The attitude of Iranian nurses about do not resuscitate orders.

BACKGROUND: Do not resuscitate (DNR) orders are one of many challenging issues in end of life care. Previous research has not investigated Muslim nurses' attitudes towards DNR orders. AIMS: This study aims to investigate the attitude of Iranian nurses towards DNR orders and determine the role of religious sects in forming attitudes. MATERIALS AND METHODS: In this descriptive-comparative study, 306 nurses from five hospitals affiliated to Tabriz University of Medical Sciences (TUOMS) in East Azerbaijan Province and three hospitals in Kurdistan province participated. Data were gathered by a survey design on attitudes on DNR orders. Data were analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL) software examining descriptive and inferential statistics. RESULTS: Participants showed their willingness to learn more about DNR orders and highlights the importance of respecting patients and their families in DNR orders. In contrast, in many key items participants reported their negative attitude towards DNR orders. There were statistical differences in two items between the attitude of Shiite and Sunni nurses. CONCLUSIONS: Iranian nurses, regardless of their religious sects, reported negative attitude towards many aspects of DNR orders. It may be possible to change the attitude of Iranian nurses towards DNR through education.

How to Prevent Workplace Incivility?: Nurses' Perspective.

BACKGROUND: Many articles have studied workplace incivility and its influence on outcomes, but very few have been conducted to assess how to prevent this issue. In this study, we aimed to determine how to prevent workplace incivility from the nurses' perspective. MATERIALS AND METHODS: This was a qualitative study which was based on a conventional content analysis approach. Thirty four nurses (25 to 52 years old) from seven training hospitals in Tabriz, Iran were selected through purposive sampling. Thirty six semi-structured interviews and eight field notes were analyzed. RESULTS: The data analysis revealed 417 codes, ten categories, three subthemes and one theme, that is, A Need for a Comprehensive Attempt. Attempt of organization, nurses, and public as subthemes are needed to prevent workplace incivility. CONCLUSIONS: The findings of the study indicated that a comprehensive and systematic attempt was needed to prevent incivility. Nurses should try to improve their skills; officials should try to show the real image and position of nurses and hospitals to the community.

Validity and Reliability of the Persian Practice Environment Scale of Nursing Work Index.

BACKGROUND: The practice environment pivotal role in patients and nurses better outcomes is evident. Practice Environment Scale of Nursing Work Index (PES-NWI) is widely utilized to assess nursing work environments. The present study was conducted to demonstrate the validity and reliability of the Persian version of PES-NWI. MATERIALS AND METHODS: The instrument was translated and its psychometrics were investigated by content, construct validity (factor analysis), and homogeneity (internal consistency and intraclass correlation) on a sample of 350 nurses at educational hospitals in East Azerbaijan, Iran. RESULTS: The 30 items loaded onto 4 factors explained 34.95-50.06% of the variance. The items across the factors differed slightly from those reported by the original author of the PES-NWI. Cronbach's alpha and Pearson coefficient for the entire instrument and also for extracted factors was 0.70-0.96. CONCLUSIONS: The Persian version of PES-NWI has an appropriate level of validity and reliability in the Iranian setting for nurses. The subscale of Nursing Foundations for quality care needs modification.

Coping methods to stress among patients on hemodialysis and peritoneal dialysis.

Dialysis patients need to deal and cope with various aspects of their disease. Identifying the adaptation methods provides valuable information for planning specific treatment and medical care delivery and improving the performance of medical teams. The present study aims to evaluate the coping strategies to stress among patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) at the Imam Reza Educational-Medical Hospital, Tabriz, West Azarbaijan, Iran. This descriptive and analytical study was conducted on 70 patients in the year 2012. The subjects were selected through census method and simple random sampling method. Data were collected using a customized questionnaire and consisted of demographic information and the Jalowiec Coping Scale (JCS) through a structured interview. Descriptive and inferential statistics were used to analyze the data in SPSS (version 13). The mean score of frequency of use of the coping strategy as "sometimes used" for the HD patients was 70.94 ± 18.91 and also for PD patients as "seldom used" was 58.70 ± 12.66. The mean score of helpfulness of coping strategies in the HD group was 49.57 ± 19.42 as "slightly helpful", whereas in the PD group it was 37.21 ± 14.38 as "slightly helpful" Furthermore, both groups used the emotion-oriented coping styles more frequently than the problem-oriented methods. HD patients used coping methods more frequently than the PD patients. The majority of patients used emotion-oriented coping strategies to deal with stress factors. Use of educational, counseling and supportive programs to assist in coping techniques can facilitate the coping process with stress factors in dialysis patients.

Un-met supportive care needs of Iranian breast cancer patients.

BACKGROUND: Assessment of supportive needs is the requirement to plan any supportive care program for cancer patients. There is no evidence about supportive care needs of Iranian breast cancer patients. So, the aims of present study were to investigate this question and s predictive factors. MATERIALS AND METHODS: A descriptive- correlational study was conducted, followed by logistic regression analyses. The Supportive Care Needs Survey was completed by 136 breast cancer patients residing in Iran following their initial treatment. This assessed needs in five domains: psychological, health system and information, physical and daily living, patient care and support, and sexuality. RESULTS: Patient perceived needs were highest in the health systems and information (71%), and physical and daily living (68%) domains. Logistic regression modeling revealed that younger participants have more un-met needs in all domains and those with more children reported fewer un-met needs in patient care and support domains. In addition, married women had more un-met supportive care needs related to sexuality. CONCLUSIONS: The high rate of un-met supportive care needs in all domains suggests that supportive care services are desperately required for breast cancer patients in Iran. Moreover, services that address informational needs and physical and daily living needs ought to be the priority, with particular attention paid to younger women. Further research is clearly needed to fully understand supportive care needs in this cultural context.

Impact of guided reciprocal peer questioning on nursing students' self-esteem and learning.

BACKGROUND: Self-esteem is essential for clinical judgments. Nursing students in clinical environments should make a bridge between theoretical education and clinical function. This study was aimed to survey the effect of guided questioning in peer groups on nursing students' self-esteem and clinical learning. MATERIALS AND METHODS: In this quasi-experimental study, all nursing students in semester 4 (60) were selected. The autumn semester students (n = 28) were chosen as the control group, and the spring semester students (n = 32) as the experimental group. The experimental group underwent the course of cardiac medical surgical training by the Guided Reciprocal Peer Questioning. The control group was trained by lecture. After confirmation of the validity and reliability of tools including Rosenberg Self-esteem Scale and the researcher-made questionnaire, data were collected and analyzed by SPSS version 17.0. RESULTS: There was no significant difference concerning demographic and educational characteristics between the two groups. Mean score differences of self-esteem and learning were not significant before teaching, while they were significantly promoted after teaching in the experimental (P < 0.001) and control (P < 0.05) groups. Promotion in the experimental group was more considerable than in the control group. CONCLUSIONS: As revealed by the results, inquiry method, due to its more positive impact on self-esteem and students' learning, can be applied alone or in combination with the other methods. Conducting this study for other students and for theoretical courses is suggested.

Prerequisites for electronic learning: Iranian postgraduate nursing students' points of view.

BACKGROUND: Nursing education is mostly conducted through electronic educational programs. We aimed at assessing the Iranian postgraduate nursing students' skills and attitudes regarding the electronic education. MATERIALS AND METHODS: Ninety-seven postgraduate nursing students were surveyed using questionnaires assessing their individual-social and educational characteristics, electronic education skills, and attitudes toward the electronic education. RESULTS: Scores of the students' skills in using computer and the Internet were significantly associated with gender and the number of hours working with computer and the Internet at home and work. CONCLUSION: Prerequisites for performing electronic education programs are present at moderate levels in Iran.

The Relation between Awareness of Cancer Diagnosis and Spiritual Health among Cancer Patients.

INTRODUCTION: Disclosure of cancer diagnosis is one the main challenges in caring of patients with cancer since it may have negative effects on the spiritual health of patients. No study has ever been performed in Iran to investigate the relationship between awareness of cancer diagnosis and spiritual health in cancer patients. Therefore, the present study aimed to review the effects of awareness of cancer on spiritual health in patients with cancer. METHODS: This was a descriptive-comparative study conducted in Shahid Ghazi Tabatabaei University Hospital in 2009. The subjects included 150 patients aware of their cancer diagnosis and 150 unaware patients. The patients were selected through convenient sampling method. Using a questionnaire, the patient's spiritual health was assessed. Data analysis was conducted in SPSS17 using descriptive and inferential statistics. RESULTS: RESULTS showed the mean (SD) of spiritual health among aware and unaware patients to be 75.1 (3.8) and 75.4 (3.9), respectively. Statistically, there was no significant difference between the spiritual health of the two groups (p = 0.96). CONCLUSION: These findings showed that awareness of cancer diagnosis had no effects on spiritual health of patients. It is not surprising considering Iranian culture. However, confirmation of this finding requires further studies.

Quality of life in cancer patients and its related factors.

INTRODUCTION: Despite the importance of quality of life (QOL) in outcomes of cancer pa-tients, there have been a few Iranian studies investigating the Iranian patients' quality of life. The present study aimed to assess the cancer patients' QOL and its related factors. METHODS: This cross-sectional study conducted in Shahid Ghazi Tabatabaei Hospital affiliated to Tabriz University of Medical Sciences in 2009. The samples included 150 cancer patients aged more than 18 years who were aware of their own diagnosis. They were selected through convenient sampling method and European Organization for Research and Treatment of Cancer-Quality of life questionnaire (EORTC-QOL 30) were completed. RESULTS: Our findings showed that 44.1% of the patients had moderate QOL. QOL had a significant correlation with the level of family support (p = 0.002). CONCLUSION: Many of cancer patients have a moderate QOL. However, confirmation of such finding requires further investigations.