Impact of Coronavirus Disease 2019 Outbreak on Children and Adolescents with Type 1 Diabetes Mellitus.

BACKGROUND: This study aimed to investigate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on daily routines and health of patients with type 1 diabetes mellitus (T1DM). STUDY DESIGN: A cross-sectional study. METHODS: This study included 98 children and adolescents with type 1 diabetes who were regularly followed up in the Endocrinology outpatient clinic of Besat Hospital, Hamadan, Iran, in 2020. The primary measurements included body mass index, glycemic control, number of hypoglycemic events, number of hospitalizations, as well as bedtime and availability of insulin six months pre and post COVID-19 outbreak. The obtained data were analyzed in SPSS software (version 16). A p-value less than 0.05 was considered statistically significant. RESULTS: Out of 98 participants (mean±SD age: 13.5±49), 51% of the cases were male, and %81.6 of the patients were urban residents. Furthermore, most participants (43.9%) were in the age group of 11-15 years, and the mean±SD duration of diabetes was 4.64±3.31 years. In addition, 2.04% of the participants developed COVID-19. There was a statistically significant difference among average duration of night sleep (P<0.001), bedtime (P<0.001), time of waking up (P<0.001), amount of insulin intake (P=0.003), daily exercise (P<0.001), and availability of the insulin (P<0.001) before and during COVID-19 crisis. The frequencies of hospitalizations and hypoglycemic events were lower after the COVID-19 outbreak (P=0.005 and P=0.034, respectively). Morning insulin dose was omitted in 22.2% of participants. No differences were found between hemoglobin A1c and daytime sleep pre and post COVID-19 outbreak. CONCLUSIONS: The key challenges due to COVID-19 pandemic restrictions for Iranian T1DM patients were the need to take more insulin, lower physical activity, non-availability of insulin, and missed morning insulin dose. However, it is worth mentioning that the patients' blood glucose control did not worsen in this period.

Relationship Between Parental Stress and their Attitudes Towards Cochlear Implantation Outcomes in Children Referred to Besat Cochlear Implant Center in Hamadan 2018.

PURPOSE: This study aimed to investigate the relationship between parental stress and their attitudes towards post-cochlear implantation outcomes in children referred to Besat cochlear implant center in Hamadan during 2018. DESIGN AND METHODS: In this descriptive cross-sectional study, 100 parents of children with cochlear implantation were selected from Besat cochlear implant center in Hamadan through census method from April to October 2018. The data were collected using a demographic characteristic questionnaire, parental stress scale developed by Berry and Jones, and Parental Attitudes of Various Aspects of Cochlear Implantation. The data were analyzed using SPSS software (version 16) through correlation coefficient, one-way ANOVA, and t-test. P-value <0.05 was considered statistically significant. RESULTS: The results of this study indicated that parental stress negatively correlated with their attitudes towards the outcomes of cochlear implantation (r = -0.420), including the aspects of communication (r = -0.462), educational (r = -0.398), and social skills (r = -0.445), as well as services provided by the health care centers (r = -0.277), and the efficiencies of cochlear implantation center (r = -0.118) (P < 0.05). CONCLUSION: According to the results, parents with more positive attitudes towards the areas of communication, educational, and social skills, as well as services provided by the health care centers, and the efficiencies of cochlear implantation center experienced lower levels of stress. PRACTICE IMPLICATIONS: Nurses can measure the stress and attitudes towards cochlear implantation outcomes in children to accurately assess the needs of the family in order to improve their nursing process and advance the child's rehabilitation program.

Psychometric Properties Of The Persian Version Of The Uncivil Behavior In Clinical Nursing Education Among Nursing Students.

BACKGROUND: Some clinical staff nurses show unprofessional behavior toward nursing students in clinical nursing education that can negatively affect their self-esteem and professionally. Examination of uncivil behavior toward nursing students requires a valid and reliable instrument. Therefore, the goal of the present study was to examine the psychometric properties of the Persian version of the Uncivil Behavior in Clinical Nursing Education (UBCNE) among nursing students. METHODS: In this methodological study, a total of 558 nursing students participated who were selected using a convenience sampling method, and were asked to complete the Persian version of the UBCNE. The UBCNE was translated based on the WHO guidelines. The face, content, and construct (using explanatory and confirmatory factor analysis) validities were assessed. In addition, internal consistency was assessed using the McDonald's omega and the Cronbach's alpha coefficient, and stability was assessed using the test-retest method. RESULTS: Explanatory factor analysis led to two factors, including Dismissive Behavior and Exclusionary Behavior that together explained 62.1% of the total variance of uncivil behavior. In the confirmatory factor analysis, the comparative and parsimonious fit indices were very good, but the absolute fit indices were poor (RMSEA=0.116, GFI=0.98, NFI=0.97, AFGI=0.83, PNFI=0.78). Reliability of the UBCNE was found to be 0.93 and 0.97, using the Cronbach's alpha coefficient and the test-retest method, respectively. CONCLUSION: The two-factor structure of the UBCNE has good validity and reliability among nursing students. Therefore, it can be used to assess civil behavior in clinical nursing education.

Respecting the privacy of hospitalized patients: An integrative review.

BACKGROUND: Privacy is a complicated and obscure concept, which has special meanings in the healthcare environment; therefore, it is essential for healthcare providers to fully understand this concept. However, there is no universally accepted definition for this concept in the texts, and it has been interpreted differently, based on its application. AIM: To analyze and provide a clear and scientific definition for respect of privacy of hospitalized patients and identify the common aspects of this concept. RESEARCH DESIGN: This study was conducted using the Whittemore and Knafl's modified framework as a conceptual analysis method. Ethical consideration: This study was approved by the Research Council of the University of Social Welfare and Rehabilitation Sciences. We have respected the ethical requirements required regarding the sources and authorship. Research context and data sources: Using integrative review, a search was performed using national and international databases, including CINAHL, Scopus, Medline, Web of Science, and ISI (with no date restriction). The keywords employed during the search process were "privacy of patients," "confidentiality," "and patients' rights." In total, 1345 articles were retrieved from the databases. After the elimination of repetitive studies and with regard to the study objectives, 124 articles, 3 books, and 4 theses were entered into the study. The data were analyzed using the conventional content analysis approach. FINDINGS: The results were extracted in the form of four, seven, and two themes related to attributes such as physical, informational, social, and psychological and the antecedents and consequences of respecting patient privacy, respectively. CONCLUSION: Respect for hospitalized patient privacy contains multiple dimensions. Factors affecting the achievement of this concept include individual backgrounds, nature of the disease, and rule of paternalism. The fulfillment of patient privacy leads to such consequences as protection and improvement of human dignity as well as improved communication between the patient and the health team.

Effects of stress on mothers of hospitalized children in a hospital in iran.

OBJECTIVE: Hospitalization of a child can cause severe anxiety and stress in the parents, especially for the mother. This stress consequently affects the treatment course of the child. Hereby, we investigate the impact of different stressors in mothers of hospitalized children. MATERIALS & METHODS: In this cross-sectional study, 225 mothers of hospitalized children in the pediatric ward of Besat hospital were randomly selected and studied. Data collection tool was a two-part questionnaire gathered by interviewing the mother. The first part included demographic information of the patients. The second part included questions regarding stressors in four different categories; child-related factors, environmental factors, socioeconomic factors and health professional factors. SPSS 16.5 was used for statistical analysis and data were analyzed by one way ANOVA and T test. RESULTS: In the child-related factor category, fear of child death (84%); in the socioeconomic factor category, fear of disease in the other siblings (84%); in the environmental factor category, unpleasant odors in the ward (56%); and in the health professional category, not enough explanation about inserting IV lines, (54.2%) constituted the most important factors. There was a meaningful correlation between the stressors and the mothers' age and occupation, child age, days of hospitalization, types of admission and health insurance coverage, but there was no meaningful correlation between stressors and other factors. CONCLUSION: Professional and in depth training programs should be provided for health care providers and nursing staff regarding dealing with mothers of hospitalized children.