Lived experiences of COVID-19 disease: a qualitative meta-synthesis.

Background: During the COVID-19 pandemic, various aspects of human life were changed around the world. The present study aimed to provide a systematic review of the available evidence on lived experiences of the COVID-19 pandemic. Methods: This is a systematic review of the meta-synthesis type. Evidence from studies from 2019 to 2021 was used. Keywords of lived experiences, experiences, people, nation, patients, community, COVID-19, corona, and corona disease were searched in PubMed, Science Direct, Web of Science, and Cochrane databases. The Newcastle-Ottawa scale was used to evaluate the quality of articles. A qualitative meta-synthesis was performed by a researcher based on a three-step meta-synthesis method described by Thomas and colleagues. MAXQDA 10 was used for data analysis. The present study is based on the guidelines for Enhancing transparency in reporting the meta-synthesis of qualitative research (ENTREQ). The reliability of this study had a Kappa coefficient of 0.660 with a consistency rate of 98.766%. Results: Finally, the data from 11 articles were analyzed. The main and sub-themes obtained in this study included negative aspects (chaos, hustle associated, dualities, bad body, value decay, seclusion, psychological challenges) as well as positive aspects (opportunities arising from the individual, family, and social stability). Conclusion: Problems of life during COVID-19 should be considered as part of the COVID-19 pandemic care program. Individual assessments should normally be considered in a public health crisis. It is recommended to conduct serious, in-depth, and practical research in this field.

Predicting the risk of mortality and rehospitalization in heart failure patients: A retrospective cohort study by machine learning approach.

BACKGROUND: Heart failure (HF) is a global problem, affecting more than 26 million people worldwide. This study evaluated the performance of 10 machine learning (ML) algorithms and chose the best algorithm to predict mortality and readmission of HF patients by using The Fasa Registry on Systolic HF (FaRSH) database. HYPOTHESIS: ML algorithms may better identify patients at increased risk of HF readmission or death with demographic and clinical data. METHODS: Through comprehensive evaluation, the best-performing model was used for prediction. Finally, all the trained models were applied to the test data, which included 20% of the total data. For the final evaluation and comparison of the models, five metrics were used: accuracy, F1-score, sensitivity, specificity and Area Under Curve (AUC). RESULTS: Ten ML algorithms were evaluated. The CatBoost (CAT) algorithm uses a series of decision tree models to create a nonlinear model, and this CAT algorithm performed the best of the 10 models studied. According to the three final outcomes from this study, which involved 2488 participants, 366 (14.7%) of the patients were readmitted to the hospital, 97 (3.9%) of the patients died within 1 month of the follow-up, and 342 (13.7%) of the patients died within 1 year of the follow-up. The most significant variables to predict the events were length of stay in the hospital, hemoglobin level, and family history of MI. CONCLUSIONS: The ML-based risk stratification tool was able to assess the risk of 5-year all-cause mortality and readmission in patients with HF. ML could provide an explicit explanation of individualized risk prediction and give physicians an intuitive understanding of the influence of critical features in the model.

Eye movement desensitization and reprocessing as a therapy for rape victims: A case series.

A case series was conducted on three rape victims who were hospitalized with a diagnosis of major depressive disorder (MDD). Eye movement desensitization and reprocessing (EMDR) was employed to reduce their risk of suicide or suicidal ideations. EMDR can be an effective treatment to reduce the level of suicidal ideation in rape victims.

Barriers to efficient management of in-home care: A qualitative content analysis.

AIM: Inefficient management is one of the major barriers to development of in-home care in the society. Accordingly, the present study aims to identify the barriers to efficient management of home care nursing using a qualitative approach. DESIGN: The present study is a qualitative-descriptive work of research. METHOD: Data were collected using semi-structured, in-depth, individual interviews with 19 nurses from November 2020 to May 2021. The collected data were analysed using Graneheim and Lundman's method. RESULTS: The findings of the study were categorized into four main themes, namely lack of effective standards, ineffective interactions, inappropriate cultural/social context and professional issues, and 15 subthemes. CONCLUSION: In-home care nurses in Iran experience various problems in their practice. Creating an appropriate cultural/social context in Iranian societies, providing the necessary infrastructure, including insurance, providing comprehensive, clear guidelines for in-home care, encouraging teamwork and organizing workshops to promote effective interactions between the personnel and patients can improve the quality of in-home care nursing.

Exploring senior managers' perceptions of the COVID-19 Crisis in Iran: a qualitative content analysis study.

BACKGROUND: Identification of the experience of senior managers in tackling biological crises can be a roadmap for future crisis management planning. The aim of the present study was to investigate the experiences of senior managers during the COVID-19 crisis. METHODS: This is a descriptive qualitative research. Data were collected using in-depth and semi-structured individual interviews. Accordingly, 20 senior managers of medical universities with experience in managing the COVID-19 crisis were enrolled in the study using purposive sampling. Data were collected from February 2020 to May 2021. For data analysis, qualitative content analytical approach was used. RESULTS: According to the results, 4 main themes and 10 sub-themes were obtained; they included dealing with issues and challenges in the face of COVID-19 disease (Structural challenges, Cultural challenges, Educational challenges, COVID-19 complexity); individual and managerial competencies (Individual competencies, Managerial competencies); comprehensive, accountable, and efficient management (Comprehensive and accountable management, efficient management); and professional and organizational self-efficacy (Professional self-efficacy, organizational self-efficacy) were obtained. CONCLUSIONS: In the present study, a number of senior managers' experiences in the COVID-19 crisis management were identified. Managers and policymakers of the health system are suggested to use the results of the present study to effectively manage the crisis and improve crisis management in various health-related areas by providing an effective cultural and organizational context.

A comparative study on the quality of life and resilience of mothers with disabled and neurotypically developing children in Iran.

BACKGROUND: Mothers who take care of their disabled children usually suffer from several problems, such as physical, psychological, and social problems. The disability of children can also directly impress the quality of their mothers' lives. This study is going to check out how the disability of children affects the quality of life of the mothers. OBJECTIVE: This study was conducted to compare the quality of life and resilience of mothers with disabled and typically developed children in Fasa, Iran. METHODS: The subjects of this cross-sectional study were 240 mothers (120 mothers having disabled children and 120 mothers with typically developed children) referring to Fasa State Health Centers and Fasa State Welfare Office. They were randomly selected and included in the study. All samples were collected by the convenience sampling method. The data were collected by using the World Health Organization Quality-of-Life Scale (WHOQOL-BREF) and the Connor-Davidson Resilience Scale (CD-RISC). The collected data were then analyzed by the SPSS (v.22) software. The results of the descriptive statistics, Chi-square, independent t-test, and Pearson correlation coefficient were at a significant value of P < 0.05. RESULTS: The mean score of quality of life of mothers with disabled children on physical, psychological, social, and environmental domains was lower than that of mothers with neurotypically and statistically significant (p < 0.05); however, the mean scores on the resilience of mothers in both groups were not significantly different (p = 0.43).The results of the linear regression analysis showed that, having a disabled child (P < 0.001, t = 10.141), level of education (P < 0.001, t = 2.031), and resilience (P < 0.001, t = 8.205) affect the quality of life. The lower the education level is, the lower the quality of life. And higher resilience increases the quality of life. CONCLUSION: The quality of life of mothers with disabled children was lower compared to mothers with typically developed children, but there was no difference between mothers' resiliency in these two groups. These results suggest the necessity to provide supportive and therapeutic programs for improving the quality of life of mothers with disabled children.

Telenursing home care and COVID-19: a qualitative study.

BACKGROUND: The COVID-19 pandemic has led to many challenges such as increased number of patients and the risk of the disease progress in the world's healthcare systems, especially nursing. The capacity of technology can help nursing in such conditions. The aim of this study was to explore the lived experiences of patients with COVID-19 with home care by using telenursing. METHODS: The present study is a qualitative research conducted using the descriptive phenomenological method. The participants were selected using purposive sampling method and considering the inclusion and exclusion criteria. After obtaining ethical approval, data were collected through semistructured interviews. Open-ended questions and follow-up were used in the interviews. The interviews were conducted using Skype application and telephone. All data were recorded, and MAXQDA software was used to manage the data. Data analysis was performed using Colaizzi's seven-step method. Lincoln and Guba's criteria were used to evaluate the trustworthiness of the data. RESULTS: The main themes and their subthemes included 'facilitators' (improvement of relationships, adequate education and counselling, adequate care and support, improvement and promotion of health) and 'barriers' (lack of previous knowledge and experience, infrastructure problems, confusion in hospital programmes and the pressure caused by the COVID-19 pandemic). CONCLUSION: Given the potential capacity of telenursing, strong field studies are recommended to be conducted in this area. The results of such studies can contribute to the rapid and serious use of telenursing in the area of care, education, support, follow-up and counselling of patients.

Development and Testing of the Psychometric Properties of the Attitude Towards Medical Device-related Pressure Ulcers/Injuries Questionnaire.

BACKGROUND: Medical device-related pressure ulcers/injuries (MDRPU/Is) are a serious concern in health care. PURPOSE: To develop and assess the psychometric testing of a questionnaire to measure nursing students' attitudes about the care and prevention of MDRPU/Is. METHODS: Based on a review of the literature, a 26-item questionnaire was developed; face validity was assessed by ten (10) nursing students. The modified Lawshe's model was used, and both the content validity index (CVI) and content validity ratio were calculated. Items with a CVI more than 0.63 were retained. The minimum optimal CVI for the new instrument was 79%. Qualitative assessments were performed by 10 experienced faculty members. One-hundred-and-eighty seven (187) nursing students participated in the construct validity testing of the 11-item questionnaire. The Kaiser-Meyer-Olkin test of sampling adequacy and Bartlett's test of sphericity were performed. Following analysis of the main components and the varimax rotation, the factor analysis was determined. Internal consistency (Cronbach's alpha) and test-retest were determined using Pearson's correlation and intraclass correlation coefficient to evaluate reliability. RESULTS: During the face validity phase of the initial 26 items, 7 items had impact scores less than 1.5. After calculating the CVI and content validity ratio for all items, 8 items did not achieve the desirable score. After performing exploratory factor analysis on the remaining 11 items, the Kaiser-Meyer-Olkin test value was 0.789, and Bartlett's test of sphericity was 0.0001, which was statistically significant. Internal consistency of items (Cronbach's alpha of 0.77) showed that all items had a high correlation. The reliability of test-retest was significant using an intraclass correlation coefficient of 0.75 and Pearson's correlation coefficient of 0.86 at P < .005. CONCLUSION: In this sample of nursing students, the Attitude Towards Medical-device Related Pressure Ulcers/Injuries Questionnaire was valid and reliable. Studies including licensed clinicians are needed to confirm these results.

The Lived Experience of Nurses Caring for Patients with COVID-19 in Iran: A Phenomenological Study.

OBJECTIVE: This study aimed to explore the lived experiences of nurses caring for patients with COVID-19 in Iran. METHODS: This study was a descriptive phenomenology. Sampling was purposefully performed, and participants were selected in terms of the inclusion criteria. Data were collected through semi-structured interviews using the WhatsApp mobile messaging application. Colaizzi's method was used to analyse the data. The criteria introduced by Lincoln and Guba were used for the study rigour. RESULTS: The data were obtained from 12 nurses caring for patients with COVID-19. The mean age of the participants was 29.41 years (SD = 2.72) with a mean work experience of 6.75 years (SD = 2.52). Three main themes and six subthemes were identified: mental condition (subthemes included "anxiety and stress" and "fear"), emotional condition (subthemes included "suffering and affliction" and "waiting for death"), and care context (subthemes included "turmoil" and "lack of support and equipment"). CONCLUSION: The results of this study show that nurses working in the wards and care centres designated for patients with COVID-19 are experiencing mental and emotional distress and are working in inadequate professional conditions.

The Effectiveness of Teaching Nursing Ethics via Scenarios and Group Discussion in Nurses' Adherence to Ethical Codes and Patients' Satisfaction with Nurses' Performance.

BACKGROUND: There are shortcomings in nurses' adherence to ethical principles in practice. The present study aims to investigate the effectiveness of teaching nursing ethics via scenario-based learning and group discussion in nurses' adherence to codes of ethics and patients' satisfaction with nurses' performance. METHODS: Using a quasiexperimental design, the present study employed questionnaires which measure nurses' compliance with nursing codes of ethics and patients' satisfaction with nursing care before, immediately after, and one month after intervention. The collected data were analyzed using the independent t-test, ANOVA, and chi-square test in SPSS v.22. The level of significance was set at p < 0.05. The nurses (n = 80) and patients (n = 160) from various units of two university hospitals in the south-west of Iran participated in the present study. RESULTS: The pretest mean scores of the intervention and control groups in patient rights and patients' satisfaction with nursing care were not significantly different (p=0.07, p=0.21). Yet, there were statistically significant differences between the groups' mean scores as calculated immediately after (p < 0.001, p < 0.001) and one month after intervention (p < 0.001, p < 0.001). CONCLUSION: Employment of new approaches to teach nursing ethical principles improves compliance with nursing ethical codes and patients' satisfaction with nurses' performance.

The Effectiveness of Peer Group-Based Training on the Outcomes of Patients Undergoing Transradial Coronary Angiography.

INTRODUCTION: Coronary artery angiography using radial artery is one of the methods used for diagnosis of coronary artery disease, which causes physical and psychological problems in patients despite its precise and definite diagnosis. The present study is aimed at investigating the effect of peer group-based education on physical and psychological outcomes of patients undergoing coronary artery angiography through the radial artery. Methodology. The present clinical study was conducted on 60 patients undergoing coronary angiography through the radial artery in Vali-e-Asr educational hospital of Fasa during 2018 to 2019. The participants were divided into peer training and control groups (n = 30 in each group) using permutated block randomization. In the peer training group, the patients received the necessary precare training through peer training during and after angiography care. In the control group, the patients received the routine care by the nurse of the related ward. The peer group's stress, anxiety, and depression levels were evaluated before and after the training. Indeed, their comfort, tolerance, satisfaction, and pain levels were measured by a nurse after angiography at the time of entering the ward. Findings. The results indicated no significant difference between the two groups regarding the mean scores of stress, anxiety, and depression before the intervention (p > 0.05). After the intervention, however, there was a significant difference between the two groups concerning the mean score of anxiety (p < 0.05). Nonetheless, no significant difference was found between the two groups in terms of tolerance, comfort, satisfaction, and pain levels (p > 0.05). Finally, the level of pain decreased in both groups over time (p < 0.001). CONCLUSION: Peer group-based training was effective in decreasing the mean score of anxiety in the patients undergoing coronary angiography. Thus, this method is recommended to be utilized alongside other methods to train patients before coronary angiography due to its inexpensiveness and lack of side effects as well as not increasing the nurses' workload.

Efficacy of complementary interventions for management of anxiety in patients undergoing coronary angiography: A rapid systematic review.

Coronary angiography (CAG) is an invasive and anxiety-provoking procedure for many patients. Psychological problems, especially anxiety, are the main concern of nurses taking care of these patients before the procedure. This rapid systematic review aimed to assess the efficacy of interventions for management of anxiety in patients undergoing CAG. In this study, all published, peer-reviewed, English-language interventional studies from 2009 to 2018 were identified in a search of Scopus, PubMed, and Google Scholar databases. The relevant studies were assessed using a quality assessment checklist. All included studies were assessed by 2 researchers. Finally, 15 studies with 1,312 participants that evaluated the effects of complementary methods on management of anxiety in patients undergoing CAG were included. The findings of this rapid systematic review suggested that complementary and nonpharmacological methods, such as music therapy, reflexology, Benson's relaxation technique, aromatherapy, guided imagery, and yoga, could be used effectively for management of anxiety in patients undergoing CAG.

Efficacy of Eye Movement Desensitization and Reprocessing on the Quality of Life in Patients with Major Depressive Disorder: A Randomized Clinical Trial.

INTRODUCTION: The present study was conducted with the aim of investigating the efficacy of eye movement desensitization and reprocessing (EMDR) on the quality of life (QOL) in patients with major depressive disorder (MDD). METHODS: This is a randomized clinical trial study that investigated the efficacy of EMDR on the QOL in patients with MDD. In this study, all patients suffered from psychological trauma were currently in a major depressive episode and had a history of depression. 70 patients with MDD were selected through convenience sampling. Patients were then assigned to two groups of intervention and control (35 patients in each group). The assignment was performed randomly. For the intervention group, EMDR were performed in eight 90 mins sessions over 3 weeks. For the control group, no intervention was considered. Data on the QOL were collected using the WHO Quality of Life-BREF instrument before and after the treatment, and analysed using descriptive tests, paired t-test, independent t-test, and chi-square with SPSS v19. RESULTS: This study showed that the QOL in all its domains (physical health, psychological health, social relationships and environments) was significantly improved in patients with MDD in the intervention group after 8 sessions of EMDR. The post-treatment effect for the EMDR condition was 2.11, with a confidence interval of 1.3 to 2.7. Another finding of this study was that there was a statistically significant difference in the QOL scores in patients in the control group before and after the treatment; however, the mean difference in the intervention group was more than the control. CONCLUSION: The results of this study showed that EMDR were effective on the QOL in patients with major depressive disorder, and improved individuals' QOL and all its domains. Treatment team members may use this technique as an effective and supportive one to improve the QOL in patients.

A model to explain self-medication by Iranian people: a qualitative grounded theory study.

BACKGROUND: Self-medication (SM) is a common and global health problem. The process of attempting SM is still unclear. Exploration of SM and its contributing factors would help policymakers design and develop preventive programs. This qualitative study aimed to explore the process of attempting SM among Iranian people. METHODS: This grounded theory (GT) study was conducted among people with the experience of attempting SM (n = 17) and medical staff (n = 9) in Iran selected via semi-structured interviews. The recorded and transcribed interviews were analyzed using open, axial, and selective coding based on Strauss and Corbin's (1998) approach. RESULTS: The study results revealed that people sought to deal as simply and quickly as possible with their illnesses/symptoms according to their attitudes towards and perceptions of illnesses/symptoms as well as their economic and social problems. This simple and quick approach was the participants' main concern, resulting in taking decision-making strategies as SM facilitators. SM, in turn, provided short-term improvement and temporary satisfaction as a predominant outcome. Overall, "to avoid being trapped in the vortex of illness" was the central category, which covered and connected all the other categories developed in this study. CONCLUSIONS: The elements of this model could be used as a guide for healthcare policymakers to design preventive programs and to plan for increasing people's knowledge about the complications and consequences of SM. In addition, identification of barriers to referral to physicians and treatment of illnesses through the right way as well as reducing the health system's problems would help reduce SM.

The Effect of Eye Movement Desensitization and Reprocessing (EMDR) on the severity of suicidal thoughts in patients with major depressive disorder: a randomized controlled trial.

OBJECTIVE: Depression is a major risk factor for suicide and more than 90% of people who attempt suicide suffer from depression. The present study aimed to investigate the effect of eye movement desensitization and reprocessing (EMDR) therapy on the severity of suicidal thoughts in patients with major depressive disorder. STUDY DESIGN: Randomized Clinical Trial. METHODS: This clinical trial was performed on 70 people with major depressive disorder who exhibited suicidal thoughts. The patients were selected via convenience sampling and were randomly divided into control (n=35) and experimental (n=35) groups. EMDR was performed individually in the experimental group for 45-90 min, 3 days per week, on alternate days, for 3 weeks (9 sessions in total), whereas the controls group received routine treatment without intervention. Both groups completed the Beck Scale for Suicide Ideation (BSSI) at pre- and post-test. The obtained data were analyzed with descriptive and inferential statistics using SPSS 22 (α=0.05). RESULTS: Mean BSSI score for the experimental group was reduced significantly at post-test (11.11±4.15) compared to pre-test (26.48±5.74) (p<0.001). Although the control group's mean BSSI score was also reduced at post-test (24.93±4.42) compared to pre-test (26.68±5.05), this difference was not statistically significant (p>0.05). CONCLUSION: EMDR therapy has been shown in this study to reduce the severity of suicidal feelings. Therefore, it can be recommended as an alternative treatment method for reducing the severity of suicidal thoughts in patients with major depressive disorder.

The efficacy of interventions for back pain in patients after transfemoral coronary angiography: A rapid systematic review.

Coronary angiography is a gold standard tool for diagnosis of coronary artery disease. After this test, patients are restricted in bed to prevent vascular complications. Immobilization and bed rest can cause back pain in these patients. The objective of this rapid systematic review is to assess the efficacy of interventions for reducing back pain after transfemoral coronary angiography. All published, peer-reviewed, English-language interventional studies from 1990 to 2017 were identified in a search of Scopus, PubMed, and CINAHL databases. Relevant studies were surveyed with experimental and quasiexperimental designs that assessed the interventions for reducing back pain after coronary angiography. Data were extracted from studies and assessed. Totally 9 studies with 1062 participants which evaluated the interventions for reducing back pain after coronary angiography were included. The findings of these studies suggest that early ambulation and modified positioning were effective to reduce back pain in patients undergoing coronary angiography. The use of early ambulation 2-4 hours after angiography and changing the patients' position along with modified positioning cause a reduction in the back pain of the patients.

Experiences of self-medication among people: a qualitative meta-synthesis.

BACKGROUND: Self-medication is one of the major health-related problems in the world, which causes many problems for people and health systems. No comprehensive qualitative meta-synthesis has been done to understand the perceptions and experiences of self-medication among people. OBJECTIVES: This study aimed to analyze, re-interpret, and synthesize the existing qualitative studies on perceptions and experiences of self-medication among people around the world. METHODS: In this meta-synthesis, all published qualitative studies in PubMed, Scopus, CINAHL, and Web of Science databases were searched in May 2018. A total of 543 articles were screened in the primary stage and finally five articles that met the inclusion criteria were included in the meta-synthesis. The included studies were analyzed using Noblit & Hare approach. RESULTS: Initially, 115 codes were identified. In the second stage, the codes were merged based on similarity and shared meanings. Finally, after checking by two authors, the following five themes were emerged: cost-effectiveness, affectivity, inefficiency of the healthcare system, previous experiences, and oversimplification. CONCLUSION: The findings of this first meta-synthesis provided a comprehensive understanding of the perceptions and experiences of self-medication around the world. The findings showed that the experiences of self-medication could be classified into personal, social, organizational, and cultural categories. These findings could help policymakers address these perceptions and experiences in effective health planning.

Moving Into Action: The Master Key to Patient Education.

BACKGROUND: Illness and hospitalization are situations that increase the need for assistance and education. Poor education is currently the most common source of patient complaints in the health sector in Iran. PURPOSE: The aim of this study was to explore the perspectives and recommendations of nurses to improve patient education. METHODS: This research followed a qualitative exploratory design with a qualitative content analysis approach. The study participants, including eight head nurses and 16 staff nurses, were selected through purposive sampling. The data were collected through semistructured interviews, focus group sessions, and observations during 2016. RESULTS: Coding and analysis of the data generated one main theme, two subthemes, and four categories. The subthemes were "strengthen total commitment" and "reconstructing the infrastructure," and the categories were "developing motivational factors," "facilitating change by every impetus," "systematizing activities," and "contextual promotion." CONCLUSIONS: Study findings provide a complete picture of patient education and challenge managers to develop new strategies to plan and implement appropriate changes.