Nurse-patient communication experiences from the perspective of Iranian cancer patients in an outpatient oncology clinic: a qualitative study.

BACKGROUND: Effective communication between nurses and cancer patients is essential for patient satisfaction and optimal health outcomes in outpatient oncology settings. This study explored the communication experiences of Iranian cancer patients receiving outpatient treatment. METHODS: Semi-structured interviews were conducted with 14 adult cancer patients undergoing chemotherapy, radiotherapy, or follow-up treatment at an outpatient clinic in Urmia, Iran. Qualitative content analysis was used to analyze the data. This study adhered to the standards set forth in the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS: Three main categories emerged from the interviews with Iranian cancer patients: communication dynamics, barriers to communication, and effective communication outcomes. Patients expressed a desire for nurses who actively listen, provide emotional support, and offer thorough education about their disease and treatment options. However, they also identified barriers to effective communication, including negative nurse behaviors (such as lack of empathy), heavy workloads, gender and language discordance, and logistical challenges within the clinic setting. When communication was positive, patients reported increased commitment to their treatment plans, improved coping mechanisms, reduced stress levels, and greater satisfaction with their overall care. CONCLUSIONS: This study revealed the multifaceted nature of communication in outpatient oncology settings from the patient's perspective. Findings underscore the need for interventions that enhance nurse communication skills, address workload issues, promote cultural sensitivity, and optimize clinic logistics. These efforts can significantly improve patient experiences and treatment outcomes during cancer treatment.

"We just ignored them." Adaptation strategies used by emergency department personnel in the face of workplace violence: A qualitative study.

BACKGROUND: Workplace violence (WPV) can have adverse psychological, physical, and emotional effects on emergency department (ED) personnel. Adaptive strategies can help them better adapt to WPV. The study aimed to explore ED personnel's experiences with adaptive strategies used in the face of WPV. METHODS: In this qualitative study, 22 ED personnel (nurses, doctors, services patient care assistants, and security guards) were selected using purposive sampling from Urmia city hospitals. Deep semi-structured individual face-to-face interviews were used to collect data. After recording and implementing interviews, conventional content analysis was used to extract concepts. RESULTS: Data analysis led to extracting an overarching theme of "mastering the situation and avoiding harm." Two categories that supported the main theme were: "effort to avoid violence" and "effort to escape suffering." The seven subcategories supported main categories included "managing patients and companions, "self-control," "seeking support, "emotional discharge," "thought diversion, "tendency to spirituality," and "seeking medical assistance." CONCLUSION: Given the experiences of ED personnel regarding strategies used, health managers and policymakers are recommended to develop and implement comprehensive programs to reduce violence and empower nurses before and after dealing with violence. The following programs will help: developing and implementing guidelines such as zero-tolerance WPV policy, criminalizing violence against personnel and punishing perpetrators; holding classes related to communication skills, self-control skills, and deviant thinking skills for ED personnel; raising public awareness of the prevailing conditions in the emergency through mass media, and counseling and treating violent ED personnel.

Single and Combined Use of Benson Relaxation Technique and Oxygen Therapy on Chemotherapy-Induced Nausea and Vomiting in Gastric Cancer Patients.

BACKGROUND: Nausea and vomiting are the most common complications of chemotherapy encountered by cancer patients. To alleviate these complications and reduce patients' problems, it is necessary to use complementary methods. OBJECTIVE: The present study aimed to investigate the effect of single and combined use of the Benson relaxation technique and oxygen therapy on chemotherapy-induced nausea, vomiting, and retching in patients with gastric cancer. METHODS: This is a single-blind, four-arm, 2 × 2 factorial-design randomized clinical trial, in which a total of 100 patients with gastric cancer were enrolled and assigned to four groups of relaxation therapy, oxygen therapy, combined therapy, and control (n = 25 in each group) using simple random allocation. The intervention program included the application of Benson relaxation technique, supplemental oxygen therapy, and a combination of both. The control group merely received routine care. Data were collected using the Rhodes Index of Nausea and Vomiting Form 2 (INV-2). RESULTS: The results of the Kruskal-Wallis H test showed that there was a statistically significant difference in the mean scores of nausea, vomiting, retching, and acute phase between the four groups (p = 0.001). However, there was a statistically significant difference only in the mean score of retching in this regard for the delayed phase (p = 0.02). CONCLUSION: Overall, the single use of Benson relaxation technique and the combined use of this technique and oxygen therapy were shown to be more effective in managing chemotherapy-induced nausea and vomiting.

The COVID-19 patients' educational needs assessment questionnaire (COPENAQ): development and psychometrics.

BACKGROUND: Despite the importance of assessing COVID-19 patients' educational needs, there is currently no standard tool for a comprehensive assessment of these needs. The present study was aimed at developing a questionnaire to assess the educational needs of COVID-19 patients and determining its psychometric properties. METHODS: This study was conducted using an exploratory sequential mixed methods design in 3 stages. At the first stage, patients' educational needs were explained and determined using conventional content analysis so that a total of 15 COVID-19 patients were first selected using purposive sampling and then interviewed. At the second stage, the questionnaire items were developed using the qualitative findings and a review of valid sources related to the study subject. At the third stage, the psychometric properties of the questionnaire were determined using internal consistency reliability and the face, content, and construct validities. RESULTS: The mean content validity ratio and the content validity index were obtained to be 0.94 and 0.92, respectively. The internal consistency was evaluated using Cronbach's alpha, which was measured to be 0.97. Based on the exploratory factor analysis, the questionnaire was developed with 36 items in four subscales of "disease recognition and treatment follow-up", "prevention of infection transmission", "medication regimen", and "psychological and physiological needs". The results of confirmatory factor analysis also showed appropriateness and approval of the structural model obtained from the questionnaire. CONCLUSION: This questionnaire was found to have the necessary psychometric criteria (validity and reliability) so that it can be applied to assess the educational needs of COVID-19 patients and provide better and more effective patient education for them.

Protective reactions of ICU nurses providing care for patients with COVID-19: a qualitative study.

BACKGROUND: The exponential spread of COVID-19 has caused a huge threat to public health worldwide. Providing care for patients with COVID-19 is a stressful experience for ICU nurses, which can affect their protective reactions. The present study was conducted to explore the protective reactions of ICU nurses providing care for patients with COVID-19. METHODS: This qualitative descriptive study was conducted to discover the protective reactions of nurses providing care for patients with COVID-19. A total of 14 ICU nurses were selected by purposive sampling. Data were collected using individual semi-structured face-to-face interviews. All interviews were recorded, and then codes and themes were extracted using content analysis method. FINDING: Seventeen subcategories, six categories and two themes were extracted from the analysis of data. These themes include "Unbalanced self-protective reactions" and "Responsible self-protective reactions". CONCLUSION: During the COVID-19 epidemic and crisis, ICU nurses exhibit different self-protective reactions when providing care for patients with COVID-19, which include unbalanced and responsible reactions. Nursing managers can mitigate these unbalanced reactions by identifying them and their roots. Identifying the protective reactions of ICU nurses in providing care for patients with COVID-19 could assist in developing the necessary interventions to promote positive reactions and reduce unbalanced reactions by finding their root causes.

Observation of Patients' Privacy by Physicians and Nurses and Its Relationship with Patient Satisfaction.

The present study was conducted to determine the extent of observation of patients' privacy by physicians and nurses and its relationship with patient satisfaction. This descriptive correlational study was conducted on 600 patients selected by convenience sampling. Based on the patients' points of view, the level of observation of patients' privacy and its dimensions, especially the psychosocial dimension, were reported to be higher in nurses than in physicians. Pearson's correlation coefficient showed a direct and significant relationship between the observation of privacy by the nurses and physicians and different dimensions of patient satisfaction.

Psychological reactions of COVID-19 patients to the stress caused by the disease crisis: A descriptive phenomenological study.

PURPOSE: This study was conducted to explain the psychological reactions of COVID-19 patients to the stress caused by the disease crisis from the perspective of the survivors. DESIGN AND METHODS: A phenomenological approach was adopted to the qualitative study of 14 COVID-19 survivors selected through purposive sampling. FINDINGS: Two themes extracted as the psychological reactions of the patients to the COVID-19-induced stress included "self-moderating effect of stress" and "psychological maladaptation." PRACTICE IMPLICATIONS: The present findings appear effective in laying the foundations for performing interventions to improve constructive psychological reactions such as using self-moderating mechanisms of the COVID-19-induced stress and reducing or eliminating maladaptive psychological reactions such as depression, anger, self-blaming, and regret.

Challenges experienced by ICU nurses throughout the provision of care for COVID-19 patients: A qualitative study.

AIM: To explore the challenges experienced by ICU nurses throughout the provision of care for COVID-19 patients. BACKGROUND: The intensive care unit nurses, who are at the frontline of fighting against COVID-19 and defusing this crisis, are faced with various challenges throughout the provision of care for COVID-19 patients. METHODS: In this qualitative descriptive study, a total of 17 nurses working in intensive care units were selected using purposive sampling. Data were collected using semi-structured face-to-face interviews. After recording and transcribing interviews, the concepts were extracted using the content analysis method. FINDINGS: The nurses reported the four following challenges throughout the provision of care for COVID-19 patients: 'organization's inefficiency in supporting nurses', 'physical exhaustion', 'living with uncertainty' and 'psychological burden of the disease'. CONCLUSION: The present study portrayed a clear understanding of the challenges faced by nurses working in intensive care units during the crisis of the COVID-19 pandemic based on their lived experiences. IMPLICATIONS FOR NURSING MANAGEMENT: A profound understanding of these challenges in the current critical situation can help health care authorities adopt appropriate measures to resolve these challenges, provide health care facilities, support the health workforce, give accurate and evidence-based information and perform psychological interventions on how to handle the current crisis.

Psychological disturbances of survivors throughout COVID-19 crisis: a qualitative study.

BACKGROUND: In addition to physical problems, patients with COVID-19 suffer from considerable stress throughout the disease crisis. It is important to address mental health needs and not to ignore the psychological dimension in this group of patients. In this regard, the first practical step is to have a clear understanding of patients' psychological issues. Therefore, this study aimed to explore the psychological disturbances of COVID-19 survivors throughout the disease crisis. METHOD: This qualitative study was conducted using a phenomenological approach through 14 individual semi-structured in-depth interviews with patients recovered from COVID-19. Data were analyzed using Colaizzi's seven-step method. RESULTS: Three themes of "living in limbo", "psychological distress behind the wall" and "psychological burden of being a carrier" were extracted as the psychological disturbances of COVID-19 survivors throughout the disease crisis. CONCLUSION: This study portrayed a better understanding of psychological disturbances of COVID-19 survivors throughout the disease crisis based on their lived experiences. Given the ambiguity in the time of the disease eradication and its continuing course, a deep understanding of these experiences in the current critical situation can help healthcare officials to make appropriate decisions and take measures to assess and identify psychological traumas and perform interventions to improve the mental state of these patients.

Investigation of Relationship between Occupational Stress and Cardiovascular Risk Factors among Nurses.

BACKGROUND: One of the major causes of various work-related health problems among nurses is occupational stress. Hence, the main purpose of the present research was to find association between occupational stress of nurses and risk factors of cardiovascular disease. METHODS: In this cross-sectional study, the Osipow job stress questionnaire was employed to assess the occupational stress among the 250 nurses in Emam Khomeini hospital of Tehran in 2018. Based on stress score for participants, subjects divided into two groups: Scoring of group one was 60-179 (mild and average stress) and group two between 180 and 300 (average to acute and acute stress). Systolic and diastolic blood pressures were recorded for subjects after 10hrs fasting. Then the blood samples were collected to measure cholesterol, triglyceride and glucose levels. For determining the association between education level, job experience and study groups, the Chi-square test and for comparing job stress between two groups of study the Mann-Whitney U test was used. RESULTS: Subjects with job stress in group one was 70(28%) and group two was 180(72%). The association between level of education and two study groups was not significant (P=0.129) while between job experience and two study groups was significant (P=0.004). Mean of Blood glucose levels for group I (98.0± 37.5), was higher than group II (82.5±12.0) and statistically significant (P=0.001). No significant difference was found between two groups of study for other parameters. CONCLUSION: High level of work-related stress among subjects affected the values related to blood glucose level, but no significant relationship was found between other risk factors of cardiovascular diseases and occupational stress among nurses.

Is Emergency Medical Services (EMS) in Islamic Republic of Iran Practical and Efficient in Facing Ebola?

OBJECTIVE: To evaluate the efficacy and preparedness of Emergency Medical Services (EMS) in Islamic Republic of Iran to face Ebola. METHODS: The present study is cross-sectional and somehow descriptive. We used a standard questionnaire that was designed by "center for disease control and prevention". This questionnaire was captioned "Emergency Medical Services (EMS) checklist for Ebola preparedness". We collected a lot of data by studying that questionnaire and every manager in every province of Iran were informed about that info in 2016. This data was analyzed by using SSPP software version 16. RESULTS: Findings have showed the average score related to preparation level of EMS in facing Ebola in Iran was 63.73±12.77 percent. There was no significant difference between the country regions regarding the preparedness of to detect (p=0.975), protect (p=0.275) and respond (p=0.344) to ebola outbreaks.The highest score had been achieved by region number 5 and the lowest score belonged to region number 7. CONCLUSION: Although the acquired average score in this study is higher than standards, considering the increased threat of breaking out biologic threats especially Ebola infection, using and practicing some measures in order to enhance preparation level of Emergency Medical Services counter this infection and similar infectious diseases is inevitable.

Explaining the inhibitory characteristics of clinical instructors in the process of developing clinical competence of nursing students: a qualitative study.

BACKGROUND: Different inhibitory factors may play a role in the process of developing the students' clinical competence; among them, some of the characteristics of clinical instructors can be considered as the most important factors. PURPOSE: The aim of this study was to determine the inhibitory characteristics of instructors in the process of developing clinical competence in nursing students. METHODS: This qualitative study was conducted using the conventional content analysis. Seventeen senior nursing students were selected by purposive sampling method. Individual semistructured interviews were used to collect data. After recording and implementing the interviews, the content analysis was used to extract the concepts. RESULTS: According to participants' experiences, the three themes, i.e. "autocracy," "low clinical competence," and "self-confidence weakness" were extracted as inhibitory features of clinical instructor in the process of developing the clinical competence of nursing students. CONCLUSION: The findings of this study illustrate the characteristics of a clinical instructor, which play an important role in reducing the clinical development and lack of clinical competence development among students.