The effect of participation in support groups on retirement syndrome in older adults.

BACKGROUND: Retirement and aging are phenomena that often occur simultaneously and lead to various physical and psychological changes in older adults. Retirement syndrome consists of symptoms such as feelings of emptiness, loneliness, uselessness, lack of clear understanding of future conditions and dissatisfaction with one's performance after retirement. This phenomenon requires interventions to adapt to these changes. Considering the supportive role of nurses, the formation of support groups as an effective intervention in adapting to transitional stages is emphasized. AIMS: This study aims to investigate the effect of older adults' participation in support groups on retirement syndrome. METHODS: This Quasi-experimental study recruited a total of 80 retired older adults meeting the inclusion criteria from three Retirement Associations (Retirement centers for social security retirees are among the institutions that have been set up by the government and this organization to provide face-to-face and offline services to social security retirees, as well as providing some facilities to this segment of the society). in Iran, Research samples were randomly assigned to two intervention and control groups. The demographic questionnaire and retirement syndrome questionnaire were completed by both groups at the beginning of the study. Then, four support group sessions lasting 60 to 90 min were held twice a week for the support group, and eight weeks after the end of the intervention, the questionnaires were completed for both groups. The data were analyzed using statistical tests in SPSS version 16. The significance level was set at p < 0.05 for all tests. RESULTS: The results of the covariance analysis showed that after the intervention, the feelings of helplessness and failure (p < 0.001), feelings of older and idleness (p = 0.027), and feelings of confusion and conflict (p = 0.002) were significantly less in the support group compared to the control group. In addition, the Feeling of trying and new direction (p < 0.001) was higher after the intervention. The paired t-test results showed that in the support group, the feelings of helplessness and failure (p < 0.001), feelings of older and idleness (p = 0.004), and feelings of confusion and conflict (p < 0.001) significantly decreased after the intervention compared to before it, while the feelings of trying and new direction (p = 0.004) significantly increased. Therefore, the results showed that after the intervention, there was a statistically significant difference between the two groups in all components of the retirement syndrome. CONCLUSION: The results of this study show that participation of retired older adults in support groups can significantly improve all components of retirement syndrome, leading to an improvement in their quality of life and satisfaction.

The effects of simulated video education about falling on falling rate and fear of falling among hospitalized elderly people: a randomized clinical trial.

BACKGROUND AND AIM: Management of falling and its consequences is a major challenge of elderly nursing care. An effective educational strategy is essential to prevent falling among elderly people. The aim of this study was to evaluate the effects of simulated video education (SVE) about falling on falling rate and fear of falling (FOF) among hospitalized elderly people. METHODS: This randomized controlled clinical trial was conducted from May 2021 to February 2022. Participants were 132 elderly people conveniently selected from a leading hospital in Qom, Iran, and randomly allocated to an intervention and a control group through block randomization. Data collection instruments were a demographic and clinical questionnaire, a researcher-made falling rate questionnaire, and the Falls Efficacy Scale-International. Participants in the intervention group individually watched three simulated videos (fifteen minutes in total) and had access to the videos for frequent watching. Their FOF was assessed on the first day of hospitalization, hospital discharge, and one and three months after hospital discharge. The data were analyzed at a significance level of less than 0.05 using the SPSS software (v. 16.0). RESULTS: Groups did not significantly differ from each other respecting baseline demographic and clinical characteristics (P > 0.05). After the intervention, falling rate in the intervention group was 46% less than the control group (incidence rate ratio = 0.5454, 95% CI = 0.307-0.968; P = 0.039). Moreover, the posttest mean score of FOF in the intervention group was significantly less than the control group (P < 0.001). CONCLUSION: SVE is effective in significantly reducing falling rate and FOF. Context-based SVE is recommended to reduce falling rate and FOF among hospitalized elderly people. CLINICAL TRIAL REGISTRATION: The effects of simulated video education about falling on falling rate and fear of falling among hospitalized elderly people. CLINICAL TRIAL REGISTRATION: this research was registered (17/09/2021) in the https://www.irct.ir with registration number: IRCT20210910052427N1).

Relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals.

BACKGROUND: The quality of care has a significant impact on the condition of elderly patients. Many factors affect the quality of care, including ethical considerations. Ethical considerations, such as moral sensitivity, change in times of crisis. The present study was conducted to assess the relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals. METHODS: This was a cross-sectional descriptive correlational study. The participants included 445 nurses that were selected by quota sampling method from hospitals admitting COVID-19 patients. The data were collected using the Moral Sensitivity Questionnaire (MSQ) and Quality Patient Care Scale (QUALPAC) as self-reports. We used the SPSS software v.16 for statistical analysis. RESULTS: The total score of moral sensitivity and quality of care was 52.29 ± 16.44 and 2.83 ± 0.23, respectively. Moral sensitivity negatively correlates with psychological, social, and physical aspects (P < 0.05). Modifying autonomy, interpersonal orientation, and experiencing moral conflict predicted ß = 0.10 of the psychosocial aspect of quality of care. Structural moral meaning and expressing benevolence predicted the changes in the physical dimension of quality of care (ß = 0.02). CONCLUSION: The quality of care had a significant inverse correlation with moral sensitivity. Multiple regression analysis showed that modifying autonomy, interpersonal orientation, and experiencing moral conflict could predict the psychosocial dimensions. Structuring moral meaning could predict the physical dimension. The communication aspects were not related to any of the dimensions of moral sensitivity.

Effect of educational program based on theory of planned behavior on osteoporosis preventive behaviors: a randomized clinical trial.

BACKGROUND: The prevalence of chronic diseases is increasing worldwide. Implementing educational programs is an important step in prevention of chronic diseases in the community setting. This study was conducted to assess the effect of educational program based on the Theory of Planned Behavior (TPB) on the osteoporosis preventive behaviors in middle-aged individuals. METHODS: A randomized clinical trial was conducted on 64 middle-aged individuals presenting to primary care centers. A researcher-made questionnaire developed according to "a guide for compiling and analyzing the questionnaire based on TPB" was used for data collection. Random block sampling was applied to assign participants to control and intervention groups after ensuring the validity and reliability. An educational program on osteoporosis prevention was conducted in six educational sessions based on the TPB constructs for the intervention group in primary care centers. Control group received routine education about lifestyle changes including osteoporosis by primary care centers. Eight weeks after the intervention, the questionnaires were completed again and the data were analyzed using the SPSS V16 software. RESULTS: Independent t-test found no significant difference in the mean score of knowledge, osteoporosis preventive behavior, attitude, subjective norms, perceived behavioral control and behavioral intention between intervention and control groups before intervention (p > 0.05). After the intervention, however, a significant difference was found in the mean score of knowledge, attitude, subjective norms, perceived behavioral control and behavioral intention between the cases in intervention and control groups (P < 0.05). In addition, based on repeated measurement ANOVA, the intervention had a significant effect on knowledge, preventive behaviors, attitude, subjective norms, perceived behavioral control, and behavioral intention (P < 0.05). CONCLUSIONS: The results of the present study showed that implementation of an educational intervention based on the Theory of Planned Behavior significantly increased the knowledge along with all constructs of TPB in osteoporosis preventive behaviors. TRIAL REGISTRATION: This study was registered in the Iranian Registry of Clinical Trials IRCT2017081735647N2 (11/10/2017).

Exploring nursing managers' perceptions of nursing workforce management during the outbreak of COVID-19: a content analysis study.

BACKGROUND: The COVID-19 pandemic is a serious threat to public health worldwide. Therefore, a coordinated global response is needed to prepare health care systems to face this unprecedented challenge. Proper human resource management can increase nurses' productivity and quality of care. Therefore, the present study aims to explore the nursing managers' perception of nursing workforce management during the outbreak of COVID-19. METHODS: This is a qualitative study with conventional content analysis using Granheim and Landman approach. In this study, 15 nursing managers were selected by purposeful sampling method. Data were collected using in-depth semi-structured interviews. Ethical considerations were applied to all stages of the study. In this study, MAXQDA software version 10 was used to help manage the data. RESULTS: 66% of the participants (10/5) were female. The mean age of participants was 44 years, mean work experience of 19 years, and mean management experience of 9 years. Three categories and seven sub-categories emerged from the data analysis: 1) management of workforce recruitment (volunteer workforces, non-volunteer workforces), 2) management of workforce arrangement (flexible work schedule, rearrangement of the workforce), and 3) management of workforce retention (preventive measures, motivational measures, and psychological support). CONCLUSION: Management in critical situations requires the use of flexible and situational management principles to recruit, arrange and retain workforce, and also to compensate for the lack of manpower.

Accreditation of nursing clinical services: Development of an appraisal tool.

Aim: This study aimed to determine comprehensive and applicable indicators for assessing the quality of nursing clinical services. Design: Methodological research. Methods: The checklist was designed in three phases (conceptualization, item generation and item reduction). In the first phase, a qualitative study using conventional content analysis was performed to clarify the concept of accreditation of clinical nursing services. In the second phase, using the views of experts was obtained in phase 1 and then by a review of the literature, related items were extracted, and item pool was formed. In the last phase, validity and reliability of the checklist were examined. Result: Based on three phases (Conceptualization, Item Generation and Item Reduction), the accreditation indicators of clinical nursing services were extracted in three dimensions including structure, process and outcome at two levels of organizational (including structural and outcome indicators) and individual performance appraisal (process indicators) in 19 main categories.

Significant influencing factors and practical solutions in improvement of clinical nursing services: a Delphi study.

BACKGROUND: Clinical services evaluation with specific indicators are very helpful to identify improvable points. This study was conducted to analyze the factors affecting the quality of clinical nursing services and offer practical solutions for accreditation of clinical nursing services. METHODS: The present study was conducted using Delphi method with two rounds. At the beginning of the study a questionnaire was prepared using results of another project (clinical nursing services audit). This questionnaire was sent to 47 nursing and accreditation professionals. After the first round, causes and solutions were categorized. Then participants were asked to comment on the significance of each strategy on the prepared questionnaire. RESULTS: In the first round of Delphi in response to the question about the main causes and solutions of low quality of nursing clinical services, 394 causes and 212 solutions were mentioned by the participants. In the second round, considering moralists and specialization in the selection of nursing managers, staffing according to workload and attendance in comprehensive exam after graduation and before entering clinical fields attained the most importance. CONCLUSION: Mismatch of human resources with workload and lack of clarity with regard to duties have maximum correlation with poor quality of care. Organizational structure and communication program categories gained the highest and lowest importance respectively. This information could be used by nursing managers and policy makers to plan programs in order to improve the quality of clinical nursing services.

The Life Process of Children Who Survived the Manjil Earthquake: A Decaying or Renewing Process.

INTRODUCTION: Among earthquake survivors, children are more vulnerable than other age groups due to their exposure to harrowing scenes of devastation as well as their drastically new living situations that result from an earthquake disaster. The life process of children survivors undergoes many different changes that are affected by a wide range of factors. Understanding the life process of these children may lead to effective outcomes and interventions. In addition, observing children survivors establishes knowledge and understanding of the challenges that correspond with earthquake disasters. Further, observing this group may be further effective in decision-making and establishing types of assistance in similar circumstances. OBJECTIVES: This study was done to explain the life process of children who survived the earthquake of Manjil in northern side of Iran. Methods: This qualitative study is based on the grounded theory approach. The sampling involved purposive interviews with 12 children who survived the Manjil earthquake and were under 12 years of age at the time of the earthquake. The initial interviews were followed by continuous comparative analysis, and thus the sampling process adopted a theoretical trend. In the end, by the formation of categories and the central variable of the study, interviews were conducted with 16 subjects and sufficient data was provided. Data was collected through face-to-face, in-depth interviews using an interview guide. In order to enrich the categories formed in data analysis, we had also 6 telephone interviews with the same participants in order to complete missed needed information. Data collection began in 2015 and continued up until 2016. Data was analysed using the Strauss-Corbin approach. RESULTS: The life process of children earthquake survivors consists of 'unexpected encounter', 'transient relief activities' and 'long-lasting consequences'. The central variable of this study is 'the dark shadow of pain and the light shadow of life expectancy'. The life experience of this group of children is immersed in painful memories and varies under different conditions. DISCUSSION AND CONCLUSION: According to the results of this study, one of the factors affecting the lives of children earthquake survivors which could threaten their health is providing non-specific and transient services. Training relief staff to consider the specific needs of these children at the time of the rescue operation could contribute to improving their health level in various aspects. Considering the effective and comprehensive rehabilitation program in Disaster Management by policymakers can prevent permanent complications caused by earthquakes. Planning and taking action to identify misbehaviours in this group of children as well as raising public awareness, particularly for parents, on how to manage the outcomes of natural disasters are some of the most significant public health priorities. Providing public mental health services for parents and children who survive an earthquake helps to address potential psychological problems in this group of survivors.

Cultural Safety: An Evolutionary Concept Analysis.

Healing occurs in a safe milieu, and patients feel safe when service providers view them as whole persons, recognizing the multiple underlying factors that cause illness. Cultural safety can lead to service delivery in this way, but most nurses have no clear understanding of this concept. This study aimed to clarify cultural safety on the basis of Rodgers' evolutionary concept analysis. Cultural sensitivity and cultural awareness are the antecedents of cultural safety. These concepts include a nurse's flexibility toward his or her patients with different perspectives, creating an atmosphere free from intimidation and judgment of the patients, with an overall promotion of health in multicultural communities.

Findings From a Nursing Care Audit Based on the Nursing Process: A Descriptive Study.

BACKGROUND: Although using the nursing process improves nursing care quality, few studies have evaluated nursing performance in accordance with nursing process steps either nationally or internationally. OBJECTIVES: This study aimed to audit nursing care based on a nursing process model. PATIENTS AND METHODS: This was a cross-sectional descriptive study in which a nursing audit checklist was designed and validated for assessing nurses' compliance with nursing process. A total of 300 nurses from various clinical settings of Tehran university of medical sciences were selected. Data were analyzed using descriptive and inferential statistics, including frequencies, Pearson correlation coefficient and independent samples t-tests. RESULTS: The compliance rate of nursing process indicators was 79.71 ± 0.87. Mean compliance scores did not significantly differ by education level and gender. However, overall compliance scores were correlated with nurses' age (r = 0.26, P = 0.001) and work experience (r = 0.273, P = 0.001). CONCLUSIONS: Nursing process indicators can be used to audit nursing care. Such audits can be used as quality assurance tools.

Evolutionary concept analysis of health seeking behavior in nursing: a systematic review.

BACKGROUND: Although the research in health seeking behavior has been evolving, its concept remains ambiguous. Concept clarification, as a central basis of developing knowledge, plays an undeniable role in the formation of nursing sciences. As the initial step toward the development of theories and theoretical models, concept analysis is broadly used through which the goals can be used and tested. The aim of this study was to report an analysis of the concept of "health seeking behavior". METHOD: Employing a rigorous evolutionary concept analysis approach, the concept of health seeking behavior was examined for its implications, use, and significance in the discipline of nursing between 2000 and 2012. After applying inclusion and exclusion criteria, a total of 40 articles and 3 books were selected for the final analysis. RESULTS: The definition of attributes, antecedents, and consequences of health seeking behavior was performed through concept analysis. Core attributes (interactional, processing, intellectual, active, decision making based and measurable) were studied. The antecedents of concept were categorized as social, cultural, economic, disease pattern and issues related to health services. Health-seeking behavior resulted in health promotion and disease risk reduction. In addition, it led to predicting the future probable burden of the diseases, facilitation of the health status, early diagnosis, complete and effective treatment, and complication control. CONCLUSION: Health-seeking behavior, as a multi-dimensional concept, relies on time and context. An awareness of health-seeking behavior attributes antecedents and consequences results in promoting the status, importance and application of this concept in the nursing profession.

The effect of home-based cardiac rehabilitation program on self efficacy of patients referred to cardiac rehabilitation center.

BACKGROUND: The prevalence of coronary heart disease is increasing worldwide contributing to mortality and morbidity of millions of people. Cardiac rehabilitation is an interdisciplinary activity with the aim of facilitating and improving the physical, psychological and emotional state of the patients with cardiac complications. This study aimed to evaluate the probable positive effects of continuing cardiac rehabilitation programs at home on self-efficacy of the patients with cardiac complications. METHOD: In a randomized controlled trial, 80 patients referred to rehabilitation center from Feb 2009 to Jan 2010 were randomly divided into case and control groups. Both groups received routine cardiac rehabilitation programs in the rehabilitation center. In addition, the case group received education and practical training in various rehabilitation measures along with home visits of a community health nurse throughout the follow-up period. General Self Efficacy Scale (GSES) was used to assess self-efficacy between two groups at baseline and follow-up periods. Collected data from GSES questionnaires were analyzed using Minitab software and repeated measurement analysis model. RESULTS: No first time (before beginning of rehabilitation program) GESE differences were observed between case (26.36 ± 0.84) and control (28.53 ± 0.54) groups (P = 0.44). In the final measurement, GESE in case group was 36.59 ± 5.65 vs. 26.5 ± 0.91 in the control group. There was a statistically significant difference in self-efficacy between two groups and in different measurements (P = 0.000). CONCLUSION: Home-based cardiac rehabilitation has a positive effect on patients' self-efficacy and therefore it is recommended for the patients suffering from heart diseases. TRIAL REGISTRATION: RCT registration number: IRCT201106086747N1.

General health improves with home-based cardiac rehabilitation program.

OBJECTIVE: To determine whether continuing cardiac rehabilitation programs at home has positive effects on psychological and general health of the participants' in comparison with the control group. METHODS: This randomized controlled trial was conducted in Tabriz Shahid Madani rehabilitation center, Tabriz, Iran between February 2009 and January 2010. Eighty patients referred to the rehabilitation center were randomly divided into case and control groups. Both groups received routine cardiac rehabilitation program in the rehabilitation center. In addition, the case group received education and practical training in various rehabilitation measures along with home visits of a community health nurse in follow-up period. General Health Questionnaire (GHQ-28) was used to assess psychological and general health between the 2 groups at baseline and on follow-up period. Collected data from the GHQ-28 were analyzed using Minitab software and repeated measurement analysis model. RESULTS: In this study, 75% (n=60) of participants were male and 25% (n=20) were female with an age range of 57.41+/- 1.01 years (mean+/- SE). The results showed statistical significant difference in general health (p=0.000) between the 2 groups and in different measurements (p=0.000). CONCLUSION: Home-based cardiac rehabilitation has a positive effect on patients' general health, thus referring patients who suffer from heart diseases is recommended.