Explaining the Parenting Styles of Epileptic Children: A Content Analysis.

Objectives: Understanding the parenting practices of parents of children with epilepsy can be a practical guide for care and education planners to prevent mental disorders in these children. This study aimed to explain the parenting practices of parents of children with epilepsy in Shahrekord. Materials & Methods: This study is a qualitative study with conventional content analysis. Participants in the study consisted of 20 mothers with epileptic children in Shahrekord, who were included in the study by purposive sampling method with maximum variance in terms of child age, number of family children, and child sex. The data collection method was a semi-structured interview using the interview guide. Data analysis was performed using a conventional content analysis at the same time as data collection. Interviews continued until data saturation was reached. Results: The present study revealed five main themes in discipline methods, including over-support / over-protection, forcing to support, rejecting, parental conflict in discipline methods, and using harmful discipline methods. Conclusion: In conclusion, the experiences of mothers in the present study show that using inappropriate discipline methods can have adverse effects on the mental-emotional and social health of the child in the future and raise the need to design educational interventions to empower parents of epileptic children in coping with parenting stress effectively.

The Effect of Family-Centered Intervention via SMS on Life Expectancy and Self-Efficacy in Medication Regimen Compliance in Patients With Acute MI: A Randomized Clinical Trial.

BACKGROUND: Myocardial infarction (MI) is a life-threatening condition affecting an individual's physical and social circumstances. Life expectancy and self-efficacy are required to determine the risk of cardiac complications associated with this disease. This study examined the effect of family-centered intervention via short message service (SMS) on patients with acute MI's life expectancy and self-efficacy in medication regimens. METHOD: This study was a randomized, single-blind clinical trial. In 2018, 80 patients hospitalized with acute MI at educational centers affiliated with Shahrekord University were randomly assigned to the control and experimental groups. Routine intervention was performed in the control group. The experimental group was sent four educational text messages weekly for three months. Both groups' life expectancy and belief in their ability to adhere to their prescribed medication regimen were evaluated before and after the intervention. The data were analyzed using descriptive statistics, independent t, paired t, and chi-square tests via SPSS software. RESULTS: The results showed that the mean difference score of total life expectancy change was significantly different between the experimental (12.23± 10.48) and the control group (0.06±7.16) (P < 0.001). The mean difference score of self-efficacy in the experimental group (21.94±12.76) was significantly higher than that in the control group (4.66±9.49) (P<0.001). CONCLUSIONS: In patients with acute MI, using a text message intervention improved life expectancy and self-efficacy regarding medication regimens. Therefore, this intervention can be used as a low-cost and readily accessible tool to improve these patients' self-efficacy and life expectancy.

Development, Psychometric Testing, and Use of a Disaster Nursing Competency Scale in Iran: A Mixed Methods Study.

Nurses play an important role during disaster response and recovery. Few tools are available to assess the relative competence of nurses in disaster. This study aimed to develop, test, and evaluate a disaster nursing competency scale. This was an exploratory mixed methods study. In the qualitative phase, 35 Iranian nurses and managers with experience in disaster relief were asked about the skills they need to respond effectively to a disaster event. From the qualitative data, a 50-item questionnaire was developed. In the quantitative phase, exploratory factor analysis was conducted with 400 samples followed by a test-retest reliability assessment with 30 nurses. The developed and validated instrument was applied to 200 nurses in Iran to assess their competency. From content analysis of the qualitative data, 5 main themes emerged. In the quantitative phase, exploratory factor analysis loaded 50 items into 4 domains named management, legal and ethical, specific personal, and technical competence. Use of the tool showed that nurses estimated their competence overall at 70.28%. Findings demonstrate the necessity for new domains in disaster nursing competencies; which may be applicable as a useful tool and guideline to improve nursing education and practice.

Effects of family-centered program on the specific quality of life of patients with a pacemaker: A nursing intervention study.

BACKGROUND: Cardiac problem causes changes in different aspects of life in patients, including their activities of daily living (ADL). Because of the important role of family in caring for patient after pacemaker implantation, this study was done to evaluate the effect of family-centered empowerment model on ADL of patient after pacemaker implantation. METHODS: This randomized clinical trial study was performed on 70 patients who underwent pacemaker implantation in Shahid Chamran Hospital, Isfahan, Iran. Patients and their family in the intervention group received educational program according to family-based empowerment program. The control group only received routine interventions. Data were collected using a valid specific quality of life (QOL) questionnaire and analyzed by SPSS software. RESULTS: Patient's self-efficacy, self-esteem, and personal QOL have been improved after the empowerment program compared with the baseline and the control group (P < 0.05 for all). CONCLUSION: The QOL in patients with pacemaker is relatively low. Similar to previous studies, family-centered empowerment model, due to participation of the patients and their families in education, learning, and taking care of the patients, could be an appropriate model to implement.

Cross-Cultural Adaptation and Psychometric Evaluation of the Persian Version of the Clinical Decision-Making in Nursing Scale.

BACKGROUND AND PURPOSE: The aim of this study was the cross-cultural adaptation and psychometric evaluation of the Persian version of Clinical Decision Making in Nursing Scale (CDMNS). METHODS: The original CDMNS was translated into Persian using the Beaton's guideline. Its qualitative face validity, qualitative and quantitative content validity, its construct validity, and reliability was assessed. RESULTS: Eleven items out of forty items were deleted due to factor loading values less than 0.3. Subsequently, model fit indices changed as follows: Chi-square value divided by degree of freedom (χ2/DF): 2.8, root mean score error of approximation (RMSEA): 0.07, standardized root mean square residual (SRMR): 0.06, comparative fit index (CFI): 0.93, goodness of fit index (GFI): 0.80, and adjusted goodness of fit index (AGFI): 0.77. The Cronbach's alpha values and test-retest intraclass correlation coefficient of the 29-item scale and its subscales also increased after deleted. CONCLUSION: The 29-item Persian CDMNS is a valid and reliable instrument for assessing Iranian nurses' perceptions of clinical decision-making.

Designing an intervention program over the effects of Pilates on pregnancy outcomes among the pregnant women: A protocol study.

BACKGROUND: Pregnancy is a pleasure for most women, it is often considered as a stressful period with physiological, anatomical, biochemical, and psychological changes. Pilates exercise improved quality of life in women. Therefore, the present study targeted at designing an intervention program over the effects of Pilates on pregnancy outcomes among the pregnant women. METHODS: In this protocol, a clinical intervention will be designed in three phases. In the first phase of the study, a researcher-made checklist will be used to evaluate the pregnancy and neonatal outcomes based on the literature review. In the second phase, an intervention program of Pilates exercise will be conducted according to different studies and viewpoints of a panel of reproductive health and physical activity specialists. The exercises will include two sessions of 30 minutes per week for 12 weeks conducted under the supervision of a qualified trainer. The third phase of the intervention will include the pre-test and post-test using a standard questionnaire and a researcher-made checklist for the two intervention groups and one control group. DISCUSSIONS: The present study provides useful data regarding the design of a Pilates exercise intervention program for pregnant women with the aim of influencing pregnancy and neonatal outcomes, reducing depression, low back pain and improving maternal mental health. It can also reduce their medical and treatment costs. The strategies of this program could be important and cost effective, and therefore we hope that the success of such a program is a step forward in improving reproductive health status.

The effect of problem-solving-based interprofessional learning on critical thinking and satisfaction with learning of nursing and midwifery students.

INTRODUCTION: Problem-solving skills and learner-centered approaches provide students with the ability to solve health challenges by placing them in simulated situations. The aim of this study was to determine the effect of inter-professional learning based on problem-solving on critical thinking (CT) and satisfaction with learning experience in nursing and midwifery students. METHODS: This quazi-experimental study of a single group used pretest-posttest design. 20 undergraduate nursing and 28 midwifery students at the final academic year participated in the study. The research intervention was interprofessional learning based on problem-solving conducted in five 2-h training sessions. California's CT Scale and 10-point visual analog scale were used to measure CT skills and satisfaction with learning before and after the intervention. Finally, data were analyzed by SPSS software version 23 using descriptive statistics and paired t-test. RESULTS: The findings of this study indicated that the mean score of students' CT before the intervention was poor, while it statistically significant increased after the intervention (P < 0.05). It was also found that students' satisfaction with learning, in the scale of 0-10, was reported from 5 to 9 indicating students had a high level of satisfaction with their learning experience. DISCUSSION: Based on the findings, it can be concluded that the interprofessional education based on problem-solving has been able to significantly enhance the overall critical skills of students, especially in the dimensions of analysis, inference, and deductive reasoning, and also, students' satisfaction with learning experience was also increased.

Midwifery students' experiences of problem solving based interprofessional learning: A qualitative study.

BACKGROUND: Interprofessional learning is identified as one of the most innovative ways to encourage students of different disciplines to communicate with each other in interprofessional teams. A review of existing studies identified that inter-professional learning with nursing and midwifery students learning together had not previously been reported. AIM: This qualitative study sought to explore perceptions and experiences of midwifery students from interprofessional learning with nursing students. METHODS: This study was an exploratory qualitative study employing focus groups. Participants were 30 female students in the fourth year Bachelor of Midwifery at one university in Iran who undertook the surgical training course in midwifery in their seventh semester by inter-professional learning based on problem solving. Data were analysed according to the six steps of the concurrent thematic analysis method. FINDINGS: One main theme of challenging approach in learning emerged and two sub-themes 1) being challenged in a simulated clinical situation and 2) demonstrating professional knowledge. CONCLUSION: Interprofessional learning by challenging students of various professions during shared interprofessional learning can be followed by positive outcomes such as improved critical thinking, interprofessional communication, teaching-learning motivation and independent learning.

Effectiveness of concept mapping and traditional linear nursing care plans on critical thinking skills in clinical pediatric nursing course.

INTRODUCTION: Concept map is a useful cognitive tool for enhancing a student's critical thinking (CT) by encouraging students to process information deeply for understanding. However, the evidence regarding its effectiveness on nursing students' CT is contradictory. This paper compares the effectiveness of concept mapping and traditional linear nursing care planning on students' CT. METHODS: An experimental design was used to examine the CT of 60 baccalaureate students who participated in pediatric clinical nursing course in the Shahrekord University of Medical Sciences, Shahrekord, Iran in 2013. RESULTS: Participants were randomly divided into six equal groups of each 10 student, of which three groups were the control group, and the others were the experimental group. The control group completed nine traditional linear nursing care plans, whereas experimental group completed nine concept maps during the course. Both groups showed significant improvement in overall and all subscales of the California CT skill test from pretest to posttest (P < 0.001), but t-test demonstrated that improvement in students' CT skills in the experimental group was significantly greater than in the control group after the program (P < 0.001). CONCLUSIONS: Our findings support that concept mapping can be used as a clinical teaching-learning activity to promote CT in nursing students.

Introducing a spiritual care training course and determining its effectiveness on nursing students' self-efficacy in providing spiritual care for the patients.

INTRODUCTION: How to train nurses to provide spiritual care, as one of the basic competencies of nursing, based on patient's perception and culture has been considered highly important. Although nurses' training is recommended in this area, few researches have studied the format of such programs. This study is conducted with the aim of introducing the training course of spiritual care and determining its effectiveness on nursing students' self-efficacy in providing spiritual care. MATERIALS AND METHODS: The method of this study was of a pre-post interventional research. Senior students (n = 30) of the Shahrekord University of Medical Sciences, passing the training course in the field, were chosen as the studied sample. Study intervention was the implementation of the designed curriculum based on nursing books, focusing on providing the spiritual care for patients. The dependent variable of the study was the students' self-efficacy feeling in providing spiritual care to the patients. A researcher-madequestionnaire, as well as the pre-post interventional tests, was used, then, to assess this variable. By means of Statistical Package for the Social Sciences software, data were analyzed, and the level of significance was considered at P <0.05. FINDINGS: The findings of the study showed that self-efficacy mean score of nursing students in providing spiritual care in the pretest was 13.74, showing the average level of perceived self-efficacy. The students' self-efficacy mean, after participating in the training spiritual care programs, however, changed to 21.1, indicating the increased level of self-efficacy. Results of paired t-test, also, showed that self-efficacy mean score of the study samples has significantly increased in the posttest, compared with the pretest. DISCUSSION AND CONCLUSION: According to these findings, it can be concluded that based on this designated curriculum, students have a chance of getting acquaintance with some concepts as: Spirituality and spiritual care, identifying the spiritual needs of patients, and designing a care plan to meet these requirements. These factors, therefore, have a great impact on students' effectiveness in providing spiritual care for patients.

Comparative investigation of the effectiveness of face-to-face verbal training and educational pamphlets on readiness of patients before undergoing non-emergency surgeries.

BACKGROUND: The thought of having a surgery can be stressful for everyone. Providing the necessary information to the patient can help both the patient and the treatment team. This study was conducted to compare the effectiveness of face-to-face verbal training and educational pamphlets on the readiness of patients for undergoing non-emergency surgeries. MATERIALS AND METHODS: The study was a before-after randomized clinical trial. 90 patients scheduled to undergo non-emergency surgery who referred to Shahrekord Ayatollah Kashani Hospital in 2013 were distributed randomly and gradually into two experimental groups (group of face-to-face verbal training and group of educational pamphlet) and one control group. Dependent variable of the study was pre-surgery readiness. Data analysis was carried out by using SPSS statistical software. Statistical analysis were analysis of variance (ANOVA) and correlation test. RESULTS: Results showed that the mean scores of pre-surgery readiness in both interventional groups were significantly higher than that in the control group after the intervention (P < 0.05). However, there was no significant difference between the two experimental groups (P > 0.05). CONCLUSIONS: Each of the methods of face-to-face verbal education and using the pamphlet could be equally effective in improving the readiness of the patients undergoing surgery. Therefore, in environments where the health care providers are facing with the pressure of work and lack of sufficient time for face-to-face verbal training, suitable educational pamphlets can be used to provide the necessary information to patients and prepare them for surgery.

Ethical and legal challenges associated with disaster nursing.

BACKGROUND: In disaster situations, nurses may face new and unfamiliar ethical and legal challenges not common in their everyday practice. RESEARCH QUESTION/OBJECTIVES/HYPOTHESIS: The aim of this study was to explore Iranian nurses' experience of disaster response and their perception of the competencies required by nurses in this environment. RESEARCH DESIGN: This article discusses the findings of a descriptive study conducted in Iran in 2012. PARTICIPANTS AND RESEARCH CONTEXT: This research was conducted in Iran in 2012. Participants included 35 nurses who had experience in healthcare delivery following a disaster event in the past 10 years, either in a hospital or out-of-hospital context. ETHICAL CONSIDERATIONS: This research study was approved by the Ethics Committee of the Isfahan University of Medical Sciences. FINDINGS: From this study, five themes emerged as areas that nurses require competence in to work effectively in the disaster setting. This article focusses on one theme, the ethical and legal issues that arise during disaster response. Within the theme of ethical and legal issues, two sub-themes emerged. (1) Professional ethics explores professional responsibility of nurses as well as sense of ethical obligation. (2) Adherence to law refers to nurses' familiarity with and observation of legal requirements. DISCUSSION: This article adds to a growing pool of literature which explores the role of nurses in disasters. The findings of this study emphasize the need for nurses working in the disaster setting to be aware of professional responsibilities and familiar with legal requirements and the challenges related to observing ethical responsibilities. CONCLUSION: In highlighting these issues, this article may provide a useful starting point for the development of an educational framework for preparing nurses and other health professionals to work in the disaster setting.

Iranian nurses' perception of essential competences in disaster response: A qualitative study.

BACKGROUND: Today disasters, natural and man-made, are a part of many people's lives. Iran has a long history of disaster events. Nurses are one of the most significant groups within Iranian disaster relief operations, providing immediate and longer term care for those affected by the disaster. However, the competence of Iranian nurses and their training for this work has received little attention. This paper presented the results of a study aimed to explore the context. MATERIALS AND METHODS: A qualitative study was performed in 2012 in Iran. Interviews were conducted with 35 nurses. The sampling of participants was purposeful and continued until data saturation was achieved. Themes were identified using inductive qualitative content analysis. Trustworthiness of the study was supported considering auditability, neutrality, consistency, and transferability. FINDINGS: Data analysis undertaken for the qualitative study resulted in the identification of five main themes included 1-management competences, 2- ethical and legal competences, 3-team working, 4-personal competences, and specific technical competences that presented in this report. CONCLUSIONS: This report presents an overview of nursing competences required for Iranian nurses in disaster relief. It is argued that additional competencies are required for nurses who care in high-risk situations, including disaster. Nurses need to prepare themselves more effectively to be responsible and effective in the nursing care.

Giving bad news: a qualitative research exploration.

BACKGROUND: The manner in which healthcare professionals deliver bad news affects the way it is received, interpreted, understood, and dealt with. Despite the fact that clinicians are responsible for breaking bad news, it has been shown that they lack skills necessary to perform this task. OBJECTIVES: The purpose of this study was to explore Iranian mothers' experiences to receive bad news about their children cancer and to summarize suggestions for improving delivering bad news by healthcare providers. MATERIALS AND METHODS: A qualitative approach using content analysis was adopted. Semi-structured interviews were conducted with 14 mothers from two pediatric hospitals in Iran. RESULTS: Five major categories emerged from the data analysis, including dumping information, shock and upset, emotional work, burden of delivering bad news to the family members, and a room for multidisciplinary approach. CONCLUSIONS: Effective communication of healthcare team with mothers is required during breaking bad news. Using multidisciplinary approaches to prevent harmful reactions and providing appropriate support are recommended.

Iranian nurses' experience of essential technical competences in disaster response: A qualitative content analysis study.

BACKGROUND: Today disasters are a part of many people's lives. Iran has a long history of disaster events and nurses are one of the most significant groups within the Iranian disaster relief operations, providing immediate and long-term care for those affected by the disaster. However, the technical competence of Iranian nurses and their training for this work has received little attention. This article presents the results of a study that aims to explore this context. MATERIALS AND METHODS: A qualitative study was conducted using in-depth interviews to collect data from 30 nurses, who were deliberately selected from the health centers affiliated to the Isfahan University of Medical Sciences. Themes were identified using the conventional qualitative content analysis. The trustworthiness of the study was supported by considering the auditability, neutrality, consistency, and transferability. The study lasted from 2011 to 2012. RESULTS: Data analysis undertaken for the qualitative study resulted in the identification of five main themes, which included: (1) Management competences, (2) ethical and legal competences, (3) team working, and (4) personal abilities and the specific technical competences presented in this report. CONCLUSIONS: This report presents an overview of the nursing technical capabilities required for Iranian nurses during disaster relief. It is argued that additional competencies are required for nurses who care in high-risk situations, including disasters. Nurses need to prepare themselves more effectively to be responsible and effective in nursing care.

Investigation of competencies of nurses in disaster response by utilizing objective structured clinical examination.

BACKGROUND: Nurses are members of the health care team for crisis response. Identifying nurses' capability in responding to a disaster and promoting their preparedness will lead to effective use of human resources and decreasing the detrimental effects of disaster. The purpose of this article was to determine emergency nurses' competences in triage, life support, and basic clinical skills in disaster response. MATERIALS AND METHODS: This study was a descriptive study in which 40 emergency nurses were recruited by purposeful sampling. Moreover, their competencies in performing triage, life support, and basic clinical skills were evaluated by utilizing eight-station objective structured clinical examination (OSCE). RESULTS: Our findings showed that the mean scores of nurses' performance were: In triage (4.3 ± 1.27), life support (4 ± 1.5), airway management (5.3 ± 1.7), chest tube insertion (7.3 ± 1.8), nasogastric tube insertion (5.6 ± 2.5), IV therapy (2.5 ± 0.8), IV line insertion (6 ± 1.4), suturing (9.1 ± 1.6), and urinary catheterization (10.4 ± 2.2). No statistically significant correlation was found between demographic variables and nurses' performance (P > 0.05). CONCLUSION: According to our findings, it can be concluded that competencies of nurses in performing triage, life support, and basic clinical skills were undesirable. Because emergency nurses are members of the emergency medical team, they should be prepared for disaster response via continuous training programs.

Struggling to create new boundaries: a grounded theory study of collaboration between nurses and parents in the care process in Iran.

AIM: To develop a substantive grounded theory of nurse-mother interaction in the care of chronically ill children in hospital setting. BACKGROUND: Interaction between nurses and parents is critical in paediatric hospital settings. This area of practice in developing countries has been under-researched. METHOD: The qualitative research design of grounded theory methodology was used to develop a theory of nurse-parent interaction within the child care. Registered Nurses (n=17) and mothers of chronically ill children (n=14) from two central paediatric hospital in Iran participated in this study. In-depth interviews with nurses and mothers were conducted using theoretical sampling between July 2007 and August 2008. The data were analysed using constant comparative analysis. FINDINGS: 'Struggling to create new boundaries' as a core variable was a dominant socio-psychological process that was manifesting itself within three stages: facing up to and perceiving the environmental pressures, balancing nurse's duties, and controlling the nurse-parent boundary in the care. CONCLUSION: It is concluded that nurses and parents need a care model, which addresses their collaboration and improved interpersonal relationship and clearly defines the boundary of their roles based on the needs of both sides while allowing parents to choose their role in these defined boundaries and providing parent education with aim to empower them for care at home.

Parental participation and mismanagement: a qualitative study of child care in Iran.

The purpose of this study was to explore parents' and nurses' experiences of parental participation in child care in hospitals in Iran. Using thematic analysis, the data were collected through interviewing 14 parents and 11 nurses from two pediatric hospitals. The results showed that four major themes emerged, including the necessity of a parent's presence, the unplanned and informal delegation of care to the parents (which itself had five subthemes: the parents as nurses, the delegation of care without sufficient and planned parental training, informal parent-to-parent support, the continuum of parents' willingness to participate, and the neglect of parents' needs), the inconsistency of care, and the parents as informal evaluators of care. Based on the study's findings, effective communication by nurses with parents is required. Nurses need to make an ongoing assessment of parents' wishes for involvement and negotiate care accordingly, with enough support and supervision to warrant quality of care.