Virtual care in the health care system: A concept analysis.

BACKGROUND: Health care providers need a better understanding of virtual care to recognise and use it for service delivery. AIM: To provide a more comprehensive definition of the concept of virtual care. METHOD: This study was conducted based on Walker and Avant's concept analysis method. A comprehensive review of the published texts in English from 2012 to 2022 was performed using the PubMed, Web of Science, Scopus, ProQuest, Science Direct, Ovid, CINAHL and Google Scholar databases. RESULTS: The main aspects and attributes of virtual care, including the use of any information and communication technology in various formats such as platforms, telephone calls, messages, email consultation, remote monitoring, secure and two-way digital communication between health care providers and patients, the possibility of providing remote care synchronously or asynchronously, more interaction between patients and caregivers, the possibility of transferring information between patients and health care providers and within the teams themselves, symptom management, sending diagnostic results in the form of video visits, and providing follow-up care, are attributes that distinguish virtual care from telehealth, telemedicine and other methods of providing remote healthcare services. CONCLUSION: Considering the positive and negative consequences of implementing virtual care, the findings of this study developed a basis for an operational definition of the concept so that providers can understand the meaning of virtual care and consider it when providing virtual care to patients. The findings of this study can be used in many international and national contexts in the health care system and in future studies on interventions to increase the use of virtual care.

Cultural competence of nursing educators at medical universities of 2nd regional planning in Iran.

BACKGROUND: One of the facets of nursing care, as a holistic profession, is cultural care. Considering the role of culture in individuals' health behaviors, nurses are recommended to be mindful of cultural care. Since nursing educators should be culturally competent to teach cultural care to students, this study aimed to determine the cultural competence of nursing educators of medical sciences universities in the 2nd regional planning in Iran. METHODS: The current research was a descriptive and survey study framed within Campinha-Bacote's cultural competency model. All nursing educators of universities of medical sciences in the 2nd regional planning of Iran (Tabriz, Urmia, Ardabil, Khoy, Maragheh, Sarab, and Khalkhal) were considered as research units, and the cultural diversity questionnaire for nursing faculties (CDQNE-R) was sent to them. Out of 129 questionnaires sent, 84 were turned back. The data were analyzed by the SPSS 22 software. RESULTS: The results of this study showed that the research participants agreed with the subscales of cultural awareness, cultural knowledge, cultural skill, and cultural desire according to Sealey and Yates' interpretation scale. Also, the research units cast doubts on the cultural encounter subscale. The mean scores of the participants' responses to the questions of every subscale equaled 4.11, 3.52, 3.71, 3.38, and 3.93 for the subscales of cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire, respectively. Likewise, the mean scores of participants' responses to the subscales of transcultural educational behaviors and general cultural competence equaled 3.90 and 3.73. CONCLUSIONS: The nursing faculties participating in the present study agreed with the 4 sub-models of Campinha-Bacote cultural care and the presence of cultural competence criteria. Also, the research units had doubts about the cultural encounter subscale. This result means that the research participants were undecided about their level of participation in face-to-face interactions with people from different cultural, racial, and ethnic groups. According to the results of the study, it is important to hold transcultural nursing training workshops and courses to maintain and improve the level of cultural competence of nursing faculties at universities of medical sciences in the 2nd regional planning in Iran.

A scoping review of virtual care in the health system: infrastructures, barriers, and facilitators.

For virtual care models to be able to improve the safety and quality of care, it is essential to identify the strengths and weaknesses of virtual care. In this Scoping review, literature published on virtual care was identified using international databases. The results of the included studies were summarized using a predefined taxonomy. In total, 20 studies were included in the present review. Extracting the findings of the articles showed four main topics, including "virtual care delivery models," "Video conference software platforms to provide virtual care," "virtual care delivery challenges," and "virtual care implementation facilitators." Therefore, with the development of emerging digital technologies, unique opportunities to provide virtual care and improve the provision of health services have been created in the health care system worldwide. Multifunctional video conference software platforms using specific models for each scope of care practice should be considered.

An introduction to the TPSN model: a comprehensive approach to reducing the theory-practice gap in nursing.

BACKGROUND: There are still concerns about the effectiveness of clinical education models which are done with the aim of reducing the theoretical-practical gap in nursing. In this article, we intend to describe an innovative model to create an integration and structured relationship between educational and healthcare provider institutions. The basis of this work is the full-time presence of nursing teacher in the clinical settings and the development of their role to improve the education of students and nurses and the quality of nursing services. METHODS: This was a participatory action research. This action research was implemented in four steps of problem identification, planning, action and reflection. Interviews, focus groups and observation were used for the qualitative part. Clinical Learning Environment Inventory (CLEI), Job Satisfaction in Nursing Instrument questionnaires and Patient Satisfaction with Nursing Care Quality Questionnaire were completed before and after the study. Qualitative content analysis, paired and independent t test were used for data analysis. RESULTS: The academic-practice integration Model of TPSN is a dynamic and interactive model for accountability in nursing Discipline. Unlike the medical education model that includes patients, students, and physicians as the three points of a triangle, this model, which is shaped like a large triangle, places the person in need of care and treatment (patient, client, family, or society) in the center of the triangle, aiming to focus on the healthcare receiver. The model consists of three components (Mentoring component, Preceptorship component, and integrated clinical education component). Each of the components of this model alone will not be able to eliminate the ultimate goal of bridging the theory-practice gap. CONCLUSIONS: A new and innovative model was proposed to reduce the theory-practice gap in the present study. This model increases the collaboration between educational institutions and healthcare settings compared with the previous models. The TPSN model helps students, nurses, and nursing instructors integrate theoretical knowledge with clinical practice and act as professional nurses.

Society, family, and individual characteristics as double-edged swords in the social reintegration of Iranian female survivors from unintentional severe burns: a qualitative study of enablers and barriers.

BACKGROUND: Reintegrating to society is a significant challenge during burn survivors' rehabilitation. AIM: This study aims to describe what Iranian female survivors from unintentional severe burns experience as enablers and barriers of social reintegration (SR). METHODS: Fourteen adult female burn survivors whose burns were unintentional participated in this qualitative study. Data were gathered through semi-structured face-to-face or telephone interviews and analyzed using inductive content analysis. RESULTS: Thirteen subcategories and six categories were emerged. Categories and subcategories of enablers content area were as follows: positive impact of society on SR (normal treatment of society, instrumental support), positive impact of family on SR (magnifying personal abilities assets, empathy and emotional support), and positive impact of personal characteristics on SR (coping with others stares, right to have a normal social life). Categories and subcategories of Barriers content area were as follows: negative impact of society on SR (being questioned in public, incorrect judgment about intent of burns, burns as a contagious disease), negative impact of family on SR (embarrassment of appearing in public with the survivor, family mistrust), and negative impact of intra-personal factors on SR (exaggeration of the post-burn changes, being over-sensitive to the others looks). From the deep interpretation of the data two overarching themes were emerged: "acceptance of the new normal by the society and the individual" and "being encompassed by misconceptions and mistreatments". CONCLUSIONS: Society, family and the individual characteristics have a dual role to play in the success of social reintegration in Iranian female unintentional burn survivors.

Moral distress and burnout in Iranian nurses: The mediating effect of workplace bullying.

BACKGROUND: Moral distress and workplace bullying are important issues in the nursing workplace that appear to affect nurse's burnout. AIM: To investigate the relationship between moral distress and burnout in Iranian nurses, as mediated by their perceptions of workplace bullying. ETHICAL CONSIDERATIONS: The research was approved by the committee of ethics in research of the Urmia University of Medical Sciences. METHOD: This is a correlation study using a cross-sectional design with anonymous questionnaires as study instruments (i.e. Moral Distress Scale-Revised, Maslach Burnout Inventory and The Negative Acts Questionnaire-Revised). Data were collected from 278 nurses from five teaching hospitals in Urmia, the capital of Western Azerbaijan, northwest of Iran. Structural equation modeling and bootstrapping procedures were employed to recognize the mediating role of their perceptions of workplace bullying. RESULTS: The mean score of moral distress, burnout, and the Negative Acts Questionnaire-Revised Scale among the participants were 91.02 ± 35.26, 79.9 ± 18.27, and 45.4 ± 15.39, respectively. The results confirmed our hypothesized model. All the latent variables of study were significantly correlated in the predicted directions. The moral distress and bullying were significant predictors of burnout. Perception of bullying partially mediated the relationship between moral distress and burnout. The mediating role of the bullying suggests that moral distress increases burnout, directly and indirectly. CONCLUSION: Nursing administrators should be conscious of the role of moral distress and bullying in the nursing workplace in increasing burnout.

Preserving self-concept in the burn survivors: a qualitative study.

BACKGROUND: Burn injury is a devastating experience affecting all aspects of a person's essence, including his/her identity and perception. These patients require complex cognitive efforts to redefine their identity to deal with difficult condition after burn injury and preserve self-concept. The experience of life after burn injury is generally a solitary one, closely related to the patients' cultural and religious context. Therefore, this study was conducted aiming at investigating burn patients' experiences regarding how to preserve self-concept in life after burn injury in Iran. MATERIALS AND METHODS: This qualitative study was carried out using qualitative content analysis and in-depth unstructured interviews with 17 surviving burn subjects. RESULTS: During the qualitative content analysis process, the concept of "locating" as the essence of the participants' experience was extracted as follows: (A) self-exploration (exploring the changes in one's life), (B) others' exploration (exploring the changes in the life of family members and the relationship between self and others), (C) position evaluation (self-position analysis), and (D) self-concept preservation. CONCLUSION: The present study has developed new understandings of mental experiences of burn patients' self-concept by describing the concept of "self-locating". It helps us in classifying and understanding the concepts described in comprehensive theories developed in this area. They do this by focusing on what burn patients experience for choosing self-preservation strategies and having a meaningful life. The finding can be used as a conceptual framework for palliative care program in Iran.

Family-based education and follow-up program for patients with burns: A mixed assessment study.

BACKGROUND: Burn injuries are a major cause of morbidity and mortality worldwide, affecting not only the patients but also their families. Family-based education and follow-up program are interventions that aim to improve the quality of life and psychosocial outcomes of patients with burns and their families. However, we find a lack of evidence on the effectiveness and feasibility of these programs in different settings and populations. This study aimed to evaluate the features of the family-based education and follow-up program (FBEFP), a pilot project that was developed and implemented at the Tabriz Sina Teaching Hospital in 2020 to improve its burn care system. DESIGN: A mixed-methods approach was used to collect and analyze both quantitative and qualitative data from various sources, such as, questionnaires, medical records, interviews and observation notes, to assess the content, process, and outcome of the program. The study followed the three steps of the CDC's framework for program evaluation: describing the program, measuring its effectiveness, and providing recommendations for improvement. RESULTS: The results of this study revealed the positive impacts of the FBEFP on the patients' physical, psychological, and social outcomes and quality of life. 4.8% of the people in the follow-up group were re-admitted, while this amount was 7.2% in the group without follow-up. Although the number of readmissions was less in the non-follow-up group, statistically no significant difference was observed between the two ratios before and after follow-up. In order to evaluate satisfaction rates, In the follow-up group, 72 patients and in the non-follow-up group, 38 patients were reached. After converting these data to normal distribution, using t-tests, it was determined that the difference between the two studied groups was highly significant. In other words, the follow-up process had favorable results on satisfaction of the studied people. However, the study also identified some challenges and barriers in implementing the program, such as lack of resources, staff training, and family involvement. CONCLUSION: FBEFP is a promising intervention that enhances the well-being of patients with burns and their families. However, more evidence is needed to support its effectiveness and feasibility in different contexts and populations. The study also provided valuable insights into the benefits and challenges of implementing a Family-Based Education and Follow-up Program for patients with burns in a low-resource setting. The study contributed to the development of guidelines and recommendations for future research and practice in this field.

The Perceived Informational Needs of Family Caregivers of Children Hospitalized in a Burn Department: A Cross-sectional Study.

Children are most vulnerable to burn injuries, and their families are their most important source of support. Therefore, it is necessary to identify the information needs of such parents and support them to help children adapt to the new situation, recover to pre-accident conditions, and reintegrate into school and society. This study aimed to investigate the perceived information needs of family caregivers of children admitted to the burn wards of hospitals. This cross-sectional study was conducted on 200 family caregivers of children admitted to the burn ward of a hospital in Tabriz, Iran. Participants were selected through convenience sampling, and the required data were collected by using questionnaires on socio-demographic information, information needs, information resources, and information acquisition methods. The obtained data were analyzed statistically using descriptive statistics (mean, standard deviation, frequency, and percentage) and inferential statistics (Mann-Whitney, Kruskal-Wallis, and Spearman correlation tests). Results indicated that the greatest informational need among family caregivers was related to the child's condition. The treatment team was identified as the most important source of information for them. It was found that information should be provided in a comprehensive and understandable manner, while maintaining honesty and human dignity. The study findings contribute to our understanding of the specific information needs of family caregivers in managing the medical care of children with burns. These findings can serve as a basis for interventions and support services aimed at meeting the needs of these families and improving the quality of care for children with burns.

Barriers to the implementation of virtual care programmes for patients with chronic wounds: Qualitative empirical research.

AIM: To assess the barriers to the implementation of virtual care for patients with chronic wounds from wound therapists' perspective. DESIGN: A qualitative study. METHODS: The study was conducted in two consecutive phases: (1) literature review, (2) descriptive qualitative study. In the first phase, texts published in English until 2023 were identified using international databases. The entire text of the selected studies was evaluated independently by two reviewers. Data analysis was carried out using textual content analysis. In the second phase of the study, twelve participants from Iranian wound care clinics participated. Data were collected through focus group discussion and analysed using conventional content analysis. Integration of both phases was conducted in the data analysis stage. RESULTS: The most important barriers in providing virtual care to patients with chronic wounds were identified into five categories including lack of policymaking in virtual care, ethical challenges in virtual information and communication technology, social, economic and cultural issues, IT users' insufficient knowledge and limitation of virtual care scope of practice. CONCLUSION: The findings of the present study identified different barriers in the implementation of virtual care for patients with chronic wounds. In order to successfully develop a virtual care programme, it is necessary to adopt suitable policies regarding information and communication technology, provide the necessary legal frameworks, assign an adequate budget and consider the ethical, cultural, social and social issues. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Identifying barriers to developing a virtual care programme will help manage patients with chronic wounds at home. IMPACT: This study accurately identifies barriers to providing virtual care for patients with chronic wounds and helps plan to address these barriers and facilitate the development of a virtual care programme for these patients at home. REPORTING METHOD: This research has adhered to the SRQR reporting guideline. NO PATIENT OR PUBLIC CONTRIBUTION: The involvement of patients or the public in the design, or conduct, or reporting, or dissemination plans of this research was not suitable.

An appropriate simulation-based training for surgical technology students.

BACKGROUND: Using simulation in an appropriate education plan which has always been challenging; To be used alone or in combination with other methods and the order of it's use. This article was intended to compare student's knowledge, clinical skill and readiness-capability using simulation and combination of it with traditional training methods to collect necessary evidence for development of an appropriate simulation- based educational plan for surgical technology students. METHODS: This is a controlled pre/post-test quasi-experimental study in 2019. All surgical technology students who had selected the scrub and circulate course (n = 28) were randomly divided into two groups. One of the groups was educated with traditional training method (TTM). On the same day, the other group was educated with simulation training method (STM). After two weeks, group α received simulation training and group ß was subject to traditional training. Multiple-Choice Test for Knowledge Assessment and Clinical Skills as well as Readiness-Capability (KCSRC) of appendectomy Surgery checklist were used in this study. Data were analysed after each training method, after Two weeks and after blended education.For data analysis, Mixed-Design ANOVA and SPSS software 24/v were employed. RESULTS: The mean scores of knowledge, clinical skills, and readiness-capability were 14.2 ± 2.91, 44.42 ± 17.74, 21.58 ± 4.18 in group α and 12.66 ± 3.21, 41.17 ± 16.19, and 18.58 ± 7.85 in group ß, respectively. The comparison between mean scores of KCSRC before the first training and after combined training in each group showed that the mean of all scores significantly increased in group α (p < 0.0001), which indicates that the education plan starting with TTM and continued with STM has the most significant effect on results. CONCLUSION: According to the results of the study, it seems that starting the education plan for surgical students with TTM and then continuing with STM would be more effective on education of students, especially on students' long term learning.

The impact of institutionalizing the nursing process based on TPSN model on the quality and quantity of nursing diagnoses.

AIM: Nursing diagnosis is the basis of applying nursing process and evidence-based care in nursing. This issue has been affected by the gap between theory-practice in nursing. The attending nursing teachers Project aims to create an organizational link between health care centres and nursing schools, reducing the gap between theory-practice and empowering nurses to apply nursing diagnosis. DESIGN: The present study was part of the second cycle of an action research study conducted in the cardiology ward in 2019-2020. METHODS: Interventions were performed in the form of Teacher, Patient, Student, Nurse Model to empower nurses in quantity and quality of nursing diagnosis. RESULTS: The results indicated a significant increase in the number of nursing diagnoses recorded. Moreover, the qualitative criteria based on PES components were found to have changed significantly after the interventions. Empowering nurses in the form of this Project could suggest that creating proper structures between nursing schools and health care centres, full-time presence of faculty members in hospitals, and enhancing their roles in these institutes will lead to improvements in educational as well as health care systems.

Turnover intention among operating room nurses during the COVID-19 outbreak and its association with perceived safety climate.

BACKGROUND: In critical situations such as the COVID-19 pandemic, nurses always face a lot of stress that can increase their turnover intention. Since a suitable safety climate in the workplace is considered an important factor in preventive management of occupational hazards and people's adaptation to stressful conditions, the present study aimed to determine Turnover intention among operating room nurses during the COVID-19 outbreak and its association with perceived safety climate. METHODS: In this descriptive correlational study, participants were 190 operating room nurses working at public hospitals in Mazandaran (Iran) who were selected by stratified random sampling. Data were collected using the Anticipated Turnover Scale and the Nurses' Safety Climate Questionnaire and analyzed using SPSS16. RESULTS: The results of the linear regression analysis revealed that safety climate significantly reduced turnover intention among nurses in the COVID-19 pandemic (P < 0.001). An increase of one unit in the total score of safety climate led to a 0.6 reduction in the turnover intention of operating room nurses. CONCLUSION: The present findings demonstrated an unfavorable safety climate perceived by perioperative nurses in the COVID-19 pandemic, with a significant inverse relationship with turnover intention. Strategies such as training personnel on the prevention of the disease transmission in the surgery of patients infected with or suspected of COVID-19, creating a proper supportive environment for personnel, and providing appropriate protective equipment to prevent infection with COVID-19 seem absolutely vital to improving the safety climate in the operating room, thereby reducing turnover intention.

Burn self-stigma: A hybrid concept analysis.

AIM: As burn self-stigma has not been addressed fully, the purpose of current study is to analyze dimensions of the concept using literature and lived experiences in burn survivors. METHODS: Using hybrid concept analysis method, we investigated self-stigma in three phases (i.e. theoretical, fieldwork, and final analytical phase). In the first phase we reviewed the literature using PubMed, SCOPUS, Web of Science, Cochrane Library, OVID, SID and Google Scholar. Thirteen semi-structured interviews with burn survivors were conducted during the fieldwork phase. Two extra interviews with health care providers were undertaken for the aim of data triangulation. Textual content analysis and inductive content analysis were used to analyze the data of the first and second phases of this study, respectively. The findings of both phases were combined in the final analytical phase and a comprehensive definition was emerged. RESULTS: We assigned all our findings into three content areas (i.e. antecedents, properties and consequences), which are dimensions of self-stigma. In final analytical phase antecedent, properties and consequences of the concept were formed in one (society's misconception about burns), three (negative definition of self, emotional responses, and behavioral responses), and three (negative individual effects, negative social effects, and negative familial effects) categories, respectively. Based on these categories and their corresponding subcategories, a comprehensive definition of the concept was presented. CONCLUSION: Burn self-stigma is a state in which burn survivors experience unfavorable thoughts and feelings about themselves as a result of society's misconceptions about them. They give emotional and behavioral responses that define them in a negative way. In the end, the burn survivor's individual, familial, and social dimensions are significantly impacted.

Caring Needs of Cancer Patients from the Perspective of Home Care Nurses: A Qualitative Study.

OBJECTIVE: Cancer is the third leading cause of death in Iran. Todays, caregiving to patients with cancer is shifting towards home based care, and home care needs from a caregiver's perspective can help improve the patient care. This qualitative study aimed to examine the home care needs of cancer patients from the perspective of home care nurses. METHODS: This is a qualitative descriptive study carried out at home care centers in the northwest of Iran. A total of 15 participants were recruited through purposive sampling and underwent face-to-face semi-structured interviews. Data were analyzed through Conventional content analysis method in MAXQDA software.  Measures of trustworthiness were established throughout the study using Lincoln and Guba's (1985) criteria (dependability, credibility, transferability, and confirmability). RESULTS: Data analysis resulted in the extraction of four main categories including physical needs (pain relief, gastrointestinal problems including nausea and anorexia and nutritional problems, lethargy, wound care), psychological support (need for hope and emotional support), educational needs (need for information and self-care) and financial support (service insurance coverage, charity support). To promote these patients home care, insurance coverage of nursing home care services was emphasized by the participants. CONCLUSION: Various aspects of cancer patients home care needs were identified. Interdisciplinary home-based palliative care collaboration is needed to address their physical, psychological, and moral needs.

Attitude, preventive practice and perceived barriers among perioperative and anesthesia nurses toward surgical smoke hazards during the COVID-19 outbreak.

BACKGROUND: Surgical smoke (SS), which is produced by the use of high-temperature devices for cutting and coagulation of tissue during surgical procedures, is considered a serious threat to the health of operating room (OR) staff due to the presence of hazardous substances and possibility of transmitting various infections such as HPV, HIV, COVID-19 and so on. This study was conducted to determine the Attitude, preventive practice and perceived barriers among perioperative and anesthesia nurses toward surgical smoke hazards. METHODS: In this cross-sectional descriptive study, conducted at hospitals of Tabriz University of Medical Sciences (Iran) in 2021, 262 perioperative and anesthesia nurses were included by stratified random sampling. Data were collected using a demographic questionnaire and an SS questionnaire consisting of questions on attitude (17 item), practice (8 item), and barriers (13 item). Collected data were analyzed using SPSS16. RESULTS: The mean attitude and preventive practice scores (49.52 ± 12.36 and 15.8 ± 2.05, respectively) of the operating room nurses were reported at moderate and weak levels, respectively. There was a direct and significant relationship between attitude and practice scores (r = 0.129, P = 0.019). The main barriers to the prevention and dealing with the hazards of SS in ORs were reported in management (3.68 ± 1.06) and equipment (3.24 ± 0.66) dimensions, respectively. CONCLUSION: It is recommended to adopt strategies to improve the attitude of OR staff regarding the preventive measures against surgical smoke hazards. Moreover, appropriate equipment and support of managers should be provided by explaining the policies and guidelines to prevent the complications of surgical smoke.

Disaster preparedness and core competencies among emergency nurses: A cross-sectional study.

AIM: With the rise in frequency and severity of disasters in recent decades, it is essentially important that nurses must be adequately prepared to handle them. This study was aimed to evaluate the levels of disaster core competencies and preparedness of nurses in the emergency department. DESIGN: A cross-sectional survey design was used. METHODS: This cross-sectional research was conducted from August 2020 to December 2020 among 271 nurses in the emergency departments of six hospitals in Qazvin, Iran. The participants completed the "Nurses Perceptions of Disaster Core Competencies Scale" (NPDCC) (45 items) and the disaster preparedness (a single-item visual scale). Data were analysed by one-way analysis of variance, independent t-tests and multiple linear regression analysis. RESULTS: The mean scores of disaster preparedness and core competencies of nurses were 6.75 out of 10 (SD = 1.63) and 2.88 out of 5 (SD = 0.80), respectively. "Technical skills" (mean = 3.24, SD = 0.91) were the highest and "communication skills" (mean = 2.57, SD = 0.95) were the lowest across the subscales of the scale. A significant association was found between disaster core competencies and preparedness of nurses (p < .001). Regression analysis results indicated that nursing disaster core competencies were perceived betted by older nurses (B = -0.405) who had experience in the disaster stage (B = 0.228) and nurses with disaster response experience (B = 0.223) and lower professional experience (B = 0.309). Nurses with a postdiploma degree (B = -0.480) and bachelor's degree (B = -0.416) were perceived to have lower disaster core competency than nurses with a master's or PhD degree. CONCLUSION: There are still gaps in disaster preparedness and core competencies for emergency nurses that need to be addressed. Nursing managers must support an improvement in nursing disaster core competencies. This may be done by conducting sessions for routine disaster scenarios and providing formal disaster preparedness training.

A Comparative Study of the Impacts of Aloe vera Gel and Silver Sulfadiazine Cream 1% on Healing, Itching and Pain of Burn Wounds: A Randomized Clinical Trial.

Introduction: Although several studies have highlighted the beneficial effects of Aloe vera on burn wounds, limited clinical evidence exists in this regard. This study aimed to evaluate the impact of the Aloe vera gel on healing, itching and pain of burn patients. Methods: This clinical trial was conducted at Sina Hospital in Tabriz, Iran. The patients with second and first degree burn wounds on symmetrical organs, were randomly assigned to control (n=34) and experimental (n=34) groups. The Aloe vera gel and silver sulfadiazine cream were used in the experimental and control groups, respectively. To assess the healing effects, the Bates-Jensen Wound Assessment Tool (BWAT) was employed. Regarding itching and pain, visual analogue scale (VAS) was used for precise evaluation and comparison on days 1, 3, 5, 7, 9 and 14. The data were analyzed using SPSS version 13. Results: Although the wounds in both groups healed up completely within two weeks, the healing process among the patients in the experimental group was faster. The peak of wound itching was on day 7 in both groups. The wound itching significantly reduced half an hour after being dressed with Aloe vera gel. The wound pain in the experimental group was less than control group during the study period. Moreover, there was no pain in either experimental or control group on day 14. Conclusion: Aloe vera is an effective agent in reducing itching and pain, and it can substantially increase the rate of healing. Accordingly, this agent can be considered in the treatment of burn wounds.

Nursing process from theory to practice: Evidence from the implementation of "Coming back to existence caring model" in burn wards.

AIM: To develop the caring model and utilize and evaluate the effect of the model in the nursing student's learning process in burn wards. DESIGN: A longitudinal multiphase study. METHODS: In the first phase, "Coming back to existence caring model" was developed, in the second phase, to evaluate the program, 35 students in the first semester and 31 students in the second semester of the 2017-2018 academic year were selected randomly, and their logbooks were analysed. RESULTS: Components of the nursing process, based on the model, were wound management, care and documentation, early mobilization, discharge planning and patient education. The lowest nursing process utilization in both semesters was in the sexuality domain. The most nursing diagnosis was a risk for infection. In the discharge plan, education about how the patient communicates with others in the second semester was less than other educational content (61/3%). However, empowering students was remarkable.

The risk of surgery-related pressure ulcer in diabetics: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: Postoperative pressure ulcers are known as the most important quality indicators of intraoperative care that create critical and costly complications during hospital care. Accordingly, this study was performed to determine the risk factor for diabetes in postoperative pressure ulcers. MATERIALS AND METHODS: The present study is a systematic review of PubMed, Scopus and the Web of Science databases with using standardized keywords of the performed English language articles between Jan 2010 to Jan 2020. The articles were searched independently by two related researchers to avoid possible biases. Then, all collected articles were reviewed, and articles with inclusion criteria were evaluated using a data collection table. It should be noted that the data were analyzed using STATA software version 11.1. RESULTS: Overall, the results showed that 19724 patients were identified from 15 studies conducted in Asia (six), the America (four), Europe (four), and Australia (one) from 1989 to 2019. The results showed that patients with diabetes were more likely to experience surgery-related pressure ulcers than patients without diabetes (The odds ratio of 1.52; the 95% confidence interval: 1.25-1.85). CONCLUSION: In general, patients with diabetes increased the risk of surgery-related pressure ulcers about 1.5 times more than others. Accordingly, the reduction of surgery-induced pressure ulcers should be more extensively considered in patients with diabetes.