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The coronavirus disease 2019 (COVID-19) disease was first detected in December 2019 in Wuhan, China. This disease is currently one of the most important global health problems. The novel coronavirus COVID-19 is a respiratory illness, that has caused a deadly pandemic that is spreading rapidly around the world. It is not only a respiratory system virus that causes severe lung disease, but also a systemic disease agent that can affect all systems. People with COVID-19 disease usually have respiratory signs, however, the liver disorder is not an uncommon presentation. In addition, many studies around the world have revealed that the liver is injured to various degrees in patients with severe acute respiratory syndrome coronavirus 2 disease. This review mainly focuses on the impact of COVID-19 on Liver Injury at various ages.
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BACKGROUND: One of the best approaches to promote clinical reasoning in nursing education is Virtual Patient (VP). The purpose of this study was to design and implement VPs for nursing student's education in caring for cancer patients. MATERIALS AND METHODS: In the first stage, through a descriptive-exploratory qualitative study using a focus group method, topics with higher priority in cancer nursing were identified. Then, based on the VP Nursing Design Model (VPNDM) for each of these topics, a scenario and then an interactive VP was designed and implemented in the Open Labyrinth application. The content validity of VPs was evaluated by eight experts and then the face validity was examined in the pilot group including 15 nursing students. RESULTS: Topics with higher priority in cancer nursing courses were mastectomy, chemotherapy, radiotherapy, hypercalcemia, spinal cord compression, cardiac tamponade, and superior vena cava syndrome. For five scenarios based on the nursing process in three sequences (signs and symptoms, diagnosis and interventions) the VPs were designed. In this process, learning objectives, determining the critical path, adding branches at the decision point, adding feedback, completing the clinical course and related data, and adding multimedia were considered. VPs were revised based on the proposed modifications following face and content validity. CONCLUSIONS: This article presents VP design steps for use in a nursing student training course. The researchers were able to provide and validate five VPs to care for cancer patients based on the VPNDM.
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BACKGROUND: Moral distress and moral courage among healthcare professionals have received considerable attention in recent years. However, there is a paucity of studies investigating these topics among nurses. Thus, the present study aimed to evaluate the association between moral distress and moral courage among nurses in an Iranian sample population. MATERIALS AND METHODS: The present cross-sectional study was conducted during February-December 2018. Corley's Moral Distress (MDS-R) and Sekerka's moral courage scales were used to collect the data. MDS-R is a 21-items scale which includes frequency and intensity ranges from 0 (never) to 4 (very frequently) and 0 (none) to 4 (great extent), respectively. In addition, the moral courage scale contains 15 items ranging from "never true" (1 point) to "always true" (7 points). In total, 225 eligible nurses were entered into this study. Finally, SPSS-16 was used for statistical analysis at the α = 0.05 level. RESULTS: The mean scores of the frequency and intensity of moral distress and moral courage were 45.41 (95% CI = 43.37-47.45), 44.24 (95% CI = 42.98-45.42), and 59.63 (95% CI = 58.50-60.87), respectively. Eventually, a significant relationship was found between the moral courage and frequency of moral distress (r = 0.46, p < 0.001) and the intensity of moral distress (r = 0.73, p < 0.001). CONCLUSIONS: In general, encouraging healthcare managers and administrators is considered as crucial for developing supportive structures and highly sensitive management which promotes moral courage while reducing moral distress in nurses' work setting.