The Effect of a Training Program Based on the Theory of Planned Behavior on the Self-Care of Patients with Cerebrovascular Accident: A Randomized Controlled Trial.

Background: Cerebrovascular accident dramatically impacts patients' lives. However, this chronic disease could be managed by boosting self-care and following healthy behaviors. Accordingly, this trial sought to specify the impact of a training program established on the theory of planned behavior on the self-care of clients with this condition. Materials and Methods: This trial was performed on 80 clients, who were selected using a random numbers table and divided into two equal groups to receive either usual care alone or usual care plus a training program based on the theory of planned behavior (five in-hospital individual sessions for 5 weeks and weekly phone follow-ups for 2 months after discharge). Self-care and the dimensions of the theory of planned behavior were investigated at baseline and 2 months after the last in-hospital session using the standardized Shah version of the modified Barthel index and a researcher-made questionnaire, respectively. Results: The mean score of self-care was significantly higher in the experimental arm at the posttest (Mann-Whitney = 506.00, p = 0.005). Also, the increase in mean change of self-care from baseline to posttest was significantly more in the experimental arm (t78= -6.6, p < 0.001). Such findings were also found for all dimensions of the theory of planned behavior. Conclusions: Based on results, nurses and health policymakers can incorporate training based on the theory of planned behavior into routine care programs for patients with cerebrovascular accident to boost their self-care. The implemented intervention also could be reproduced in other contexts. Hence, further trials are requested to specify the sustainability of the findings.

Organizational Learning: The Missing Link to Promote Nurses' Professional Self-Efficacy.

INTRODUCTION: Nurses are one of the important sources of organizational learning, and the main elements of knowledge transfer in hospitals. They can play a major role in the process of organizational learning. One of the factors affecting nurses' learning is self-efficacy. OBJECTIVE: The aim of this study was to evaluate the association between organizational learning and professional self-efficacy among nurses. METHODOLOGY: A cross-sectional study was conducted among 150 nurses in Ali Ibn Abitaleb Hospital in Zahedan City, Iran in 2018, selected by simple randomized sampling. Tools used were the Neefe Organizational Learning Questionnaire (Neefe, 2001), and Riggs and Knight's Self-Efficacy Questionnaire (1994). RESULTS: The results showed a significant positive correlation (p <0.05) between self-efficacy scores and the organizational learning dimensions of systems thinking, team learning, and shared vision. Linear regression analysis showed that these three dimensions of organizational learning predicted 16.1% of the professional self-efficacy variations. DISCUSSION: Organizational learning has a direct relationship with nurses' professional self-efficacy. Promotion of organizational learning characteristics in hospitals will enhance nurses' self-efficacy.

Facilitators and Threats to the Patient Dignity in Hospitalized Patients with Heart Diseases: A Qualitative Study.

BACKGROUND: Patient's dignity is an important issue which is highlighted in nursing It is an issue that is highly dependent on context and culture. Heart disease is the most common disease in Iran and the world. Identification of facilitator and threatening patient dignity in heart patients is vital. This study aimed to explore facilitator and threatening patient dignity in hospitalized patients with heart disease. METHODS: This qualitative content analysis study was performed in 2014 in Kerman, Iran. 20 patients admitted to coronary care units and 5 personnel were selected using purposeful sampling in semi-structured and in depth interviews. Researchers also used documentation and field notes until data saturation. Qualitative data analysis was done constantly and simultaneously with data collection. RESULTS: Three central themes emerged: a) Care context which includes human environment and physical environment, b) Holistic safe care including meeting the needs of patients both in the hospital and after discharge, c) Creating a sense of security and an effective relationship between patient and nurse, including a respectful relationship and account the family in health team. CONCLUSION: The results of this study showed that care context is important for patient dignity as well as physical environment and safe holistic care.