "Shared governance feasibility instrument" can provide a new insight into organisational performance for all policy-makers and beneficiaries of higher education. This not only leads to the use of intelligence and capabilities of the beneficiaries, but also aids in faster movement toward achieving organisational goals. IMPLICATIONS FOR NURSING MANAGEMENT: This study and the developed instrument may serve as a guide for the feasibility of implementing shared governance to assess management styles and performance in higher education centers.

Factors predisposing to shared governance: a qualitative study.

BACKGROUND: The method of implementing shared governance varies among organizations. Identifying the predisposing factors can facilitate and precipitate its successful implementation and aid educational institutions in achieving their goals. This study determined the antecedents of shared governance in nursing schools. METHODS: Eleven participants including faculty members of nursing schools, and managers of three major medical universities of Tehran were selected using purposive sampling method and underwent in-depth semi-structured interviews in this qualitative study. Conventional content analysis was used to analyze the data. RESULTS: Data analysis led to the emergence of four categories including the participatory context of higher education institutions, infrastructural obligations, coordination with contemporary needs, and participation-oriented managers resulting in twelve subcategories. CONCLUSION: This study showed that managers can play a key role in the successful implementation of shared governance in the appropriate context of higher education institutions. Hence, the deliberate selection of managers who believe in managerial participation and their training are mandatory in nursing schools. The senior or higher level managers of educational institutions can empower themselves and their staff in participatory skills along with providing suitable resources of work serving as a suitable model of participation.

Incidence trends of colorectal cancer in Iran during 2000-2009: A population-based study.

BACKGROUND: As the third leading cause of death, cancers have a special place in the Iranian health system. Several studies have been done in some regions of the country with few years of follow-ups, but this was the first standardized study to investigate the incidence trends of colorectal cancer in Iran in a one-decade period. METHODS: The registered data for colorectal cancer cases in National Cancer Registry System were extracted from the Center for Disease Control & Management of Ministry of Health. The codes from 18 to 21 among cancers were selected for colon and rectum cancers. Incidence rates were directly standardized, using WHO population. The significance of incidence rate trends was tested through Poisson regression. RESULTS: In this study, 36,650 cases of colorectal cancer were observed for 10 years in Iran, which increased from 813 cases in 2000 to 6,210 cases in 2009. Gender ratio of men to women was 1.39. Significant increasing trends of colorectal cancer were observed during the period of the study. The standardized incidence rate increased from 1.6 per 100,000 persons per year in 2000 to 11.3 in 2009 in males (p<0.001), and it increased from 1.6 per 100,000 persons per year in 2000 to 10.9 in 2009 in females (p<0.001). CONCLUSION: Colorectal cancer has an increasing trend in Iran. The rising trend of colorectal cancer as well as other types of cancers is partially due to improvement in cancer registry systems in the early years of registry. Moreover, westernized lifestyle and an increase in environmental risks could explain this rising trend.

Caregiving consequences in cancer family caregivers: a narrative review of qualitative studies.

Background: Cancer is a significant public health issue, causing various challenges for individuals affected by it. As cancer progresses, patients often become dependent on others for support. Family caregivers and members play a crucial role in the recovery and rehabilitation of these patients. However, caregivers themselves face numerous challenges throughout the course of their family member's illness. Exploring the experiences of family caregivers can inform long-term planning and supportive interventions to address their caregiving difficulties. This study reviews previous literature on caregiving outcomes. Method: This study presents a narrative review of qualitative studies, analyzing a total of 23 articles. The results were extracted and organized into subcategories. After revision by the research team, main categories were identified. These categories encompass both positive and negative outcomes of caregiving. Results: The findings of this review demonstrate that caring for a family member with cancer has significant implications for caregivers. These implications include: (A) Positive outcomes of caregiving (such as achieving self-management and balance, promoting kinship intimacy, finding meaning and purpose, and experiencing spiritual growth) and (B) Negative outcomes of caregiving (including care-related physical exhaustion, disruption of personal life plans, psycho-emotional consequences, and socio-economic burden). Conclusion: The results of this study highlight the challenges faced by family caregivers and emphasize the importance of addressing their needs within the healthcare system. By providing support and attention to their well-being, caregivers can enhance their resilience and adaptability in managing caregiving difficulties.

Threats to professional dignity of Iranian clinical nurses: A qualitative study.

AIM: Identifying threats to the nurses' professional dignity has an important role in maintaining and promoting their dignity. This study aimed to evaluate the perception of Iranian nurses' experiences of threats to their professional dignity in clinical settings. DESIGN: A qualitative directed content analysis approach was used. METHODS: The present qualitative study was conducted in Iran.Clinical nurses were selected using the purposive sampling method. Data were collected through in-depth semi-structured interviews with 15 clinical nurses from October 2020 to March 2021. The qualitative content analysis method was used to analyze the data. RESULTS: Two main categories and 16 subcategories were extracted as follows: (1) professional factors (containing seven subcategories) and (2) organizational factors (containing nine subcategories). CONCLUSIONS: To promote the professional dignity of nurses, it is recommended to identify the factors threatening their professional dignity and create healthy work environments for them.

Fear of Cancer Recurrence and Coping Strategies among Prostate Cancer Survivors: A Qualitative Study.

BACKGROUND: Fear of cancer recurrence (FCR), as a commonly reported problem among prostate cancer survivors, has not been fully understood. This study aimed to explore the experience of FCR and relevant coping strategies among Iranian prostate cancer survivors. METHODS: Qualitative research was conducted on 13 men who completed treatments for prostate cancer in the last 24 months. The participants were selected through purposeful sampling, and in-depth semi-structured interviews were used for data collection. Conventional content analysis was used for data analysis. RESULTS: Data analysis led to the emergence of three themes. "Living with insecurity" describes the participants' experiences regarding what triggers FCR with two categories, including "fear of incomplete cure" and "fear of cancer return." In addition, "struggling to cope" with two categories, including "psychological strategies" and "spiritual coping," presents coping strategies used by the participants for reducing FCR. Furthermore, "trying to prevent cancer recurrence" with two categories, "seeking health" and "lifestyle modification," indicates coping strategies used by the participants to prevent cancer recurrence. CONCLUSIONS: Healthcare providers need to consider the cultural characteristics of prostate cancer survivors when assessing their FCR, encourage them to disclose their concerns and fears, and provide tailored interventions in order to reduce FCR among them.

The effect of hospital-to-home transitional care using a digital messaging application on the health outcomes of patients undergoing CABG and their family caregivers: a randomized controlled trial study protocol.

Objectives: Given the increasing trend of care transition from healthcare settings to patients' own home, patients and their family caregivers should take more responsibilities for care at own home. This study is going to investigate the effect of a transitional care program from hospital to own home using a digital messaging application on patients' undergoing coronary artery bypass graft (CABG) surgery and their family caregivers' health outcomes. Methods: A parallel randomized controlled trial study will be conducted in a hospital in a metropolis located in southwestern Iran. Sampling will be performed sequentially and the eligible dyad of patients and family caregivers will be randomly assigned to intervention and control groups. The intervention group will receive a transitional care program for 8 weeks using the WhatsApp on the mobile phone based on the person-centered care approach, but the control group will receive routine care for patient's transition. Data collection will be conducted at baseline, immediately after the intervention, and two months after the intervention using demographic questionnaire, Cardiac Self-Efficacy Scale (CSES), MacNew Heart Disease Health-Related Quality of Life questionnaire (MNHD-Q), Cardiac Symptom Scale (CSS), Morisky Medication Adherence Scale, and Caregiver Burden Scale (CBS). Descriptive and inferential statistics will be used for data analysis. Conclusions: The results of this study will allow evaluating the effectiveness of an innovative transitional care program to patients' own home using a digital messaging application. If the transitional program is shown feasible and effective it can be incorporated into existing care programs and stimulate further studies on the use of digital solutions for improving the continuity of care in own home.

Experiences of Facilitators and Inhibitors to Treatment Adherence in Patients with Heart Failure.

Treatment adherence is a fundamental aspect of heart failure (HF) management. This study aimed to explore the experiences of facilitators and inhibitors of treatment adherence in patients with HF. This descriptive qualitative study was conducted from May 2020 to June 2021. Participants including people with HF, their family caregivers and physicians, and nurses were selected purposefully, with the aim of obtaining sufficient information power. Semi-structured interviews were used to collect data. Data were analyzed using thematic analysis. Two main themes "the driving forces behind treatment adherence" and "the deterrent forces behind treatment adherence" emerged from the analysis. The first theme contained the following subthemes: "supportive family," "positive personality characteristics," and "having health literacy." The second theme consisted of "negligence," "psychological problems," "cultural, social, and economic problems," "physical limitations," and "lack of self-care management knowledge." Nurses can consider facilitators and inhibitors of treatment adherence in designing educational and care programs for patients with HF.

Evaluating the Effect of Peer Education on the Hope of Patients with Thalassaemia Major: A quasi-experimental study.

Objectives: Thalassaemia major (TM) is one of the most common chronic genetic disorders in today's world. The psychological impacts of this disease can affect patients' hope. Considering the positive role and importance of suitable educational methods, this study aimed to determine the effect of peer education on the hope of patients with TM. Methods: This quasi-experimental single-group study included patients with TM undergoing treatment at the Imam Khomeini Hospital, Zabol, Iran, between March and July 2020. A continuous sampling method was used and data collection tools included a demographic questionnaire and Snyder's Hope Scale. Patients were educated in groups by eligible peers in two sessions for 60 minutes per session. Hope was measured before (pre-test) and one month after (post-test) the educational sessions. Descriptive statistics and a paired sample student t-test were used. Results: A total of 50 participants were included in this study. The mean age of the participants was 24.5 ± 4.24 years. At the pre-test, the mean total hope score was 26.72 ± 5.82; this increased to 28.21 ± 5.11 at the post-test (P = 0.028). The mean hope score of patients in the pathway thinking dimension significantly increased after peer education (P = 0.01). Despite an increase in the score of the agency thinking dimension, this was not statistically significant (P = 0.297). Conclusion: The findings of this study indicate that peer education can improve hope in patients with TM. Considering that this educational method is easy, cheap and experienced-based, it can be used in combination with other healthcare measures to improve TM patients' hope.

Androgen Deficiency in Aging Males: Translation and Validation Study of the Iranian Version.

BACKGROUND: Considering the importance of psychometric evaluation of the male sex hormone deficiency questionnaire by Iranian nurses, this study aimed to determine the translation and validation of the Iranian version of the Androgen Deficiency in Aging Males (ADAM) questionnaire. MATERIALS AND METHODS: This study was cross-sectional. After obtaining permission from the instrument maker, translating it into Farsi, retranslated it into English, and determining validity and reliability. The study population was 200 Iranian men who admitted to hospitals affiliated with Iran University of medical science and were older than 50 years and selected by convenience sampling method. They were evaluated and monitored based on the Iranian version of the ADAM questionnaire. Sensitivity and specificity were assessed and analyzed by Rock Chart analysis. Descriptive and analytical statistical tests were used at a significant level of 0.05. RESULTS: Findings showed that the Iranian version of the ADAM questionnaire had good face validity. Results showed that Cronbach's alpha in this questionnaire was 0.93, which indicates high reliability, and all the valid questionnaires were reported for the Scale-Content Validity Index (SCVI) calculation. Hence, the questionnaire has good content validity. The Iranian version of the ADAM questionnaire has a sensitivity of 93.85% and a specificity of 77.14% at the cut-off point of 2.2, indicating high sensitivity and specificity. CONCLUSIONS: The Iranian version of the ADAM questionnaire is valid and reliable and has high sensitivity and specificity. Nurses can also use it as an adjunctive scale to screen andropause men over 50 years of age.

Investigating the effect of educational intervention based on the Pender's health promotion model on lifestyle and self-efficacy of the patients with diabetic foot ulcer: A clinical trial.

BACKGROUND: This study aimed to investigate the effect of educational intervention based on the Pender's health promotion model (HPM) on lifestyle and self-efficacy of the patients with diabetic foot ulcer. MATERIALS AND METHODS: In this clinical trial conducted in 2019, 74 patients based on inclusion criteria were selected through convenience sampling and allocated to two groups of intervention (n = 37) and control (n = 37) using the randomized permuted block method. In this study, Demographic characteristics and localized Diabetes Foot Care Self-Efficacy Scale and Health-Promoting Lifestyle Profile Questionnaire for diabetic foot care were completed by two groups. The obtained data were analyzed using SPSS 16 and through descriptive and comparative statistics, independent t-test, paired t-test, and ANCOVA. RESULTS: After the intervention, the mean score of the intervention group significantly increased in all lifestyle dimensions (P < 0.001). Furthermore, the mean score of self-effcacy increased in the intervention group after the intervention (P < 0.001). Comparing the change in the mean scores of lifestyle and self-efficacy in both the groups 50 days after the intervention, an increase was observed in the mean scores of self-efficacy (P < 0.001) as well as those of lifestyle and its dimensions in the intervention group compared to those in the control group (P < 0.001). CONCLUSION: Educational intervention based on the Pender's HPM can promote the self-efficacy, lifestyle, and its dimensions in the patients with diabetic foot ulcers. The results of this study can be used in educational interventions aiming at patients with diabetic foot ulcers to change their lifestyle and improve their self-efficacy.

The Effect of Self-Management Training on Anxiety and Comfort of Burn Patients Candidate for Skin Grafting.

BACKGROUND: Self-management programs on needs of burn patients are still essential. So this study determined the effect of self-management training on anxiety and comfort of burn patients who were candidate for skin grafting. METHODS: In a continuous sampling method in Shahid Motahari Burn Center affiliated to Iran University of Medical Sciences, 80 burn patients candidate for skin grafting were divided into equal groups of intervention and control. Educational intervention was undertaken in the form of booklet during two sessions before and after skin grafting. Visual comfort scale questionnaire and Spiel Berger state-trait anxiety inventory were completed by patients before training and one month after intervention. RESULTS: There was a significant difference between the frequency of comfort level in both groups before and after the intervention. The level of comfort in the intervention group increased more than control group. The mean level of patients' anxiety showed a significant difference between groups and scores in intervention group were significantly more than control group. CONCLUSION: Attention and control of anxiety and comfort in burn patients are one of the essential elements of their care. It can be suggested that self-management training can reduce anxiety and increase burn patients' comfort.

Investigating the Knowledge, Attitude and Perception of Hand Hygiene of Nursing Employees Working in Intensive Care Units of Iran University of Medical Sciences, 2018-2019.

Introduction: Nosocomial (hospital-acquired) infections are one of the most important issues in patients' health and safety. They result in prolonged stay and emerging disabilities among patients, increased antibiotic resistance, increased mortality, and elevated health care costs for both individual patients and healthcare system. Given that the transmission of pathogens in the hospital environment is usually done through contaminated hands of health care employees, hand hygiene observation is effective in preventing nosocomial infections. Research performed in various countries has shown a variety of reasons for non-compliance with hand hygiene such as poor knowledge about this issue and lack of positive attitude towards it. For this purpose, a study designed by us in 2018-2019 aimed to determine the hand hygiene related knowledge, attitude and perception of nurses working in intensive care units of treatment educational centers of Iran University of Medical Sciences. Methodology: The present research was a descriptive cross-sectional study conducted on a sample composed of 600 nurses, assistant nurses and assistant paramedics working in intensive care units of seven medical educational centers of Iran University of Medical Sciences. The census method was used and 366 (60%) persons have freely participated in the study. Data collection tools, including one questionnary on demographic and occupational characteristics, two World Health Organization questionnaries on hand hygiene knowledge and perception, and the second part of KAP questionnaire regarding hand hygiene attitude, were all provided to nursing employees by referring to the intensive care units, so that they could complete them and deliver the results. Data analysis was performed using SPSS, version 20, software. Using descriptive statistics, frequency distribution tables for qualitative variables and numerical indices of minimum, maximum, mean and standard deviation for the research quantitative variables and analytical statistics (Pearson coefficient, ANOVA and independent T tests), tables related to the comparisons and correlations were provided. Results: Of all nursing employees who participated in the study, 56.6% had good knowledge of hand hygiene, 71.3% an impartial or neutral attitude towards this practice and 64.5% a high perception of it. A statistically significant relationship was obtained between knowledge and education (P=0.029), perception and age range (P=0.002), work experience (P=0.029), and ward of workplace (P=0.014). Conclusion: Structured, regular and continuous educational programs with various and effective methods to maintain, promote and remove nursing employees' deficit of knowledge should continue more seriously. It is also necessary to identify the factors affecting the promotion of positive perception and attitude among nursing employees about hand hygiene.

The Effect of Short-Term Training Course by Nurses on Body Image in Patients with Burn Injuries.

BACKGROUND: Burn is the fourth most common cause of trauma worldwide and is the fourth among the injuries and surgeries requiring medical care. This study was designed to determine the effect of a short-term training course by nurses on body image in patients with burn injuries. METHODS: This study was a semi-experimental single-group survey assessing before and after interventions. Totally, 130 subjects (65 women and 65 men) were enrolled. The training course was held in 3 sessions of two hours. The contents of the group training course (a group of 5 people) were in relation to the body image and the factors affecting it, and the ways to improve the body image. The data collection instrument was the satisfaction with appearance scale (SWAP). RESULTS: The mean scores of the body image of patients before and after the intervention were 49.44±11.39 and 41.63±11.89, respectively. There was a significant difference between the mean scores of body image before and after educational interventions (T=6.013, P≤0.001). The mean score of body image in women before and after intervention was 49.2±10.9 and 41.2±11.65, respectively (T=4.51, P≤0.000). The mean score of body image in men before and after intervention was 49.6±11.89 and 42.07±12.19, respectively (T=4.51, P≤0.000). CONCLUSION: Short-term courses held by nurses were shown to have a significant role in improving the body image of burn patients.

Characteristics of Shared Governance in Iranian Nursing Schools: Several Souls in One Body.

BACKGROUND: Shared governance is a decentralized structural model that gives individuals the right to make decisions and a position analogous to managers. The shared governance is different based on context in every organization. This study identified the characteristics of shared governance in Iranian nursing schools. MATERIALS AND METHODS: In this qualitative research, 11 participants were selected using purposive sampling method. Deep semi-structured interviews were conducted, and the data were analyzed using conventional content analysis. Lincoln and Guba's criteria were used to verify the accuracy and trustworthiness of the data. RESULTS: Through data analysis, the theme of "several souls in one body" was achieved in addition to the seven categories of "climates based on common interests," "conscious participatory decision-making," "mutual accountability," "multiplicity of ideas," "decentralized structure," "interrelationship," and "sublime organization." CONCLUSIONS: According to the findings, the characteristics of shared governance in the social culture of Iran are like several souls in one body, emphasizing all aspects of participation and morality in the organization. Managers and administrators in higher education and nursing faculties need to pay attention to all aspects of shared governance, including spirituality in managing the covered institutions.