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.

Harmony in hardship: Unveiling parental coping strategies with the challenges of child's hematopoietic stem cell transplantation.

PURPOSE: Pediatric Hematopoietic Stem Cell Transplant (HSCT) profoundly affects various dimensions of parents' lives. Effective coping strategies are essential for improving psychological well-being and overall quality of life. Therefore, this study aimed to explore parental coping strategies with their child's HSCT challenges. DESIGN AND METHODS: This qualitative study was conducted in Iran from February to November 2023, utilizing conventional content analysis with purposive sampling. For data collection, unstructured interviews were conducted, followed by in-depth semi-structured interviews with open-ended questions. Saturation was reached after analyzing qualitative data from 20 participants. RESULTS: Data analysis unveiled a main theme labeled "harmony in hardship". This overarching concept encapsulates the participants' endeavors to cope with the various hurdles and complexities stemming from their child's HSCT. This theme consisted of five categories: "emotional release", "positive coping", "avoidance coping", "spiritual coping", and "seeking support". CONCLUSION: Parents utilized multifaceted coping strategies to manage the complexities of their child's HSCT journey. Understanding these mechanisms is crucial as they can positively influence parents' psychological well-being and improve their overall quality of life. IMPLICATIONS FOR CLINICAL PRACTICE: Healthcare professionals should recognize the diverse coping strategies employed by parents of children undergoing HSCT and provide tailored interventions and support. Furthermore, implementing structured support programs and training initiatives for healthcare professionals can enhance their capacity to meet the diverse needs of parents during this challenging journey.

Comparison of the Effects of Aromatherapy With Damask Rose and Chamomile Essential Oil on Preoperative Pain and Anxiety in Emergency Orthopedic Surgery: A Randomized Controlled Trial.

PURPOSE: Patients who are awaiting emergency surgery experience high levels of anxiety and pain. This study aimed to compare the effects of aromatherapy with damask rose and chamomile essential oil on the preoperative pain and anxiety associated with emergency orthopedic surgery. DESIGN: A parallel-group randomized controlled design was used. METHODS: Ninety participants were selected and randomly assigned to three groups: the damask rose group (n = 30), the chamomile group (n = 30), and the control group (n = 30). In the damask rose and chamomile groups, three drops of 40% essential of each plant were used for inhalation aromatherapy (three drops every hour for 3 hours) Visual Analog Scales were used to evaluate participants' pain and anxiety levels at baseline, immediately after the intervention, and 1 hour after the intervention. FINDINGS: The results of repeated measures Analysis of Variance (ANOVA) showed that both of the intervention groups experienced a decrease in pain and anxiety over time compared to the control group (P < .001). ANOVA results showed that immediately after the intervention, the anxiety level of the damask rose group compared to the chamomile and control groups was significantly lower (P = .01). However, there was no significant difference in terms of anxiety between the damask rose and chamomile groups 1 hour after the intervention (P = .07). CONCLUSIONS: The use of damask rose and chamomile in aromatherapy was found to effectively lower anxiety and pain levels in emergency orthopedic surgery patients. The antianxiety effect of damask rose is faster than chamomile.

Mothers' experiences of privacy in neonatal intensive care units: A qualitative study.

BACKGROUND: Examining the privacy experiences of mothers in neonatal intensive care units (NICUs) can play a crucial role in bolstering patient privacy safeguards and elevating the overall quality of health care. However, our understanding of mothers' experiences regarding privacy issues they may face after their infants' hospitalization in the NICU is limited. AIM: This study aimed to investigate the experiences of mothers concerning privacy within NICUs to contribute valuable insights for improving infant care and privacy protection. DESIGN: A qualitative content analysis using a conventional approach was conducted. A total of 18 participants, with diverse sociodemographic backgrounds, were interviewed using open-ended questions. Qualitative content analysis was undertaken for data analysis. SETTING: The study was conducted in the NICU of an urban teaching hospital in Iran. RESULTS: The study identified four main themes: 'understanding of privacy', 'fluctuating respect for privacy', 'efforts to maintain privacy' and 'privacy barriers'. Participants viewed privacy as multidimensional, influenced by cultural and religious factors. Respect for privacy varied, with instances of both adherence and violation. Mothers employed strategies to preserve privacy, emphasizing the importance of their infants' privacy. Privacy barriers included hospital attire, the physical space of the NICU, inhomogeneous human resources and insufficient supervision and training. CONCLUSION: This study, the first of its kind in the NICU context, provides valuable insights into maternal experiences of privacy. Integrating these insights into practice and future research can contribute to creating more empathetic and privacy-respecting NICU environments. RELEVANCE TO CLINICAL PRACTICE: Health care providers can use these findings to enhance support for mothers, potentially reshaping physical spaces and communication practices within NICUs.

Nursing students' experiences of teaching and learning during the COVID-19 pandemic: a systematic review and meta-synthesis of qualitative studies.

INTRODUCTION: During the COVID-19 pandemic, the sudden transition to virtual learning led to several challenges for nursing students. This study aimed to synthesis nursing students' experiences of teaching and learning during the COVID-19 pandemic. CONTENT: A meta-synthesis of qualitative articles were conducted. Three online databases were searched from December 2019 to December 2022. Qualitative studies and qualitative sections of mixed method studies were included. SUMMARY: Twenty-four qualitative studies and seven mixed-method studies were included in the review. The findings consisted of one main theme "educational transformation", and three categories "challenging face-to-face clinical training", "transition from face-to-face to virtual education", and "support continua". The evidence indicated that during this health-related crisis, most of the training was provided as distance learning in various forms. According to the findings, distance education alone cannot replace face-to-face education and is suggested to be considered as a supplementary learning method. OUTLOOK: This study provides a comprehensive understanding of nursing students' experiences during the COVID-19 pandemic, offering practical implications for educators and institutions globally. The lessons learned can inform strategic decisions, policies, and practices to enhance the resilience and adaptability of nursing education in the face of unforeseen challenges.

Emergency order allocation of e-medical supplies due to the disruptive events of the healthcare crisis.

The availability of electronic (e-medical) homecare essentials, such as thermometers, oximeters, and oxygen concentrators during the peaks of the pandemic coronavirus disease (COVID-19), has been witnessed as critical in saving the lives of people across the world. This paper presents a supply order allocation strategy of e-medical homecare essentials (HCEs) in a multi-supplier environment by a distributor while ensuring sufficient and timely availability for emergency consumption during pandemic peaks. The results, based on the actual demand data of HCEs obtained from a regional HCE distributor during the pandemic peak of the second wave in India, i.e. April-May 2021, suggest that a minimum (maximum) average of 94% (98%) availability of e-medical HCEs respectively at pharmacies could be achieved during the peak demand period using the proposed emergency order allocation algorithm in this study. Conclusively, the analysis of this study could generate insightful implications for emergency operations decisions in the HCEs supply-distribution channel.

Cutaneous adverse reactions of COVID-19 vaccines: A systematic review.

Numerous vaccines are under clinical development and implementation for the prevention of severe course and lethal outcomes of coronavirus disease 2019 (COVID-19). This systematic review aims to summarize and integrated the findings of studies regarding cutaneous side effects of COVID-19 vaccines. This systematic review conducted by searching the scientific databases of PubMed, Scopus, Science direct, and Web of knowledge from the beginning of the COVID-19 to May 10, 2021. Articles were reviewed and analyzed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Seventeen studies on cutaneous side effects of COVID-19 vaccines were included after the screening of search results based on to the eligibility criteria. The results showed that the most common injection site reactions and delayed large local reactions, arising from all vaccine types, were redness/erythema (39%), followed by: itchiness (28%), urticarial rash (17%) on the neck, upper limbs, and trunk, morbilliform eruptions (6.5%), Pityriasis rosea (3%), swelling, and burning, and so forth. Most cutaneous reactions occurred in women (84%), and middle-aged people, after the first dose of vaccine, with the onset ranged from 1 to 21 days after vaccination. In addition, cutaneous reactions were generally self-limiting, and needed little or no therapeutic intervention, that were not regarded as a barrier to injecting a second dose. In conclusion, severe cutaneous side effects are very rare and approved vaccines have satisfactory safety profiles. Therefore, mild or moderate cutaneous reactions should not discourage people from vaccination. In certain groups such as patients with allergies and a history of local injection reactions, pre-vaccination counseling and assurance, also use of appropriate medications may be helpful. However, more studies are needed to investigate the side effect profile of all COVID-19 vaccines.

Changes and challenges in sexual life experienced by the husbands of women with breast cancer: a qualitative study.

BACKGROUND: Breast cancer (BC) in women can bring various problems to their marital and family life. Sexual life based on the experiences of the husbands of women diagnosed with BC has not been fully understood. Therefore, this research aimed to explore changes and challenges in sexual life experienced by the husbands of women diagnosed with BC. METHODS: A qualitative research was carried out on 18 men whose wives had been diagnosed with BC at reproductive age. They were selected using purposeful sampling and were interviewed using in-depth semi-structured interviews. Collected data were analyzed using the conventional content analysis method. RESULTS: 'Sexual life suspension' was the main theme of this research. Also, 'unfulfilled sexual expectations', 'perceived barriers to satisfy sexual expectations', and 'efforts to adapt to sexual problems' were subthemes. CONCLUSIONS: The husbands of women with BC need support to improve their sexual and marital relationships. Education and counseling about sexual life during the treatment of BC should be incorporated into the healthcare program.

Qualitative exploration of sexual life among breast cancer survivors at reproductive age.

BACKGROUND: Our understanding of the experiences of women at reproductive age regarding sexual life and issues they may face after starting the treatment of breast cancer is limited. Therefore, this qualitative study aimed to explore sexual life and its related issues among breast cancer survivors at reproductive age in Iran. METHODS: A qualitative research was conducted. Participants were 21 breast cancer survivors who were under 51 years of age that were chosen using purposeful sampling. In-depth semi-structured interviews were carried out for data collection and the content analysis method was used for data analysis. RESULTS: The data analysis led to the development of main theme of 'unfulfilled sexual life'. Also, four subthemes were: 'undesirable sexual function', 'context-based beliefs', 'unmet information and supportive needs', and 'emotional crisis'. CONCLUSIONS: Our research findings inform healthcare providers about the experiences of breast cancer survivors and related changes in their sexual and marriage life at reproductive age. Nurses and other healthcare providers in the multidisciplinary team should proactively identify health-related problems and design appropriate caring strategies to mitigate sexual and marriage issues among breast cancer survivors. Also, the establishment of sexual health counseling units for breast cancer survivors can help this vulnerable group of women with the improvement of their long-term sexual satisfaction.

Effect of the exercise programme on the quality of life of prostate cancer survivors: A randomized controlled trial.

AIM: The aim of this study was to investigate the effect of the exercise programme on the quality of life of prostate cancer (PCa) survivors. METHODS: A randomized controlled, parallel trial was conducted from April 2017 to January 2018 on 80 PCa survivors. They were randomly assigned to intervention and control groups (n = 40 in each group). The exercise programme was designed based on the self-management approach (SMA). The intervention group participated in a 12-week exercise programme consisting of one session of group exercise and three sessions of individual exercise per week using exercise facilities in the community. Data were collected using the quality of life questionnaires and the follow-up checklist. RESULTS: In the intervention group, statistically significant improvements in physical, role, emotional, social and sexual functions were reported. Also, the patients in this group reported reduced fatigue, insomnia, constipation, diarrhoea, urinary, bowel and hormonal treatment-related symptoms in comparison with before the exercise programme (p < 0.05). CONCLUSIONS: Nurses are suggested to plan for improving the participation of PCa survivors in exercise programmes using exercise facilities in the community in order to reduce the complications of treatment and improve their quality of life.

A New Algorithm for Digital Image Encryption Based on Chaos Theory.

In recent decades, image encryption, as one of the significant information security fields, has attracted many researchers and scientists. However, several studies have been performed with different methods, and novel and useful algorithms have been suggested to improve secure image encryption schemes. Nowadays, chaotic methods have been found in diverse fields, such as the design of cryptosystems and image encryption. Chaotic methods-based digital image encryptions are a novel image encryption method. This technique uses random chaos sequences for encrypting images, and it is a highly-secured and fast method for image encryption. Limited accuracy is one of the disadvantages of this technique. This paper researches the chaos sequence and wavelet transform value to find gaps. Thus, a novel technique was proposed for digital image encryption and improved previous algorithms. The technique is run in MATLAB, and a comparison is made in terms of various performance metrics such as the Number of Pixels Change Rate (NPCR), Peak Signal to Noise Ratio (PSNR), Correlation coefficient, and Unified Average Changing Intensity (UACI). The simulation and theoretical analysis indicate the proposed scheme's effectiveness and show that this technique is a suitable choice for actual image encryption.

Nursing workload in intensive care units and the influence of patient and nurse characteristics.

BACKGROUND: Understanding factors that can potentially influence patient care and nursing workload in intensive care units is important. Previous studies have shown contradictory outcomes about the relationships between nursing workload and patient and nurse characteristics. AIMS AND OBJECTIVES: This study aimed to investigate nursing workload in intensive care units and examine the association between this in relation to patient and nurse characteristics. DESIGN: A cross-sectional design was conducted. METHODS: All nurses who were working in the intensive care units of five hospitals and met the study criteria were enrolled in the study. Two demographic questionnaires collected nurse and patient demographic information. The Nursing Activities Score was applied to determine nursing workload in three shifts (morning, evening, night) for each nurse. Data were analysed using the independent sample t-test, one-way analysis of variance, and multivariable linear regression analysis. RESULTS: The Nursing Activities Score was calculated for 509 patients who were under the care of 105 intensive care unit nurses. The mean (SD) Nursing Activities Score was 72.84% (22.07%). Morning shifts, male patients, medical treatments, and referred patients from the emergency ward and other intensive care units imposed a higher workload for nurses. Specifically, female nurses, increased number of patients receiving care, and increased patient length of intensive care unit stay were directly associated with increased Nursing Activities Scores. Work in surgical and burn intensive care units were inversely associated with the Nursing Activities Score. CONCLUSION: This study suggests that the workload of nurses in intensive care units can be affected by both nurse and patient characteristics. RELEVANCE TO CLINICAL PRACTICE: The findings can be used to ensure appropriate staffing of intensive care units by nurses. However, nurse and patient characteristics should not be considered the only factors that influence nursing workload in intensive care units.

Investigating the effects of renewable energy on international trade and environmental quality.

This research investigates how renewable energy consumption interacts with international trade and environmental quality in Nordic counties from 2001 to 2018. The present study adopted the CIPS unit root test and cross-sectional dependence (CD) test to test the stationarity and diagnose the cross-sectional dependence issues, respectively. Further, the study employed a dynamic common correlated effect (DCCE) model for robustness. The findings revealed that renewable energy strongly and positively associated with international trade in Nordic countries. Also, the results indicate that renewable energy consumption improved to environmental quality. Therefore, policies to promote renewables can provide for economic growth and environmental sustainability and ensure crucial sustainable development goals. Further, the findings provide theoretical support for the formulation of eco-friendly policies to understand the role of renewable energy in spurring international trade, which supports balancing eco-environmental sustainability.

The effect of behavioral parent training on sleep problems of school-age children with ADHD: A parallel randomized controlled trial.

OBJECTIVE: The aim of this study was to examine the effect of behavioral parental training (BPT) on sleep problems in children diagnosed with ADHD. METHODS: This parallel randomized controlled trial was conducted in a psychiatric clinic in an urban area of Iran. Participants of this study were 58 school-age children who were diagnosed with ADHD, were receiving methylphenidate and had at least one problem in sleeping. They were randomly assigned into BPT or control groups. Participants' parents in the BPT group underwent a 5-week behavioral intervention program. Data were collected at baseline, immediately after the intervention, and two months after the intervention. Data were analyzed using Chi-square, Fisher's exact test, independent sample t-test, and repeated measure ANOVA test via the SPSS software. RESULTS: Children in the intervention group experienced a significant improvement in total sleep scores two months after the intervention compared to the control group (p = 0.03). Also, the findings showed a significant decline in total sleep problems in the intervention group compared to the control group over time (p = 0.01). CONCLUSION: The results suggest that BPT could be an effective method in improving sleep problems of school-age children diagnosed with ADHD undergoing methylphenidate treatment.

A novel extended approach under hesitant fuzzy sets to design a framework for assessing the key challenges of digital health interventions adoption during the COVID-19 outbreak.

In recent years, Digital Technologies (DTs) are becoming an inseparable part of human lives. Thus, many scholars have conducted research to develop new tools and applications. Processing information, usually in the form of binary code, is the main task in DTs, which is happening through many devices, including computers, smartphones, robots, and applications. Surprisingly, the role of DTs has been highlighted in people's life due to the COVID-19 pandemic. There are several different challenges to implement and intervene in DTs during the COVID-19 outbreak; therefore, the present study extended a new fuzzy approach under Hesitant Fuzzy Set (HFS) approach using Stepwise Weight Assessment Ratio Analysis (SWARA) and Weighted Aggregated Sum Product Assessment (WASPAS) method to evaluate and rank the critical challenges of DTs intervention to control the COVID-19 outbreak. In this regard, a comprehensive survey using literature and in-depth interviews have been carried out to identify the challenges under the SWOT (Strengths, Weaknesses, Opportunities, Threats) framework. Moreover, the SWARA procedure is applied to analyze and assess the challenges to DTs intervention during the COVID-19 outbreak, and the WASPAS approach is utilized to rank the DTs under hesitant fuzzy sets. Further, to demonstrate the efficacy and practicability of the developed framework, an illustrative case study has been analyzed. The results of this study found that Health Information Systems (HIS) was ranked as the first factor among other factors followed by a lack of digital knowledge, digital stratification, economic interventions, lack of reliable data, and cost inefficiency In conclusion, to confirm the steadiness and strength of the proposed framework, the obtained outputs are compared with other methods.

The Effects of Inhalation Aromatherapy Using Lavender Essential Oil on Postoperative Pain of Inguinal Hernia: A Randomized Controlled Trial.

PURPOSE: One of the main problems after inguinal hernia surgery is postoperative pain. The purpose of this study was to examine the effects of aromatherapy with lavender oil inhalation on postoperative pain after inguinal hernia surgery. DESIGN: A randomized controlled design was used. METHODS: Ninety participants were selected and assigned to two groups: the intervention group (n = 45) and the control group (n = 45). The patients in the intervention group inhaled four drops of 2% lavender essential oil with oxygen for 20 minutes. The patients in the control group inhaled only oxygen. Postoperative pain was measured 0 minutes after being transferred to the surgery ward, and then 2 hours, 6 hours, and 24 hours after surgery using the visual analog scale. FINDINGS: In comparison to the control group, levels of pain severity in the intervention group were significantly lower in four stages of measurements (P < .001). Also, in all stages, measurements showed significant statistical differences within the groups (P < .001). CONCLUSIONS: Aromatherapy with lavender essential oil helped decrease postoperative pain after inguinal hernia surgery.

A hybrid data envelopment analysis and game theory model for performance measurement in healthcare.

Performance measurement plays an important role in the successful design and reform of regional healthcare management systems. In this study, we propose a hybrid data envelopment analysis (DEA) and game theory model for measuring the performance and productivity in the healthcare centers. The input and output variables associated with the efficiency of the healthcare centers are identified by reviewing the relevant literature, and then used in conjunction with the internal organizational data. The selected indicators and collected data are then weighted and prioritized with the help of experts in the field. A case study is presented to demonstrate the applicability and efficacy of the proposed model. The results reveal useful information and insights on the efficiency levels of the regional healthcare centers in the case study.

A concept analysis of transitional care for people with cancer.

AIM: Transitional care as the journey between different caregivers in multiple healthcare centres is crucial for the provision of care to people with cancer, but it is often complex and poorly coordinated. This study aimed to analyse the concept of transitional care for people with cancer. DESIGN: Rodgers' evolutionary concept analysis. METHODS: A systematic literature search was conducted on the databases of PubMed (including MEDLINE), EMBASE, Scopus and Web of Science to retrieve articles published between 2000 and 2022. RESULTS: Twenty-nine eligible articles were selected and their findings were classified in terms of related concepts and alternative terms, antecedents, attributes and consequences. Attributes included three main categories, namely 'nurse-related attributes', 'organisation-related attributes' and 'patient-related attributes'. Antecedents of transitional care for people with cancer were categorized into two main categories: 'patient-related antecedents' and 'caregiver-related antecedents'. Consequences were categorized into 'psychological consequences' and 'objective consequences'.

The effect of increasing duration of family members' presence on sleep status in patients with acute coronary syndrome in cardiac care unit: A randomized controlled trial.

AIM: To investigate the effect of increasing duration of family members' presence on sleep status in patients with acute coronary syndrome (ACS) admitted to the cardiac care unit. DESIGN: Randomized controlled trial. METHODS: Ninety patients with ACS randomly assigned into two groups. No intervention was performed in control group. In the intervention group, the time of family members presence was changed from 1 h per day to 2 h per day from the second to the fourth day. Then, ST Mary's Hospital Sleep Questionnaire was completed by the patients every day during the study. RESULTS: The patients in the intervention group had statistically significantly better sleep status during the course of intervention compared to the control group. PATIENT OR PUBLIC CONTRIBUTION: The increasing duration of family members' presence can improve the sleep quality and quantity of ACS patients.