Family-centered empowerment approach to optimize phosphate management among hemodialysis patients: an experimental study.

BACKGROUND: This study aimed to investigate the effect of a family-centered empowerment program on hyperphosphatemia management. METHOD: This experimental study was performed on 80 randomly selected eligible patients with hyperphosphatemia undergoing hemodialysis. Patients were assigned randomly to two groups of family-centered empowerment program (FCEPG) and control group (CG) by coin toss (40 people per group). Data collection tools were the researcher-made Phosphate Control Knowledge Scale, the researcher-made Adherence to Dietary Restriction of Phosphorus Intake Scale, the eight-item Morisky Medication Adherence Scale, and serum phosphorus measurements. Data were collected before the intervention, one month, and three months after the intervention. Patients in FCEPG participated in a family-centered empowerment program. The statistical significance level was considered to be 0.05. RESULTS: Inter-group comparisons showed no significant difference between FCEPG and CG in terms of the mean score of knowledge of phosphate control, adherence to dietary restriction of phosphorus intake, adherence to medication, and the mean serum phosphorus level before the empowerment program, but showed significant differences between them in these respects at one month after the program and three months after the program (p < 0.05). Intra-group comparisons showed a significant difference in FCEPG between the mean and standard deviation of all four variables before the empowerment program and the corresponding values one month and three months after the program (P < 0.05). CONCLUSION: The findings of this study can be used in various fields of healthcare in the hospital and community.

Effects of Rosa damascena (Damask rose) on menstruation-related pain, headache, fatigue, anxiety, and bloating: A systematic review and meta-analysis of randomized controlled trials.

Recent studies have reported inconclusive results regarding the therapeutic effects of Rosa damascena on the outcomes of primary dysmenorrhea (PD) and premenstrual syndrome (PMS). Hence, this study is aimed to summarize the findings of randomized controlled trials (RCTs) regarding the effects of this treatment on menstruation-related pain as the primary outcome and menstruation-related headache, fatigue, anxiety, and bloating as the secondary outcomes. This study evaluated parallel-group and cross-over RCTs on aromatherapy, topical treatment, or oral intake of R. damascena products for the treatment groups versus placebo, nontreated, or conventional treatment groups. Seven electronic databases (Web of Science Core Collection, Scopus, Embase, CENTRAL, CINAHL, SID, and MagIran) and one search engine (PubMed) were searched from inception to January 15, 2021. Of 1468 trials found in the initial search, 983 potentially relevant articles were screened by title and abstract. After examining the full-text of 13 studies for compliance with the inclusion criteria, seven studies were considered eligible for this review. A random-effects model was used to pool the data; otherwise, a narrative summary was presented. The retrieved studies were conducted on females with PD or PMS, aged 18-35 years. The total sample size of the intervention and comparator arms was 276 and 272. The results showed that R. damascena had a nonsignificant alleviating effect on the menstruation-related pain (weighted mean difference [WMD]: -0.47; 95% confidence interval [CI]: -1.25, 0.31; P = 0.234). Such findings were also found for menstruation-related anxiety (WMD: -0.40; 95% CI: -0.91, 0.11; P = 0.125). However, the treatment significantly reduced the menstruation-related headache (WMD: -0.42; 95% CI: -0.74, -0.11; P = 0.008), fatigue (WMD: -0.48; 95% CI: -0.87, -0.09; P = 0.015), and bloating (WMD: -0.72; 95% CI: -1.21, -0.22; P = 0.005). Since R. damascena had no significant effects on menstruation-related pain and anxiety, further studies with improved methodological quality are suggested to evaluate the effects of the treatment on these symptoms, using different dosages and durations.

An explanatory study on the concept of nursing presence from the perspective of patients admitted to hospitals.

AIMS AND OBJECTIVES: To clarify the concept of nursing presence through patients' perception. BACKGROUND: The holistic caring process at the bedside must incorporate the concept of nursing presence. Most of the research about nursing presence is based on nurses' experiences, and research into patients' experiences is minimal. According to goals of patient centredness, the association between the patient satisfaction and nursing presence, and patients' ability to understand this concept, it is important to explore this concept from the patients' perspective. DESIGN: A qualitative approach. METHODS: Based on purposive sampling technique, 12 patients were recruited. After participant observation, 15 interviews were carried out with participants. Data were transcribed verbatim and analysed using conventional qualitative content analysis. RESULTS: Five main categories were drawn from the data including informed concentration, task-centred/patient-centred relationship, clarification of meanings, comprehensive participation and accountable encounter. Data analysis alongside the authors' reflections resulted in the emergence of one overarching theme, 'coconstructed interaction', which shows the notion that effective nurse-patient interaction enhances cooperation, coordination and collaboration in caring and improves nursing outcomes. CONCLUSIONS: Accordingly, the nursing presence would be ideal for patient-centred caring. RELEVANCE TO CLINICAL PRACTICE: Knowing the perspectives of patients is important as the evaluation of nursing care quality should rely on outcome indicators that are sensitive to patients. For instance, client satisfaction and health status acceptance, especially as it relates to coping, comfort level, hope, and participation in decision-making, are included in the nursing outcomes' classification system. Thus, the findings of this study may facilitate improvement in the quality of care by continuous improvement in knowledge, attitudes and abilities of nurses. It is therefore recommended that managers and clinical nurses, by relying on these findings, design the caring activities so that nurses' presence can act as a facilitating factor for improving quality assurance.

Correlation between inner strength and health-promoting behaviors in women with heart failure.

INTRODUCTION: Inner strength is a factor for mental health and well-being and, consequently, a dynamic component of holistic healing. Health-promoting behaviors are appropriate activities to improve health status and prevent the progression of the functional defect resulting from heart failure. The present study aimed to determine the correlation between inner strength and health-promoting behaviors in women with heart failure referred to hospitals affiliated with Shahid Beheshti University of Medical Sciences (SBMU) in 2013. METHODS: In this cross-sectional study, 145 women with hearth failure were selected through convenient sampling from the clients referred to hospitals affiliated with SBMU. The data collection tool included a three-section questionnaire of personal characteristics, inner strength, and health-promoting life profile II (HPLP II). The data analysis used descriptive statistical tests and Pearson correlation coefficient through SPSS version 20. RESULTS: A direct significant correlation was found between inner strength and all dimensions of health-promoting behaviors and overall health-promoting behaviors (p=0.000) as well as between all dimensions of inner strength (except for the dimension of knowing and searching with physical activity and the dimension of connectedness with personal accountability in healthcare as well as connectedness with physical activity) with health-promoting behaviors (p=0.000 to p=0008). CONCLUSION: To improve the level of health and well-being and reduce the costs of care services in women with health failure, close attention should be paid to developing and empowering their inner strength.

Health-promoting behaviors and their association with certain demographic characteristics of nursing students of Tehran City in 2013.

BACKGROUND & OBJECTIVES: Nursing students provide health services and their behavior may affect the clinical services that they provide to clients. In addition, Health-promoting behaviors among nursing students may affect the quality of patient education. Therefore, the aim of this study was to determine the relationship between health-promoting behaviors and certain demographic characteristics of nursing students in Tehran. METHODS: This cross-sectional study was performed on 404 undergraduate nursing students (107 males and 297 females) of universities of Tehran who were selected through stratified random sampling procedure. The data collection tools were: demographic characteristics questionnaire and health-promoting lifestyle profile 2. This standard instrument has 6 subscales of nutrition, physical activity, spiritual growth, health responsibility, interpersonal relations, and stress management. In order to keep the weight of the expressions of the tool and subscale scores the mean were calculated. For this purpose, each expression was scored on a scale of 1 to 4. Internal consistency (Cronbach's Alpha) of this tool was a=0.86. Data was analyzed by using statistical tests of Chi Square, Independent T and ANOVA. RESULTS: According to the results, health-promoting behaviors among the students scored highly. The analysis of subscales of health-promoting lifestyle profile 2 showed that the highest mean belongs to the subscale of spiritual growth and the lowest mean belongs to the subscale of physical activity. The mean of health-promoting behaviors among married students was higher than among single students. Moreover, as students advanced through academic years, health responsibility increased and stress management reduced. DISCUSSION: Undoubtedly, physical activity and stress management have a significant role in personal health and occupational satisfaction of students, which consequently help them provide better services to clients. Therefore, considering the low scores of students in these sections, nursing education managers, policymakers and planners should pay attention to these problems.