What are the outcomes of hospice care for cancer patients? A systematic review.

PURPOSE: Over the past 2 decades, cancer has been the leading cause of death worldwide. Accordingly, cancer patients are the largest group of patients admitted to a hospice, accounting for 40% of overall hospice admissions every year. Therefore, the purpose of this systematic review is to investigate the outcomes of caring for cancer patients at hospices. METHODS: PubMed, Scopus, and Web of Science databases were searched for English language articles published during the period from January 2008 to January 2022. The keywords used to search in this systematic review were included hospice, cancer, and neoplasm (for PubMed search only), which were searched in the titles and abstracts of the articles. RESULTS: Out of 803 articles found in the initial search, 38 were selected based on inclusion criteria. The studies indicated that hospice care resulted in outcomes such as reduced referral and admission to the emergency department (only one study reporting opposite results), reduced length and number of hospital admissions, reduced use of chemotherapy and radiotherapy, increased pain reports, improved pain management, enhanced end-of-life quality, significantly reduced cost of treatment, reduced number of invasive interventions, death at home, increased survival and satisfaction of patients, and poor nutritional support. CONCLUSION: Given the numerous and significant benefits of care in a hospice for cancer patients, health managers are recommended to consider developing hospices and introducing patients to these centers. Besides, they need to compensate for some shortcomings by, for example, providing better nutritional support and developing a care plan based on the type of cancers that the patients are suffering in hospices so that more specialized services can be delivered.

Factors affecting the emergence of diplomacy in Iranian nurse managers: a qualitative study.

AIM: To explore the factors affecting the emergence of diplomacy in Iranian nurse managers. BACKGROUND: Today, with the development of complex health systems, diplomacy in health care can take place at organizational, national and international levels. INTRODUCTION: Diplomacy's role is to convince others peacefully to achieve goals. Diplomacy in nursing can facilitate professional development and direct policy and decision-making process towards the development of a healthcare system. METHODS: The study used a qualitative descriptive approach. The sampling method was purposeful, and data were collected via in-depth, unstructured and face-to-face interviews with 16 participants. The interviews were digitally recorded, transcribed verbatim and analysed through conventional content analysis based on Graneheim and Lundman's work. RESULTS: In total, 212 codes were generated, which were grouped into three main categories, namely paradigmatic socio-political changes (two subcategories), nurses' dissatisfaction with their status in healthcare system (two subcategories) and multidimensional development of the nursing profession (four subcategories). DISCUSSION/CONCLUSIONS: Socio-political changes, development of the nursing profession and nurses' dissatisfaction with the health system have led to the emergence of diplomacy roles in nurse managers, the recognition and development of which can improve the effectiveness of nurse managers in policymaking. IMPLICATIONS FOR NURSING & HEALTH POLICY: The recent COVID-19 pandemic outbreak has demonstrated the urgent need to use diplomacy to solve health problems and adjust or develop policymaking at the national and international levels. Strengthening their role in diplomacy, nurse managers can play an important role as diplomats at various levels of policymaking and in health crisis management.

Intimate Partner Violence in the Middle East Region: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVE: Intimate partner violence (IPV) is a clinical and social problem globally, especially in the Middle East. This study aimed to analyze the prevalence of IPV and its types against women in the Middle East region. METHOD: PubMed, Scopus, and Web of Science were searched in January 2020. From 1995 to 2020, all studies performed in the Middle East, investigating at least one type of abuse against women and written in English, entered the study. All included studies were appraised using Joanna Briggs Institute Checklist, which was adapted for prevalence studies. The random effect model of meta-analysis was performed using the Mantel-Haenszel method by comprehensive meta-analysis software. Each type of abuse as event rate with 95% CI was calculated for each variable. Heterogeneity was investigated using the I 2 statistic test. RESULTS: Fifty-five studies encompassing 138,692 participants were included in our meta-analysis. The rate of overall abuse was 26.3 (n = 55, 95% CI: [15.8, 40.5], p = .002). The highest rate of abuse in the included studies was reported for psychological abuse 48.6% (n = 46, 95% CI: [39.8, 57.5], p = .758). The rate of abuse for physical, economical, sexual, and injury were 28.4% (n = 53, 95% CI: [22.1, 35.7], p = .0001), 19% (n = 10, 95% CI: [9.8, 33.7], p = .0001), 18.5% (n = 45, 95% CI: [13.6, 24.6], p = .0001), and 18.4% (n = 5, 95% CI: [7.1, 40.2], p = 0.008), respectively. The overall abuse reported by World Health Organization Multi-Country Domestic Violence (DV)Questionnaire was 25.7% (n = 17, 95% CI: [18.4, 34.7], p = .0001). This value was 41.8% (n = 11, 95% CI: [29.7, 55], p = .223) for the Conflict Tactics Scale Questionnaire. CONCLUSION: Although this review highlights the lack of or insufficient IPV data in some contexts and inconsistencies in defining and measuring IPV among studies, the evidence shows that a moderate to high pattern of abuse has been observed in the study population. Due to this region's unique cultural-religious characteristics, it is urgent to reduce this phenomenon.

Investigating the strengths and weaknesses of online education during COVID-19 pandemic from the perspective of professors and students of medical universities and proposing solutions: A qualitative study.

This study aimed to explore the strengths and weaknesses of e-learning during the COVID-19 pandemic from the perspective of its primary stakeholders, namely professors and students, and to provide practical solutions. Design is a qualitative study. We enrolled 22 faculty members and 58 students purposively. Research data were collected through a data collection checklist and via email and continued until the data were saturated. The qualitative content analyses were the basis of analysis in this study. Strengths were presented in 6 themes and 26 subthemes, weaknesses in 5 themes and 23 subthemes, and solutions were presented in 5 themes and 20 subthemes. Save money, time and energy; use modern software and educational technologies; and the ability to individualize education were among the strengths of e-learning. The most important weaknesses related to e-learning include infrastructure difficulties, problems related to the ability of professors and students to use educational systems. The most beneficial solutions offered included improving and upgrading the e-learning infrastructure, empowering professors and students to use educational systems. We concluded that using online teaching has many strengths as well as some weaknesses. Identifying these strengths and weaknesses can help policymakers plan better.

Diplomatic activities of Iranian Nursing Organization: A qualitative study.

BACKGROUND: Nursing organizations play an important role in fulfilling the professional demands of nurses. The Iranian Nursing Organization (INO) is also using diplomatic activities in this direction. AIM: This study was conducted to explain the diplomatic activities of INO. METHODS: A descriptive qualitative study was conducted using conventional content analysis. A purposive sampling approach was used. Data were collected via in-depth, unstructured, face-to-face interviews with 21 nurses at various INOs in different cities from March to July 2020. The data collection process continued until data saturation. Interviews were analyzed using Graneheim and Lundman's (2004) guidelines. The MAXQDA software (v. 10) was used. FINDING: The results showed that the diplomatic activities of INO comprise professional (three categories), social (two categories), and diplomacy in power network (two categories). CONCLUSION: INO carries out diplomatic activities at organizational, national and international levels and pursues its professional nursing goals through diplomacy. INO also uses social diplomacy and political diplomacy to influence decision-makers in the community and network of power.

The Effect of Clofibrate on Decreasing Serum Bilirubin in Healthy Term Neonates under Home Phototherapy.

OBJECTIVE: This study was designed to determine the effect of clofibrate on neonatal uncomplicated jaundice treated with home phototherapy. METHODS: This clinical trial study was performed on 60 newborns with jaundice that received home phototherapy. Inclusion criteria were body weight between 2500 to 4000 gr, breastfed, total serum bilirubin (TSB) between 14 to 20 mg/dl, aged over 72 hours. The neonates were randomly divided into two groups. All received home phototherapy. Group I received a single dose of 50 mg/kg clofibrate and the other group served as control group. Total serum bilirubin level was measured every 24 hours. FINDINGS: Two groups were matched regarding weight, sex, age and first TSB. At 24 and 48 hours of treatment, the mean values of TSB in the clofibrate group were 13.72 (1.56), 9.5 (0.56) and in the control group 15.30 (1.44), 12.6 (1.44). The results show that TSB was significantly decreased after 24 and 48 hours in clofibrate group (P<0.001). The mean duration of phototherapy in group I was 72(0.0) hours and in the control group 76.80 (±9.76) hours. The duration of phototherapy was significantly shorter in clofibrate group (P<0.001). CONCLUSION: Clofibrate is effective for outpatients with neonatal hyperbilirubinemia who are under home phototherapy. Of course, further studies are needed for approved routine use of this drug in the treatment of neonatal jaundice.