Effect of educating health promotion strategies model on self-care self-efficacy in elderly with kidney transplantation.

BACKGROUND: After kidney transplantation, older adults encounter numerous problems which can negatively affect their self-care self-efficacy. According to studies, behavior modeling training has an effect on patient's self-care. Therefore, the present study was conducted to determine the effect of implementing health promotion strategies on self-care self-efficacy in older adults undergoing kidney transplantation. MATERIALS AND METHODS: This quasi-experimental study was conducted on 60 older adults undergoing kidney transplantation in Tehran's Shahid Doctor Labbafinejad Hospital in 2020. Patients were randomly divided into intervention and control groups by using block randomization method. For the patients of the intervention group, the educations were provided based on the model of individual health promotion strategies in eight sessions (i.e., 8 weeks, one session per week) for 40-60 minutes. The subjects of the control group received only their routine care. The two groups completed on-line the self-care self-efficacy questionnaire, before, immediately after and one month after the intervention. The results were analyzed by Chi-square, t-test and repeated measures analysis of variance in SPSS v19. RESULTS: According to the results, no significant difference was observed between the two groups in terms of demographic characteristics and the mean score of self-care self-efficacy before the intervention (P > 0.05). The mean score of self-care self-efficacy (P = 0.001) and some of its dimensions including stress reduction (P = 0.01) and adaptability (P = 0.01) was significantly different in the two groups in the three time intervals. Moreover, the two dimensions of decision making (P = 0.07) and enjoying the life (P = 0.20) were not significant. CONCLUSION: According to the results, education based on health promotion strategies can effectively improve self-care self-efficacy and some its dimensions. Therefore, teaching health promotion strategies as a low-cost and simple method can positively affect self-care self-efficacy in older adults undergoing kidney transplantation.

The effects of Rosa damascene aromatherapy on anxiety and sleep quality in burn patients: A randomized clinical trial.

INTRODUCTION AND OBJECTIVE: Sleep disorders and anxiety are common problems in burn patients, and aromatherapy is a common complementary treatment in medicine. The aim of this study was to determine the effects of aromatherapy with the inhalation of rose essential oil on anxiety and sleep quality in burn patients. MATERIALS AND METHODS: This randomized controlled clinical trial was performed on 60 patients admitted to the Valiasr Hospital B in Arak from March 2021 to the end of July 2021. The patients were chosen by the convenience sampling method and then randomly divided into the intervention and control groups based on the block randomization method (six blocks). Aromatherapy along with the routine care was provided to the participants of the intervention group for three consecutive nights. These participants inhaled five drops of 40 % rose essential oil. The members of the control group also inhaled five drops of distilled water as a placebo. In both groups, anxiety and sleep quality were assessed using the St. Mary's Hospital Sleep Quality Questionnaire (SMHSQ) and the Spielberger State-Trait Anxiety Inventory (STAI), respectively, before and after the intervention. RESULTS: The sleep quality scores of the intervention and control groups after the intervention were 17.88 ± 2.04 and 26.11. 3.31, respectively, showing a statistically significant difference (P < 0.05). Our results also showed a statistically significant difference in the anxiety score between the intervention and control groups after aromatherapy (P < 0.05). RESULTS: Rose essential oil aromatherapy reduced anxiety and improved sleep quality in burn patients, suggesting this approach as a useful complementary method along with other therapeutic measures in these patients.

The barriers and facilitators of developing clinical competence among master's graduates of gerontological nursing: a qualitative descriptive study.

BACKGROUND: Clinical competence development is a main goal of specialized nursing courses. Nonetheless, some master's graduates of gerontological nursing programs have inadequate Clinical competence. The aim of this study was to explore the barriers and the facilitators to clinical competence development among the master's graduates of gerontological nursing. METHOD: This qualitative descriptive study was conducted in 2020. Participants were twenty nursing master's students, master's graduates, and instructors of gerontological nursing. They were purposively selected from several faculties of nursing and midwifery in Tehran, Isfahan, and Kashan, Iran. Semi-structured interviews were held for data collection and the conventional content analysis proposed by Graneheim and Lundman was used for data analysis. Data were managed using the MAXQDA 10 software. RESULTS: The main barriers to clinical competence development were students' neglectfulness towards learning, inefficiency of educational system, and ineffective management. The main facilitators to clinical competence development were effective educational planning and management improvement. CONCLUSION: There are different personal, educational, and managerial barriers and facilitators to clinical competence development among master's graduates of gerontological nursing. Effective educational planning and management improvement are needed for clinical competence development among master's students and graduates of gerontological nursing.

The safety of a novel single-drape cover for sterile back tables in the operating room compared to the standard two-drape method: an experimental study.

BACKGROUND: Covering the prepared sterile back tables (PSBTs) during periods of nonuse and during active surgeries may decrease contamination of sterile surgical instruments that have direct contact to surgical wound. The Association of periOperative Registered Nurses (AORN) declared that an easy method for covering and removing the drape will ultimately be most effective (e.g. standard two-drape method). Hence, this study was designed to test the hypothesis that using a novel single-drape cover had more efficiency and safety in decreasing airborne bacteria-carrying particles (ABCPs) settling on the PSBTs during static and dynamic periods than the standard two-drape method. METHODS: This experimental study was conducted with using 918 agar plates to detect contamination of the PSBTs with ABCPs on two conditions (static and dynamic) at an academic medical center in Kashan, Iran, from September 25, 2021, to January 20, 2022. The contamination of PSBTs was evaluated by 6 agar settle plates (n = 918 in total) on each PSBT in static and dynamic operating room (OR) conditions. At each time-point, this set-up was repeated on two occasions else during data collection, establishing 81 PSBTs in total. Tested groups included the PSBTs covered with the standard two-drape method, the novel single-drape cover, or no cover. The plates were collected after 15, 30, 45, 60, 120, 180, 240 min and 24 h. The primary outcome measured was comparison of mean bioburden of ABCPs settling on covered PSBTs on two conditions by using agar settle plates. The secondary outcomes measured were to determine the role of covering in decreasing contamination of PSBTs and the estimation of time-dependent surgical instrument contamination in the uncovered PSBTs on two conditions by using agar settle plates. RESULTS: Covering the PSBTs during static and dynamic OR conditions lead to a significantly decreased bioburden of ABCPs on them (P < 0.05). No differences were seen between the standard two-drape method and the novel single-drape cover (P > 0.05). CONCLUSIONS: We found that there is no preference for using the novel single-drape cover than the standard two-drape method. Our results showed a significant decrease in bioburden of ABCPs on the PSBTs when those were covered during static and dynamic OR conditions, indicating the efficiency for covering the PSBTs during periods of nonuse and during active surgery.

The effect of the Alexander Technique on pain intensity in patients with chronic low back pain: A randomized controlled trial.

OBJECTIVE: The present study was performed to determine the effect of the Alexander Technique on the intensity of pain in patients with chronic low back pain (LBP). METHODS: This study is a clinical trial that was performed on 80 patients with chronic LBP in Kashan, Iran. Participants were randomly assigned in control and intervention groups. To assess the participants' LBP, a visual analog scale of pain (VAS-Pain) was completed by both groups. In the intervention group, in addition to routine care for LBP patients, the Alexander Technique was performed in three 60-min sessions per week for 12 weeks. The control group participants received routine care for LBP patients. The two groups completed the VAS-Pain scale immediately after and one month after the intervention. RESULTS: The results showed that there was no statistically significant difference between the two groups in terms of demographic characteristics and mean pain intensity score before the intervention (p > 0.05). Immediately after and then one month after the intervention, there was statistically significant differences between the two groups regarding the mean scores of pain (p < 0.05). The results of repeated measures ANOVA showed that, in the intervention group, the mean score of pain had decreased over time (p < 0.05). CONCLUSION: The results of the present study showed that the Alexander Technique was effective in reducing the intensity of pain among the participants. We recommend the Alexander Technique as a useful and effective intervention for reducing chronic LBP.

The effect of Swedish massage on pain in rheumatoid arthritis patients: A randomized controlled trial.

BACKGROUND AND PURPOSE: Joint pain is one of the most common symptoms in rheumatoid arthritis patients and require medical attention. The purpose of this study was to assess the effects of Swedish massage on pain and painkiller consumption in rheumatoid arthritis patients. MATERIALS AND METHODS: A total of 60 patients participated in the experiment, with half assigned to the control group (n = 30) and half to the experimental (n = 30) group using the block randomization method. On patients in the experimental group, a 30-min Swedish massage was performed regularly for eight weeks: twice a week for the first four weeks, and three times a week for the last four weeks. The control group received routine care. The visual analogue scale-pain was used to measure pain in the two groups at three points of time: before the beginning of the experiment, immediately after the last session, and one month after the last session of the intervention. RESULTS: The analysis of covariance showed that there were significant differences between the two groups' mean scores of pain and painkiller consumption immediately after and one month after the last session of the intervention (p = 0.01). Furthermore, in the experimental group, the mean scores of pain and painkiller consumption decreased over the three points of time (p < 0.05). CONCLUSION: Swedish massage can be effective in reducing pain and the need to use painkillers in rheumatoid arthritis patients.

Clinical competence in nursing: A hybrid concept analysis.

BACKGROUND: Clinical competence (CC) is central issue in nursing. There are some controversies about this concept that needs further investigation. The present study was conducted to analyze the concept of clinical competence in nursing. METHODS: This concept analysis was conducted using the three-phase hybrid model. In the theoretical phase, the Science Direct, PubMed, CINAHL, ProQuest, Scopus, Web of Science, SID, Iranmedex, and Magiran databases were searched to retrieve articles published from 2000 to 2020. Forty two eligible articles were included and analyzed. In the fieldwork phase, semi-structured interviews were held with eighteen university lecturers, clinical instructors, students, and hospital nurses and the data were analyzed through conventional content analysis. In the final analytic phase, the findings of the first and the second phases were combined. RESULTS: The majority of literature defined CC in nursing as a combination of knowledge, and skills, and attitudes that is consistent with those of the fieldwork phase. Most participants in fieldwork stated that gaining CC is a process that is achieved over time through practice and repetition and increasing experience. A nurse needs to acquire personal, social and professional competencies during the study and work period. The CC has antecedents of efficient education, and organizational support. It also has consequences for patients and nurses such as satisfaction, and quality care. CONCLUSION: CC is a continuous process of obtaining knowledge, values, and attitudes, and skills such as critical thinking skills that brings creativity and innovation in nursing practice.

Workplace Conflicts Among Emergency Department Nurses: Instrument Development and Psychometric Properties.

BACKGROUND AND PURPOSE: Conflicts in nursing workplace are frequent and can be resolved by individuals or groups. The purpose of this study was to develop a valid and reliable measure for the Workplace Conflicts among Emergency Department Nurses (WCEDN). METHODS: A three-stage mixed methods study was conducted: (a) In-depth interviews with emergency department (ED) nurses were performed and themes were extracted from the data (b) Findings of the content analysis in combination with results of a literature review were examined, and preliminary instrument items were developed. The initial instrument comprised 50 items. (c) Content validity, face validity, content validity ratio, content validity index, and construct validity using exploratory factor analysis were performed. RESULTS: Subscales in the final instrument included Intrapersonal Conflict, Intragroup Conflict, Intergroup Conflict, and Causes of Conflict. Reliability of the instrument was .86, and the feasibility was 96.8%. CONCLUSIONS: The final 40-item WCEDN demonstrated strong psychometric properties.

The effects of foot reflexology on depression during menopause: A randomized controlled clinical trial.

OBJECTIVE: The purpose of this study was to determine the effects of foot reflexology on depression during menopause. DESIGN: Randomized controlled clinical trial. SETTING: Gynecology outpatient clinic. INTERVENTIONS: We enrolled 90 menopausal women with depression. Participants were assigned to the intervention (n = 45) and control (n = 45) groups by block randomization. Participants in the intervention group received 15 min of foot reflexology on each foot for a total of 30 min in evenings, twice a week for six weeks. Participants in the control group received only the routine care for menopause patients. MAIN OUTCOME MEASURES: The Beck Depression questionnaire was completed by all participants at the beginning of the trial and the end of the intervention and two months after completion of the intervention. RESULTS: A total of 121 patients were assessed for eligibility to participate in the study. One-hundred patients met the criteria to participate, and 90 participants-45 participants in each group-completed the study. In the intervention group, the mean scores of depression before, immediately after, and two months after the study were 26.97 ± 4.47 (95% CI = 25.3-28.3), 22.55 ± 5.18 (95% CI = 20.9-24.1), and 21.20 ± 5.74 (95% CI = 19.4-22.9), respectively. In the control group, these scores were 26.15 ± 5.01 (95% CI = 24.6-27.6), 26.22 ± 5.14 (95% CI = 24.7-27.7), and 26.66 ± 3.87 (95%CI = 25.5-27.8), respectively. Using Repeated Measures ANOVA, the comparison of the mean scores of depression in the two groups indicated that the scores were decreased over time. CONCLUSION: The findings indicated that the foot reflexology technique can be effective for reducing women's depression during menopause. However, considering the study's limitations, including a small sample size and no intervention in the control group, more studies are needed to verify the findings.

Psychometric Testing of the Persian Version of the Perceived Perioperative Competence Scale-Revised.

The clinical competence of nursing students in operating room (OR) is an important issue in nursing education. The purpose of this study was to evaluate the psychometric properties of the Persian Perceived Perioperative Competence Scale-Revised (PPCS-R) instrument. This cross-sectional study was conducted across 12 universities in Iran. The psychometric properties and factor structure of the PPCS-R for OR students was examined. Based on the results of factor analysis, seven items were removed from the original version of the scale. The fitness indices of the Persian scale include comparative fit index (CFI) = .90, goodness-of-fit-index (GFI) = .86, adjusted goodness-of-fit index (AGFI) = .90, normed fit index (NFI) = .84, and root mean square error of approximation (RMSEA) = .04. High validity and reliability indicated the scale's value for measuring perceived perioperative competence of Iranian OR students.

Religious Practices and Self-Care in Iranian Patients with Type 2 Diabetes.

This study aimed to examine the relationship between religious practices and self-care of patients with type 2 diabetes. A descriptive cross-sectional survey was conducted on 154 diabetic patients who were referred to two general teaching hospitals in Qom City (Iran). Data were collected using demographic questionnaire, private and public religious practices, and summary of diabetes self-care activities questionnaires. Data were analyzed using descriptive statistics and statistical tests including independent t test, and Pearson correlation coefficient. Significant positive correlations were observed between religious practices and self-care activities in diabetic patients (p < 0.05). Significant positive correlations were also found between some religious practices and self-care activities subscales (p < 0.05). Healthcare providers should be aware of the role that religion plays in the lives of diabetic patients and be able to take religious factors into account when developing care plans. Doing so will enhance a more patient-centered approach and thereby support patients in their role as self-care decision-makers.