The Effect of Spiritual Group Therapy on the Quality of Life and Empowerment of Women with Breast Cancer: A Randomized Clinical Trial in Iran.

This randomized clinical trial was carried out on 74 women with breast cancer between May 2015 and April 2016 in the south of Iran. The patients were selected using a simple sampling method and randomly divided into an intervention (n = 30) and a control (n = 37) group. Five spiritual therapy sessions were conducted for the intervention group. Each session lasted one hour. The quality of life and empowerment of the patients were measured before and one month after the intervention. To collect data, four instruments were used, including a demographic information form, the European Organization for Research and Treatment of Cancer QOL questionnaire Cancer-30 (EORTC QLQ C-30), EORTC QLQ Breast-23 (EORTC QLQ-BR23), and the Cancer Empowerment Questionnaire (CEQ). After the intervention, a difference was observed between the groups concerning the mean score of general health (P = 0.016) and emotional function (P = 0.029), but there was no significant difference between the groups concerning the mean score of empowerment (P = 0.62). Thus, it appears that spiritual group therapy can improve the quality of life of this group of patients.IRCT registration number: IRCT 2014050417546N2.

Care self-efficacy in adolescents with mental disorders: A qualitative study.

BACKGROUND: The promotion of health in adolescents with mental disorders depends on their levels of self-care empowerment. Self-efficacy is a significant prerequisite for successful self-management and behavior change in adolescents with mental disorders. The present study was conducted to explain the concept of care self-efficacy in adolescents with mental disorders. MATERIALS AND METHODS: This qualitative study was carried out using the conventional content analysis approach. Semi-structured interviews (n = 34) were conducted with adolescents having mental disorders, their families, and healthcare providers. The participants were selected from neurology and psychiatry clinics affiliated with University of Medical Sciences using the purposeful sampling method in 2021. Data were analyzed according to Graneheim and Lundman method. RESULTS: According to the findings of content analysis, four main themes were derived from the data: "health information-seeking behavior," "adaptation of life to the disease and treatment conditions," "adaptive coping," and "social self-care." CONCLUSION: Based on the findings, the promotion of adaptive styles and social support is effective in acquiring social competencies. As a result, policymakers are suggested to design health-oriented educational programs based on care self-efficacy principles to promote health in adolescents with mental disorders.

Designing and psychometric properties of the hospitalized patients' spiritual needs questionnaire (HPSNQ) in the medical-surgical hospital setting.

BACKGROUND: The evaluation of spiritual requirements in patients can facilitate the delivery of spiritual care as an essential element of holistic healthcare. The objective of this research was to develop and evaluate the psychometric properties of a questionnaire on patients' spiritual needs in medical-surgical hospital settings. METHODS: This research utilized an exploratory sequential design, involving the creation of a pool of items through both inductive and deductive methods. The questionnaire's psychometric properties were then assessed using various techniques, such as face and content validity, item analysis, construct validity, internal consistency, stability, confirmatory factor analysis, and the Gradual Response Model of Samejima. The data analysis was conducted using MPLUS software, version 5.1. RESULTS: The study's results showed that a four-factor structure (interpersonal connectedness, relationship with God, transcendence, and peaceful environment) with 43 items was successfully extracted through exploratory factor analysis. The confirmatory factor analysis supported the findings of the exploratory factor analysis. The Cronbach's alpha coefficients for the scale and factors ranged between 0.83 and 0.95. Furthermore, the interclass correlation coefficients for the scale and factors were between 0.89 and 0.96. CONCLUSIONS: The questionnaire designed in this study is a reliable and valid instrument that can be utilized by healthcare, educational, and research institutions to evaluate the spiritual needs of patients in medical-surgical hospital settings.

Live experience of nursing students with internship program: A phenomenological study.

BACKGROUND AND AIM: The internship is a program for transition of nursing students to the clinical setting. This study was conducted to describe and interpret the experiences of nursing students from the internship program. MATERIALS AND METHODS: This was an interpretative phenomenological study following Van Menen's approach in six steps. Twelve nursing students were selected from 12 different universities in Iran from April to August 2020. Data was collected through 15 in-depth interviews (three supplementary interviews) over the course of 25-90 min and verbatim transcriptions. Data were analyzed with MAXQDA version 10 software. The researcher used four Guba and Lincoln criteria to obtain a rigorous study. RESULTS: In this study, three main themes and eight subthemes were extracted. The main themes included "professional identity development," "moving toward professional self-efficacy," and "developing coping strategies for workplace adversities." The subthemes were "promoting the cognition of profession," "acceptance among colleagues as a nurse," "accepting professional roles," "self-awareness of weaknesses in patient care," "self-reliance," "advancing clinical skills," "adopting effective coping strategies," and "avoiding tension in clinical settings." CONCLUSION: Nursing internship students have experienced moving toward professionalization with professional identity and self-efficacy development, and they succeeded in clinical challenges by learning coping approaches.

Critical Care Nurses' Adherence to Ethical Codes and Its Association with Spiritual Well-Being and Moral Sensitivity.

Background: Adherence to ethical codes is a major pillar of nursing care that is affected by various factors. Identifying these factors can lead to better ethical performance. The present study was conducted to determine critical care nurses' adherence to ethical codes and its association with spiritual well-being (SWB) and moral sensitivity (MS). Methods: In this descriptive-correlational study, data were collected using the moral sensitivity questionnaire (MSQ) by Lützén et al., Paloutzian and Ellison's spiritual well-being scale (SWBS), and the adherence to ethical codes questionnaire. The study was conducted on 298 nurses working in critical care units of hospitals affiliated with Shiraz University of Medical Sciences in southern Iran in 2019. This study was examined and approved by the Ethics Committee of Shiraz University of Medical Sciences. Results: The majority of the participants were female (76.2%) and single (60.1%), with a mean age of 30.69 ± 5.74 years. The mean scores of adherence to ethical codes, SWB, and MS were 64.06 (good), 91.94 (moderate), and 134.08 (moderate), respectively. Adherence to ethical codes had a positive correlation with the total score of SWB (P < 0.001, r = 0.25) and MS (P < 0.001, r = 0.27). A positive correlation was also observed between MS and SWB (P < 0.001, r = 0.41). Meanwhile, MS (ß = 0.21) had a greater effect than SWB (ß = 0.157) on adherence to ethical codes. Conclusion: Critical care nurses showed a good adherence to ethical codes. MS and SWB also positively affected their adherence to ethical codes. Nursing managers can use these findings to devise plans for the promotion of MS and SWB in nurses and thus help improve their ethical performance.

The effects of mobile-based education on nurse self-concept among nursing students: an embedded mixed methods study.

OBJECTIVES: This study evaluates the effects of mobile-based education (MBE) on nurse self-concept (NSC) among nursing students. METHODS: This embedded mixed methods study was conducted in 2020-2021 in a main quantitative phase and a supplementary qualitative phase. In the quantitative phase, a quasi-experimental study with the Solomon four-group design was conducted on 117 second-year nursing students of Shiraz University of Medical Sciences, Shiraz, Iran. 70 students in the first (C1: n=37) and the second (C2: n=33) semesters of the 2020 academic year were respectively considered as the control groups, and 40 students in the first semester of the 2021 academic year considered as the experimental groups (I1: n=20 and I2: n=20). Participants in the experimental groups received NSC-related MBE through an Android application, while their counterparts in the control groups received no NSC-related MBE. Cowin's Nurse Self-Concept Questionnaire was used to assess the NSC. In the qualitative phase, six students from the experimental groups were purposively selected and interviewed through face-to-face semi-structured interviews. Moreover, two focus group discussions were held with a six-person and a five-person group of students from the experimental groups. RESULTS: While the mean scores of NSC and its dimensions did not significantly change in the C1 group, the posttest mean scores of them in the E1 group were significantly greater than the corresponding pretest values (p<0.05), expect for the care dimension (p=0.586). Moreover, except for the care dimension (p>0.05), the posttest means scores of NSC and its other dimensions in the E1 and the E2 groups were significantly greater than the C1 and the C2 groups, respectively (p<0.05). Analysis of the qualitative data resulted in the generation of the main theme of multidimensional growth and development with three main categories, namely development of coping strategies, knowing professionalization strategies, and development of managerial potentials. CONCLUSIONS: NSC-related MBE is effective in improving nursing students' NSC.

Development and assessment of validity and reliability of a checklist to evaluate the Circulating and Scrub Skills of Operating Room Novices (CSSORN checklist).

BACKGROUND: Assessment of circulating and scrub skills is an important issue in operating room (OR) programs. However, there is a lack of well-designed tools that are specifically developed for this purpose. Hence, this study aimed to develop and determine the validity and reliability of a checklist to measure the circulating and scrub skills of OR novices. MATERIALS AND METHODS: This cross-sectional methodological study was conducted among 124 OR technology students who were selected during three consecutive academic years (2019-2020 to 2021-2022). The developed checklist was evaluated with face validity, content validity (quantitative and qualitative), construct validity (known-groups validity), criterion-related validity (concurrent and predictive validities), internal consistency (Kuder-Richardson 20, KR-20), and inter-rater reliability (intra-class correlation coefficient, ICC). Known-groups validity was evaluated by comparing the difference between the checklist scores of first-semester and third-semester students using independent samples t-test. Additionally, concurrent and predictive validities were evaluated by ICC through measuring the correlation between the total score of checklist and grades of a multiple-choice test and two clinical apprenticeship courses, respectively. Data were analyzed in the Statistical Package for Social Sciences software. RESULTS: After reconciling the preliminary checklist in terms of face and content validities, a checklist with 17 sub-scales and 340 items called "Circulating and Scrub Skills of Operating Room Novices (CSSORN)" was developed. Regarding the known-groups validity, the third-semester students had higher scores compared to the first-semester students (p < 0.001 in most sub-scales). Besides, the total score of checklist showed a significant correlation with the criteria of concurrent and predictive validities (ICC = 0.64, ICC = 0.72; P < 0.001). The KR-20 for the entire checklist was 0.90 (range: 0.60-0.93). The ICC for inter-rater reliability was also 0.96 for the entire checklist (range: 0.76-0.99, P < 0.001 in all sub-scales). CONCLUSION: The CSSORN had appropriate validity and reliability to be used for measuring the circulating and scrub skills of OR novices. To shed light on the findings, further testing of this checklist on larger populations and in different contexts is suggested.

Using objective structured clinical examination (OSCE) for circulating and scrub skills of first-semester operating room technology students: Is it valid and reliable?

Objectives: This study aimed to determine the validity and reliability of an Objective Structured Clinical Examination (OSCE) developed for the summative assessment of the practical credit of the course titled "Principles and Techniques of Circulating and Scrub Persons' Practice." Methods: This applied descriptive study was conducted on 63 first-semester undergraduate Operating Room (OR) technology students. Totally, 17 circulating and scrub skills were incorporated in four 7-min OSCE stations. The content validity of the examination was assessed by an expert panel (n = 14). Additionally, its concurrent validity was evaluated by Intra-Class Correlation (ICC) through measuring the correlation between the total score of OSCE and grade point average, grades of the practical and theoretical credits of the course that were obtained by multiple-choice tests, and the total grade of the course (achieved by the grades of the practical and theoretical credits tests). The Inter-Rater Reliability (IRR) was also calculated by the correlation between the scores recorded by two examiners at each OSCE station using ICC. Meanwhile, the internal consistency across stations (item-total correlation) and across items within a station was determined by Cronbach's alpha (α). Results: The OSCE was deemed to fulfill the content validity criteria. The total score of OSCE showed a significant correlation with the concurrent validity criteria (ICC = 0.66-0.85, p < 0.001). Besides, the IRR was significant for the total score of OSCE as well as for the score of each station (ICC = 0.90-0.98, p < 0.001). Likewise, a good level of internal consistency was found across stations (α = 0.63-0.93) and across items within a station (α = 0.78-0.92). Conclusion: The developed OSCE had appropriate validity and reliability. Thus, it can be used to assess the circulating and scrub skills of first-semester OR technology students.

The effects of mobile-based education on nurse self-concept among nursing students: an embedded mixed methods study / Los efectos de la educación basada en el móvil en el autoconcepto de las enfermeras entre los estudiantes de enfermería: un estudio de métodos mixtos integrados / Os efeitos da educação baseada em dispositivos móveis no autoconceito dos enfermeiros entre os estudantes de enfermagem: um estudo integrado de métodos mistos

Objective. This study evaluates the effects of mobile-based education (MBE) on nurse self-concept (NSC) among nursing students. Methods. This embedded mixed methods study was conducted in 2020­2021 in a main quantitative phase and a supplementary qualitative phase. In the quantitative phase, a quasi-experimental study with the Solomon four-group design was conducted on 117 second-year nursing students of Shiraz University of Medical Sciences, Shiraz, Iran. 70 students in the first (C1: n=37) and the second (C2: n=33) semesters of the 2020 academic year were respectively considered as the control groups, and 40 students in the first semester of the 2021 academic year considered as the experimental groups (I1: n=20 and I2: n=20). Participants in the experimental groups received NSC-related MBE through an Android application, while their counterparts in the control groups received no NSC-related MBE. Cowin's Nurse Self-Concept Questionnaire was used to assess the NSC. In the qualitative phase, six students from the experimental groups were purposively selected and interviewed through face-to-face semi-structured interviews. Moreover, two focus group discussions were held with a six-person and a five-person group of students from the experimental groups. Results. While the mean scores of NSC and its dimensions did not significantly change in the C1 group, the posttest mean scores of them in the E1 group were significantly greater than the corresponding pretest values (p<0.05), expect for the care dimension (p=0.586). Moreover, except for the care dimension (p>0.05), the posttest means scores of NSC and its other dimensions in the E1 and the E2 groups were significantly greater than the C1 and the C2 groups, respectively (p<0.05). Analysis of the qualitative data resulted in the generation of the main theme of multidimensional growth and development with three main categories, namely development of coping strategies, knowing professionalization strategies, and development of managerial potentials. Conclusion. NSC-related MBE is effective in improving nursing students' NSC.

Objetivo. Este estudio evalúa los efectos de la educación basada en el móvil (EBM) en el autoconcepto enfermero (ACE) entre los estudiantes de enfermería. Métodos. Estudio de métodos mixtos realizado entre los años 2020-2021 tuvo una fase cuantitativa principal y una fase cualitativa complementaria. En la fase cuantitativa se llevó a cabo un estudio cuasi-experimental con el diseño de cuatro grupos de Salomón en los que se asignaron 117 estudiantes de segundo año de enfermería de la Universidad de Ciencias Médicas de Shiraz, Irán. Participaron en los grupos de control 70 estudiantes: 37 del primer (C1) y 33 del segundo (C2) semestres del año académico 2020 y 40 estudiantes del primer semestre de 2021 como los grupos de intervención (I1: n=20, e I2: n=20). Los participantes de los grupos de intervención recibieron EMB relacionados con el CNS a través de una aplicación Android, mientras que sus homólogos de los grupos de control no recibieron este tipo de educación. Se utilizó el Cuestionario de Autoconcepto de Enfermería (ACE) de Cowin. En la fase cualitativa, se seleccionaron intencionadamente seis estudiantes de los grupos experimentales a quienes se les realizaron entrevistas semiestructuradas cara a cara. Además, se hicieron dos grupos de discusión con un grupo de seis y otro de cinco estudiantes de los grupos experimentales. Resultados. Mientras que las puntuaciones medias del ACE y sus dimensiones no cambiaron significativamente en el grupo C1, las puntuaciones medias pos-test de las mismas en el grupo I1 fueron significativamente mayores que los correspondientes valores pre-test (p<0.05), excepto para la dimensión de cuidado (p=0.586). Además, con excepción de la dimensión de atención (p>0.05), las puntuaciones medias pos-test de ACE y sus otras dimensiones en los grupos I1 y I2 fueron significativamente mayores que las de los grupos C1 y C2, respectivamente (p<0.05). El análisis de los datos cualitativos dio como resultado la generación del tema principal de crecimiento y desarrollo multidimensional con tres categorías principales: el desarrollo de estrategias de afrontamiento, el conocimiento de estrategias de profesionalización y el desarrollo de potenciales de gestión. Conclusión. La intervención EBM es eficaz para mejorar el ACE de los estudiantes de enfermería.

Objetivo. Avaliar os efeitos da educação baseada em dispositivos móveis (EBM) no autoconceito de enfermagem (ACE) entre estudantes de enfermagem da Shiraz University of Medical Sciences, Irã. Métodos. Estudo de métodos mistos que teve uma fase principal quantitativa e uma fase qualitativa complementar. Na fase quantitativa, foi realizado um estudo quase-experimental com o desenho de quatro grupos Solomon. 70 alunos participaram dos grupos de controle: 37 do primeiro (C1) e 33 do segundo (C2) semestre do ano letivo de 2020 e 40 alunos do primeiro semestre de 2021 como grupos de intervenção (I1: n=20, e I2: n=20). Apenas os participantes dos grupos de intervenção receberam EMBs relacionados à ACE por meio de um aplicativo Android. A escala de Cowin foi utilizada para avaliar o ACE. Na fase qualitativa, foram selecionados intencionalmente seis alunos dos grupos experimentais aos quais foram realizadas entrevistas semiestruturadas face a face. Além disso, foram feitos dois grupos de discussão (um de seis e outro de cinco) com alunos dos grupos experimentais. Resultados. Enquanto as pontuações médias do ACE e suas dimensões não mudaram significativamente no grupo C1, as pontuações médias pós-teste no grupo I1 foram significativamente maiores do que os valores pré-teste correspondentes (p<0.05), exceto para a dimensão do cuidado (p=0.586). Além disso, com exceção da dimensão atenção (p>0.05), as pontuações médias pós-teste do ACE e de suas outras dimensões nos grupos I1 e I2 foram significativamente maiores do que nos grupos C1 e C2, respectivamente (p<0.05). A análise dos dados qualitativos resultou na geração do tema principal crescimento e desenvolvimento multidimensional com três categorias principais: o desenvolvimento de estratégias de enfrentamento, o conhecimento de estratégias de profissionalização e o desenvolvimento de potenciais de gestão. Conclusão. A intervenção EBM foi eficaz em melhorar o ACE de estudantes de enfermagem.

Evaluation of the effectiveness of a training programme for nurses regarding augmentative and alternative communication with intubated patients using Kirkpatrick's model: A pilot study.

AIM: Communicating with conscious intubated patients who are unable to communicate verbally is one of the challenges faced by intensive care unit (ICU) nurses. The present study was conducted to evaluate the effectiveness of a training programme for nurses regarding augmentative and alternative communication (AAC) with intubated patients using Kirkpatrick's model. DESIGN: This study had a one-group, before-after, quasi-experimental design. METHODS: Totally, 45 nurses working in ICUs participated in a blended training programme using AAC strategies to communicate with intubated patients. Their contribution was evaluated based on Kirkpatrick's model at four levels. The study data were collected using the "satisfaction and ease questionnaire," "observation checklist" and "communication knowledge test." Then, the data were analysed using the SPSS 22 software and p < 0.05 was considered statistically significant. RESULTS: Most participants were satisfied with the implementation of the programme. The nurses' mean score of communication knowledge increased after the intervention (p < 0.05). The results of evaluation of the third and fourth levels of Kirkpatrick's model also showed an increase in the success of communication, use of AAC, and satisfaction with and ease of communication (p < 0.001). IMPLICATION: Short-term and long-term effects of the blended training programme about AAC were investigated using Kirkpatrick's model. The results indicated the positive effect of the programme on the quality of the nurses' communication with intubated patients, their understanding of the patients' messages and meeting the patients' needs at a more desirable level. Thus, nurses and other staff are recommended to use this simple method of communication with patients to provide better services. In addition, further quantitative and qualitative studies are suggested to assess these communication strategies in other patients with impaired consciousness.

The effect of a self-management program on the quality of life of patients with scleroderma.

BACKGROUND: Scleroderma is a rare disease with complex disorders. It affects the quality of life with severe impacts on the skin and extensive complications in the internal organs, and does not have a definitive treatment. This study aimed to investigate the effect of a self-management program on the quality of life of patients with scleroderma. MATERIALS AND METHODS: This was a clinical trial in which 54 patients with scleroderma were randomly divided into two groups of 27 each (experimental and control groups). The data were collected using the Systemic Sclerosis Questionnaire. A self-management program was sent to the experimental group via a mobile phone application (WhatsApp) every day for three months. Statistical analysis was performed in Statistical Package for the Social Sciences V21. RESULTS: The Wilcoxon signed-rank test showed that the average overall quality of life score of the experimental group showed a significant increase after the implementation of the program (P value: 0.00). The average overall quality of life score of the control group also significantly declined after the intervention (P value: 0.00). The Mann-Whitney U test revealed that there was no significant difference in the overall quality of life score of the two groups before the intervention (P value: 0.31); however, after the implementation of the self-management program, a significant difference was observed between the two groups (P value: 0.00). CONCLUSION: According to the results, the self-management program can help improve the quality of life of patients with scleroderma.

Lived Experience of Iranian Family Caregivers of Person with Tuberculosis: A Qualitative Study / Experiencia vivida de los cuidadores familiares de personas con tuberculosis: Un estudio cualitativo / Experiência vivida de cuidadores familiares de pessoas com tuberculose: um estudo qualitativo

Objective. To investigate the lived experience of family caregivers of persons with tuberculosis. Methods.In this study, the method of hermeneutic phenomenology. Data were collected through online in-depth semi-structured interviews with nine family caregivers of TB patients. The obtained data were thematically analyzed to explain the concept of home care for TB patients through van Manen's 6-step methodology. Results. After the thematic analysis, three main themes of caregivers' mental distresses, quality care stasis, and facilitated care were obtained from 944 primary codes and 11 categories. Conclusion.Family caregivers of these patients suffer from mental distress. This issue affects the quality and ease of caregiving for these patients. Therefore, policymakers of this area should pay attention to the family caregivers of these patients and attempt to provide support; they should try to improve their quality of life.

Objetivo. Investigar la experiencia vivida por los cuidadores familiares de personas con tuberculosos. Métodos. En este estudio se utilizó el método de la fenomenología hermenéutica. Los datos se recogieron mediante entrevistas semiestructuradas en línea con nueve cuidadores familiares de pacientes con tuberculosis. Los datos obtenidos se analizaron temáticamente para explicar el concepto de atención domiciliaria a los pacientes con TB mediante la metodología de 6 pasos de van Manen. Resultados. Tras el análisis temático, se obtuvieron tres temas principales: angustia mental de los cuidadores, estancamiento de la atención de calidad y facilitación de la atención, a partir de 944 códigos primarios y 11 categorías. Conclusión.Los cuidadores familiares de estos pacientes sufren de distrés sicológico. Este problema afecta la calidad y la facilidad con que se brinda el cuidado. Por lo tanto, los responsables de la política en salud deben prestar atención a los cuidadores familiares de estos pacientes para proporcionarles más apoyo, lo que redundará en una mejoría de su calidad de vida.

Objetivo.Investigar a experiência vivida por cuidadores familiares de pessoas com tuberculose.Métodos.Neste estudo foi utilizado o método da fenomenologia hermenêutica. Os dados foram coletados por meio de entrevistas semiestruturadas online com nove cuidadores familiares de pacientes com tuberculose. Os dados obtidos foram analisados tematicamente para explicar o conceito de atenção domiciliar aos pacientes com TB utilizando a metodologia de 6 etapas de van Manen. Resultado S. Após a análise temática, três temas principais ­ sofrimento mental dos cuidadores, estagnação do cuidado de qualidade e facilitação do cuidado ­ foram derivados de 944 códigos primários e 11 categorias. Conclusão. Os cuidadores familiares desses pacientes sofrem de sofrimento psíquico. Essa questão afeta a qualidade e a facilidade com que os cuidados são prestados a esses pacientes. Portanto, os responsáveis pela política de saúde devem estar atentos aos cuidadores familiares desses pacientes para dar-lhes mais suporte, o que resultará em uma melhora em sua qualidade de vida.

Medical Error and Under-Reporting Causes from the Viewpoints of Nursing Managers: A Qualitative Study.

Background: Patient safety as a goal can be achieved by reporting medical errors (ME); however, most errors are never reported. The aim of this study is to explore the causes of ME, and the obstacles in reporting them amongst nurses. Methods: We conducted semi-structural interviews, with 12 nursing managers in the biggest teaching hospital in southern Iran (2015-2016). The interview guide concentrated on the causes of ME and barriers in reporting them. All face-to-face interviews were recorded and transcribed verbatim and analysed using thematic analysis. Results: In this study 4 main themes were extracted for the causes of ME: personal/social characteristics, nonprofessional practice, hospital related factors/organization contextual factors, and poor management. Also, 5 main themes (such as; personal characteristics, fear from reporting, nonprofessional practices, cultural and social factors, and error surveillance system features) were obtained with regards to barriers in reporting. Conclusions: ME can be reduced by improving professional practice and better human resource management. Also, reporting errors can be increased by focusing on cultural and social factors.

Psychometric analysis of Persian version of patient safety competency self-evaluation in psychiatric wards.

BACKGROUND: Assessment of the patient safety competency is necessary for the growth of nursing and safe care profession as well as evaluation of the nurses' educational needs. The present study was conducted to determine psychometric properties of the Persian version of the patient safety competency self-evaluation (PSCSE) tool in Iranian psychiatric wards. MATERIALS AND METHODS: All nurses (n = 209) working in two psychiatric hospitals of Kerman, Iran, were included in the present cross-sectional study using census method. This tool contains 41 items: six items are related to knowledge, 14 items deal with attitude, and 21 items are about skill dimension. Psychometric properties of the questionnaire including its content and face validity were also examined. The factor structure of the questionnaire was evaluated using exploratory factor analysis. The internal consistency and reliability were assessed by test-retest method with an interval of 14 days. Cronbach's alpha and corrected item-total correlation were used to measure reliability. RESULTS: The content validity index was 0.65 and the content validity ratio was 0.89. Item 14 was removed from the skill domain because it was not related to the psychiatric ward. According to the results of factor analysis, there was a significant relationship between the questions and the relevant factors. The correlation coefficient for test-retest with 14 days interval was intraclass correlation coefficient = 0.92 for the whole instrument and 0.89, 0.89, and 0.92 for the domains of knowledge, attitude, and skill, respectively. The internal consistency coefficient (Cronbach's alpha) of the whole tool was 0.95 and 0.95, 0.79, and 0.95 for the domains of knowledge, attitude, and skill, respectively. Finally, PSCSE Questionnaire was obtained with 40 items in dimensions of knowledge (6 items), attitude (14 items), and skills (20 items). CONCLUSION: Persian version of the nurses' competency tool in ensuring patient safety in psychiatric wards has acceptable psychometric characteristics.

Nurses' patient safety competency, a predictor for safe care in psychiatric wards?

PURPOSE: This study examined the relationship between patient safety competence and safe care from the viewpoints of nurses working in psychiatry wards. DESIGN AND METHODS: The present descriptive correctional study was conducted in two psychiatry hospitals in Iran in 2020. All the nurses were selected as the study participants using the census sampling method (N = 209). FINDINGS: Nurses' patient safety competency was at a low level (2.54 ± 0.52), but nurses' safe care was at a moderate level (242.08 ± 61.32). A strong positive relationship was found between the patients' safety competency and nurses' safe care (p = 0.001, r = 0.84). PRACTICE IMPLICATIONS: Nursing managers should support nurses by providing the required resources and operational strategies to improve their competency and safe care in providing quality care.

The mediating role of Courageous coping in the relations between spirituality and social support with resilience among adolescents with hemophilia.

In addition to physical disorders, people with hemophilia face complex psychological problems. Hence, protective factors such as coping strategies, social support, and spirituality to improve psychological health should be determined. This study examined the role of courageous coping as a mediator in the interrelationships between spirituality as well as social support and resilience among adolescents with hemophilia. In this descriptive-analytical study, the participants were 372 adolescents with hemophilia aged 11-21 years. Connor-Davidson resilience scale, Jalowiec Coping scale, Perceived Social Support Scale, and spirituality scale were the instruments used in this study. The analysis results of Pearson correlation revealed a significant positive relationship between spirituality as well as social support and resilience. Also, it was determined that courageous coping is a thorough mediator between spirituality and resilience. The mediating role of courageous coping did not reach meaningful levels between social support and resilience, meaning that zero was included in bootstrap interval, CI 95% (ß =.026, CI [-.002, .089]). Social support, adopting a spiritual strategy, and using coping strategies played a crucial role among the adolescents to promote their level of resilience to cope with hemophilia.

Assessing the Expectations and Perceptions of Nursing Students regarding the Educational Services in a School of Nursing and Midwifery Based on the SERVQUAL and Kano Models: A Case Study.

This study determined the gap between student expectations and perceptions to achieve a relatively accurate description of student satisfaction. Student expectations and perceptions regarding educational services across a number of different dimensions were evaluated using SERVQUAL model, and the nature of each educational factor was determined using the Kano model. Three characteristics of 30 educational services indicators were placed in the cluster of students' basic needs, 26 characteristics were placed in the performance and one-dimensional needs cluster, and one characteristic was placed in the neutral needs cluster. No characteristics were put in the cluster concerning the motivational needs of students.

Lived Experience of Iranian Family Caregivers of Tubercular Patients: A Qualitative Study.

OBJECTIVES: To investigate the lived experience of family caregivers of persons with tuberculosis. METHODS: In this study, the method of hermeneutic phenomenology. Data were collected through online in-depth semi-structured interviews with nine family caregivers of TB patients. The obtained data were thematically analyzed to explain the concept of home care for TB patients through van Manen's 6-step methodology. RESULTS: After the thematic analysis, three main themes of caregivers' mental distresses, quality care stasis, and facilitated care were obtained from 944 primary codes and 11 categories. CONCLUSIONS: Family caregivers of these patients suffer from mental distress. This issue affects the quality and ease of caregiving for these patients. Therefore, policymakers of this area should pay attention to the family caregivers of these patients and attempt to provide support; they should try to improve their quality of life.

Improving nurses' knowledge, attitude, and performance in relation to ethical codes through group reflection strategy.

BACKGROUND: The most basic responsibility of nurses that even precedes their therapeutic role is respect for professional ethics in providing clinical care. The present study was conducted to determine the effect of group reflection on the knowledge, attitude and performance of nurses in relation to ethical codes. METHODS: The present blinded, before-after, educational trial was conducted on 86 nurses working at a general hospital in the south of Iran who were randomly divided into a intervention (n = 44) and a control (n = 42) group. Data were collected before and after the intervention using three tools, including a knowledge test, an attitude rating scale and a performance questionnaire. In the intervention group, the intervention given consisted of four sessions of group reflection, and the control group received a single lecture on ethical codes. RESULTS: The mean changes in the nurses' score of knowledge after the intervention compared to before differed significantly in both intervention and control groups (P < 0.001), but there was no significant difference between the two groups in terms of the mean changes in the score of knowledge (2.73 ± 3.45 in intervention group vs. 2.57 ± 3.36 in control group, P = 0.83). Although the mean score of attitude differed significantly between the intervention and control groups in the posttest (34.7 ± 8.44 in intervention group vs. 29.95 ± 9.09 in control group, P < 0.014), the two groups were not significantly different in terms of the mean changes in the score of attitude in relation to ethical codes before and after the intervention (P < 0.14). Moreover, the two groups were significantly different in terms of the mean changes in the scores of performance in the two stages (9.07 ± 16.84 in intervention group vs. 0.67 ± 20.01 in control group, P < 0.001). CONCLUSION: Group reflection can improve the knowledge, attitude and performance of nurses in relation to ethical codes. Although lectures can help improve nurses' knowledge and attitude in this area, they have no significant effects on their performance. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (No: IRCT2016070317546N6, registration date: 10 October 2016), https://www.irct.ir/trial/16112.

Challenges Associated With Patient Transfer From Postanesthesia Care Unit to Surgical Unit in Iran: A Mixed-Method Study.

PURPOSE: This study aimed to explore the entire spectrum of challenges associated with the process of patient transfer from the postanesthesia care unit (PACU) to the surgical unit. DESIGN: The study employed a mixed-method design with concurrent triangulation approach. METHODS: The study was conducted during July-December 2018 at three teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. A total of 23 health-care providers involved with the patient transfer process from the PACU and surgical unit were recruited. Data were collected using quantitative and qualitative approaches. The quantitative study included 25 structured observations. The qualitative study included 12 unstructured observations, individual semistructured in-depth interviews (n = 13), and focused group sessions (n = 3). Data were managed using MAXQDA.10 software and analyzed using SPSS software (version 22.0). FINDINGS: Based on qualitative data, 4 main categories and 14 subcategories were extracted. The main categories were "Multifarious Activities of Nurses", "Insufficient Organizational Resources", "Task-oriented Approach", and "Deficient Professional Performance". Results showed that 51% of patient-specific information, 64% of anesthesia information, and 74% of surgical information was not transferred during patient handoffs. CONCLUSIONS: Insufficient organizational resources and deficient professional performance were identified as the main challenges associated with the transfer process of postoperative patients. Our findings provide a better understanding of these challenges and encourage health policymakers and planners to resolve these issues to promote patient safety during handoffs.