Innovative cultural care training: the impact of flipped classroom methods on critical cultural competencies in psychiatric nursing: a quasi-experimental study.

INTRODUCTION: Healthcare systems are encountering a growing number of diverse and multicultural clients due to globalization and migration. To effectively address the challenges associated with cross-cultural interactions, nurses require a comprehensive framework of critical cultural competencies. One potential approach to enhancing these competencies in mental health care settings is to use innovative methods such as the flipped classroom in cultural care training programs. This study evaluated the effect of using the flipped classroom method in cultural care training on the critical cultural competencies of nurses working in a psychiatric hospital. METHODS: This quasi-experimental study involved 70 nurses working in a psychiatric hospital affiliated with the Kerman University of Medical Sciences in southeastern Iran. Through random sampling, the nurses were allocated into two groups of intervention (n = 35) and control (n = 35). The intervention group participated in a cultural care training program using the flipped classroom method, which consisted of four sessions conducted over a four-week period. To evaluate the nurses' critical cultural competence, the Almutairi's Critical Cultural Competence Scale was administered before the training and again one month later. RESULTS: The study findings indicated no significant differences in the scores of critical cultural competencies between the intervention group (4.53 ± 0.64) and the control group (4.73 ± 0.42) during the pre-test stage (t = 1.53, p = 0.13). Both groups had a similar perception of critical cultural competencies, which was not particularly positive. However, in the posttest stage, the intervention group (5.33 ± 0.49) demonstrated a significant increase in critical cultural competencies compared to the control group (4.75 ± 0.44) (t = 5.14, p = 0.001). CONCLUSION: The study results indicated that the use of the flipped classroom method in the cultural care training program effectively enhanced the critical cultural competencies of nurses. Given the importance of cultural care in both physical and psychiatric care settings for multicultural clients, it is crucial for nurses to receive ongoing in-service education that utilizes innovative and active methods such as the flipped classroom.

Using mindfulness-based stress reduction group therapy to reduce perceived stress of vulnerable women in south of Iran.

Provision of educational and health services to vulnerable women in drop-in centers can reduce their traumas. Mindfulness-Based Stress Reduction (MBSR) group therapy is a psychological intervention to reduce perceived stress these women. This quasi-experimental study aimed to evaluate the effectiveness of MBSR group therapy in the perceived stress of 63 vulnerable women who referred to two drop-in centers in southeastern Iran. The participants were assigned into the intervention (n = 30) and control (n = 33) groups. The intervention group members were required to attend the MBSR intervention held in eight 90-minute sessions. Perceived Stress Scale (PSS) was administered to collect data before and one month after the MBSR. Based on the findings, the pre-test scores of perceived stress were not significantly different between the intervention (38.16 ± 6.04) and control (39.06 ± 5.30) groups (t = -0.62, p = 0.53). However, the perceived stress scores reduced significantly in the intervention group (30.20 ± 2.89) than the control group scores (37.96 ± 4.18) in the posttest (t = -8.35, P = 0.001). Given the significant reduction of perceived stress in participants after attending the MBSR group therapy, expert counselors, psychologists, and psychiatrists are recommended to conduct this therapy to reduce perceived stress in vulnerable women.

Improving Cultural Competence and Self-Efficacy Among Postgraduate Nursing Students: Results of an Online Cultural Care Training Program.

INTRODUCTION: Since nurses and nursing students interact with culturally diverse clients in health care settings, training programs are required to improve cultural competence and self-efficacy among them. This study aimed to investigate the effect of an online cultural care training program on cultural competence and self-efficacy among postgraduate nursing students. METHODS: The present interventional study used random sampling to allocate 80 postgraduate nursing students into the intervention and control groups. Cultural care training program was held for the intervention group. RESULTS: No significant difference in cultural competence and self-efficacy scores was found between the intervention and control groups in the pretest. However, the intervention group scored higher in terms of cultural competence and self-efficacy after the intervention. DISCUSSION: Given cultural diversity and prevalence of medical tourism, nursing instructors need to pay special attention to cultural care education at all academic levels.

Psychological wellbeing, family cohesion, and purposeful life in male prisoners: A cross-sectional study.

Background: Psychological wellbeing, family cohesion, and purposeful life are important determinants of the prisoners' overall wellbeing and health; therefore, their evaluation is extremely important in prisoners as a vulnerable group. Objective: This study evaluated psychological wellbeing, family cohesion, purposeful life, and their correlations in male prisoners. Methods: This cross-sectional study used simple random sampling to select 259 male prisoners. Data were collected using questionnaires of Ryff psychological wellbeing, Fischer family cohesion, and Crumbaugh and Maholick purpose in life. Results: Majority of (78%) the participants were 20-40 years old and married (59%). The mean scores of psychological wellbeing, family cohesion, and purposeful life of the male prisoners were moderate. Psychological wellbeing was directly correlated to family cohesion in male prisoners, but it had no significant correlation with a purposeful life. Family cohesion was not significantly correlated to a purposeful life. Conclusion: Regarding the moderate level of psychological wellbeing in prisoners, it is suggested to pay more attention to educational and supportive programs in prisons for promoting such indicators in prisoners.

The Effect of Emotional Disclosure by Writing on the Depression of Hemodialysis Patients in Iran: A Randomized Clinical Trial.

Introduction: Depression is the most common psychological problem in patients with renal failure, and it can lead to mortality in severe cases. Effective interventions are required to promote mental health in patients on hemodialysis with various types of mental disorders. The current study aimed to evaluate the effect of emotional disclosure by writing on depression of patients on hemodialysis in Iran. Methods: This clinical trial study was carried out on 140 patients undergoing hemodialysis in hemodialysis centers of Kerman. Patients were randomly assigned into two groups of intervention and control after signing the written consent forms and completing the Depression Anxiety Stress Scale (DASS 21). The intervention group was requested to write daily the deepest emotions and intrusive thoughts within 15 to 20 minutes in four consecutive days. The control group received routine care. Then, the questionnaire was recompleted two weeks later. Finally, the data were analyzed by SPSS (version 13) using independent t-test and paired t-test. Results: The mean depression score was either moderate or high. While depression scores seemed to decrease in the intervention group after the intervention, the depression scores continued to rise following the intervention in the control group. The difference in depression scores was statistically significant between the two groups before and after the intervention. Conclusion: Emotional disclosure by writing can be effective on the level of depression in patients on hemodialysis.Simus adi omnimodipsa sam fugita dolenistiae inveles est doluptat.

The effect of mindfulness-based stress reduction on resilience of vulnerable women at drop-in centers in the southeast of Iran.

BACKGROUND: Female sex workers and addicted women are among the vulnerable groups who impose high costs on the health system of every society. They are prone to psychological problems such as anxiety, stress, and reduced resilience due to their lifestyles. Since mindfulness-based stress reduction (MBSR) has been applied frequently by many psychotherapists to treat stress and anxiety, the present study investigated the effectiveness of MBSR on resilience of the vulnerable women. METHODS: The statistical population of this quasi-experimental study consisted of all eligible women who referred to the drop-in centers in Kerman in the southeast of Iran. Followed by random sampling, 63 vulnerable women were randomly assigned into the intervention (n = 30) and control (n = 33) groups. The MBSR intervention was conducted for the intervention group in eight 90-min sessions. Demographic information questionnaire and Connor-Davidson resilience scale were administered to collect data prior to and one month after the MBSR intervention. RESULTS: The pre-test resilience score was not significantly different between the intervention (53.40 ± 10.49) and the control (54.5 ± 9.27) groups (t = 0.43, p = 0.66). However, the posttest resilience score in the intervention group (60.66 ± 6.71) was significantly higher than the control group (53.88 ± 7.54) (t = 3.58, P = 0.001). Moreover, a comparison between the pretest and posttest scores revealed a significant decrease in resilience scores of the control group (t = 2.81, p = 0.009). CONCLUSION: Since MBSR intervention increased resilience of the vulnerable women in the intervention group, researchers, managers, counselors, community health nurses, and psychiatric nurses are suggested to implement related interventions to promote the health of women, especially vulnerable ones.

The Effectiveness of a Time Management Workshop on Job Stress of Nurses Working in Emergency Departments: An Experimental Study.

INTRODUCTION: One of the main risk factors for poor health is a high level of job stress. Time management skills can greatly reduce job stress. The current study aimed to evaluate the effectiveness of a one-time management training workshop on job stress among nurses working in emergency departments. METHODS: This randomized experimental study was carried out with 80 nurses working in emergency departments affiliated with a university of medical sciences. The intervention was an 8-hour workshop on time management. Pre- and posttest data were collected by demographic questionnaire and an occupational stress inventory before and 1 month after intervention. Data were analyzed using descriptive, chi-square, t test, Fisher exact, and analysis of covariance statistics. RESULTS: The mean of job stress in the intervention group increased after the intervention (186.22, SD = 22.97) from baseline (182.52, SD = 34.39) compared with the mean of job stress in the control group (204.42, SD = 22.42) and (204.35, SD = 22.45). The control group had a significantly higher job stress score before the intervention (t = -3.37, P = 0.001). There was no statistically significant difference between the intervention and control group in job stress scores after intervention (t = -3.56, P = 0.77). DISCUSSION: The time management skills training program did not reduce the moderate-high levels of job stress of nurses in emergency departments. Addressing other sources of job stress, besides time management, is needed.

Nurses' perceptions of systems thinking and safe nursing care: A cross-sectional study.

AIM: To assess nurses' perceptions of systems thinking, safe nursing care and the correlation between them. BACKGROUND: Systems thinking and safe nursing care are the key elements of quality improvement approaches, such as accreditation and patient safety programmes. However, these two variables have not been well studied in different health care settings. METHODS: In this cross-sectional study, 300 nurses were selected using the stratified random sampling method. The data were collected using a demographic data form, systems thinking scale and assessment of safe nursing care questionnaire. RESULTS: The scores of nurses' perceptions of systems thinking (63.25 ± 9.20) and safe nursing care (4.13 ± 0.60) were above average. A positive correlation was found between systems thinking and safe nursing care (r = .66, p < .001), and its dimensions: nursing skills (r = .61, p < .001), psychological needs (r = .56, p < .001), physical needs (r = .51, p < .001) and teamwork (r = .56, p < .001). CONCLUSION: Regarding the correlation between systems thinking and safe nursing care, nurses and other medical professionals, especially novices, are recommended to strengthen their systems thinking skills to improve the safe nursing care. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should deal with organisational condition and factors affecting some poor aspects of systems thinking and safe nursing care. They must lead, support and allocate resources to the foundations of systems thinking to achieve safe nursing care.

Correction to: The effect of transactional analysis on the self-esteem of imprisoned women: a clinical trial.

Following publication of the original article [1], the authors advised that the name of the 4th author had been submitted incorrectly; the author has the family name 'Pouraboli', however, their article was originally published with the family name (mis) spelled as 'Pouraboili'.

Promoting drug abuse preventive behaviors in adolescent students based on the health belief model.

BACKGROUND: Nowadays, drug abuse is one of the most important health problems that can affect the quality of life of people in mental, psychological, physical, and social dimensions. Theory-based education can help the adolescents to promote their drug abuse preventive behaviors. OBJECTIVES: The aim of this study was to determine the effectiveness of education based on the health belief model (HBM) on drug abuse preventive behaviors in adolescent students. METHODS: This study was an interventional quasi-experimental study with a pre-test/post-test design conducted in two high schools in the southeast of Iran. A two-step cluster sampling method was used and 120 students were randomly selected and categorized into the control (n = 60) and intervention (n = 60) groups. The intervention group participated in an education program based on the HBM in four 75-min sessions. Data were collected using demographic and drug abuse preventive behavior questionnaires based on the HBM. RESULTS: In the pre-test stage, the mean scores of drug abuse preventive behaviors and its dimensions were not significantly different between the intervention and control groups (t = -2.597 p = 0.641). In the post-test stage, the mean scores of the intervention and control groups were significantly different; the drug abuse preventive behaviors and its dimensions improved in the intervention group (t = 14.57, p < 0.001). CONCLUSION: The findings showed that education based on the HBM had a significant effect on drug abuse preventive behaviors and its dimensions. Therefore, educational packages based on the HBM are recommended to improve these behaviors in adolescents.

The effect of anger management skills training on anger status of the people with HIV.

PURPOSE: This study investigated the effect of anger management skills training on the anger status of people with HIV. DESIGN AND METHODS: This interventional study was conducted on 60 people with HIV. The intervention group was trained on anger management skills. Data were collected using Spielberger's State-Trait Anger Expression Inventory-II. FINDINGS: The intervention group's training on anger management skills showed a significant reduction in mean scores of the state-trait anger, and anger expression as well as a significant increase in mean scores of anger control-out and anger control-in. PRACTICE IMPLICATIONS: Expert counselors, psychologists, community health, and psychiatric nurses are recommended to train anger management skills to people with HIV.

The effect of transactional analysis on the self-esteem of imprisoned women: a clinical trial.

BACKGROUND: The imprisoned women usually have low self-esteem and suffer from various physical and mental complaints; they may suffer from feelings of emptiness, isolation, and depression. Transactional analysis (TA) is part of a comprehensive system attributed to the individual and social psychiatry for personal development of self-esteem among the imprisoned women. Therefore, the present study aimed to investigate the effect of TA group-training on the self-esteem of imprisoned women. METHODS: This clinical trial was conducted among the imprisoned women in a prison in Southeastern Iran using pretest-posttest design. In this regard, 76 women were randomly allocated to the intervention (n = 35) and control (n = 41) groups. The TA group-training program was held for eight 90-min sessions for the intervention group. Data were collected using a demographic questionnaire and the Rosenberg's self-esteem scale (RSES). Later, all participants were evaluated before and 1 month after the intervention. RESULTS: In pre-test, the mean scores of self-esteem were 11.8 ± 4.67 and 7.97 ± 4.52 for the intervention and control groups, respectively. These scores showed low levels of self-esteem and the difference between the two groups was significant (p = 0.001, t = - 3.61). In the post-test, the mean scores of self-esteem improved to the moderate level (22 ± 2.52) in the intervention group compared to the control group (8.92 ± 4.04). This indicates the significant improvement of self-esteem in the intervention group (p = 0.001, t = 17.15). CONCLUSIONS: The results showed that TA group-training had a significant effect on self-esteem. Therefore, the experienced and expert counselors and psychologists are recommended to hold transactional analysis group-training courses to enhance self-esteem among women prisoners. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20170725035289N5 Date registered: 25/08/2018.

Promoting the psychosocial and communication aspects of nursing care quality using time management skills training.

BACKGROUND: Although using time management skills is a major component of nursing professional practice, they have not received much attention. Time management training can improve the psychological and communication aspects of nursing care quality. Therefore, this study aimed to evaluate the effect of time management skills training on the psychosocial and communication aspects of nursing care quality. MATERIALS AND METHODS: This semi-experimental study was conducted at Valiasr Hospital of Shahr Babak City, Kerman Province, in the Southeast of Iran, during 2018. The study population consisted of 100 nurses who were randomly assigned to one of the two groups: an intervention group or a control group. To identify and measure the outcomes, nurses' perceptions of the psychosocial and communication aspects of care quality were first assessed by the Quality Patient Care Scale (Qualpacs) at pretest. Then, the intervention group received the 2 days of training on time management skills for 12 h. The posttest outcome data were collected from both the groups 1 month after the intervention. RESULTS: No statistically significant differences were observed between the two groups with respect to the total mean scores of nursing care quality and its psychosocial and communication aspects before the intervention (t = 1.96, P = 0.09). However, there was a statistically significant difference between the two groups in this regard after the intervention, and the mean nursing care quality scores and its related aspects were improved in the intervention group (t = 5.76, P < 0.0001). CONCLUSIONS: The time management skills training could significantly improve psychosocial and communication aspects of nursing care quality. Health-care managers should allocate facilities to clinical training programs so that health-care professionals can acquire the time management skills. The higher effectiveness of time management training can be determined by its application in diverse domains of health care.

The effectiveness of empathy training on the empathy skills of nurses working in intensive care units.

BACKGROUND: Empathy is an essential condition for effective nursing care. An empathetic relationship between the nurse and the patient leads to positive therapeutic outcomes, increases nurses' adjustment in educational and therapeutic environments and influences their ethical sensitivities. AIMS: The current study aimed to determine the effectiveness of empathy training on the empathy skills of nurses working in intensive care units of Shahid Bahonar Hospital in Kerman, Iran. METHODS: This experimental study was conducted on nurses working in intensive care units of Shahid Bahonar Hospital affiliated to Kerman University of Medical Sciences in Iran. All nurses working in intensive care units of Shahid Bahonar Hospital were selected by randomised sampling. Data were collected by the Davis Empathy Scale (possible range 0-105) and analysed using descriptive statistics and analysis of variance. RESULTS: Comparison of the mean empathy scores showed the mean scores of empathy skills in the control group were 63.45 ± 8.102 and 63.54 ± 8.05 in the pre- and post-test, respectively, which was not significantly different. But the mean scores of empathy skills in the Experimental group were 63.40 ± 8.136 and 67.7 ± 9.027 in the pre- and post-test, respectively, which showed a significant increase (p < 0.05). CONCLUSIONS: The present intervention showed the effectiveness of empathy training on the empathy skills of nurses. Empathy can be acquired and learned.

Improving the professional competency of psychiatric nurses: Results of a stress inoculation training program.

It is essential to conduct cognitive-behavioral interventions on nurses' professional competency. The present study aimed to evaluate the impact of a stress inoculation training (SIT) on professional competency of psychiatric nurses. This was an experimental study, in which 70 psychiatric nurses were allocated to two intervention and control groups (35 in each group) using cluster random design. A SIT program was conducted for the intervention group. Data were gathered by competency inventory for registered nurse (CIRN) before and one month after SIT. The participants in the intervention group reported higher scores on professional competency and its dimensions compared to those in the control group one month after SIT. The increased scores of professional competency and its dimensions after using the SIT implied the effectiveness of this method in enhancing the professional competences of psychiatric nurses. The higher efficiency of SIT can be determined by its application in diverse domains of medical professions.

Relationship between adaptation and self-esteem in addicted female prisoners in the south east of Iran.

Background Reduction of the adaptation and self-esteem can be the consequence of opium addiction and imprisonment. Drug use causes inappropriate behaviors in women, which are quite different from those in men. Social deviations, prostitution, high-risk sexual behaviors, abortion, divorce and imprisonment followed by loss of self-esteem are the consequences of women's addiction. The present study was conducted to assess the relationship between adaptation and self-esteem in addicted female prisoners. Methods In this descriptive analytical study, 130 addicted female prisoners were selected from a prison in the south east of Iran using census sampling. The data were collected by a demographic questionnaire, the Rosenberg's self-esteem scale and the bell adjustment inventory (BAI). Results According to the results, women's adaptation fell into the 'very unsatisfactory' range. The highest mean was related to the emotional dimension, while the lowest mean was in terms of the health dimension. In total, 96.4% of the participating women had low adaptation. The mean total self-esteem fell into the low range; in fact, 84.6% of the women had a low self-esteem. The results showed no significant relationships between adaptation and self-esteem in these women; however, self-esteem was significantly and inversely related to health and emotional adaptation. Conclusion The findings showed that the majority of the women had unsatisfactory adaptation as well as poor self-esteem. No significant relationships were observed between adaptation and self-esteem in the addicted female prisoners.