Clinical reasoning skill of nurses working in teaching medical centers in dealing with practical scenarios of King's model concepts.

BACKGROUND: The present study was conducted to determine clinical reasoning of nurses working in teaching medical centers in dealing with practical scenarios of King's concepts. METHODS: The study population in this cross-sectional descriptive-analytical study comprised 133 nurses. Data were collected using scenarios based on the King's model. Data were analyzed in SPSS-16. FINDINGS: Mean age of the participating nurses was 27.71 ± 8.1 years.The clinical reasoning score was less than average in most participating nurses, and had a significant relationship with education(P < 0.05), service ward(P < 0.001)and organizational position(P < 0.05). In the multivariate analysis of factors relating to clinical reasoning, higher education level (B = 9.5, P = 0.018) and organizational position (B = 4.3, P = 0.017) were predictors of clinical reasoning score. DISCUSSION: Existing nursing models such as King's, which is closely related to clinical reasoning, can be used more in educational and clinical systems, and as a clinical guide for promoting the clinical reasoning of nurses and students.

Acupressure and anxiety in cancer patients.

BACKGROUND: Anxiety has negative effects on mental and physical performance, quality of life, duration of hospitalization, and even on the treatment of patients with cancer. OBJECTIVES: Today acupressure is widely used to treat anxiety. Thus, the present study aimed to investigate the effects of acupressure on anxiety in patients with cancer. PATIENTS AND METHODS: A double-blind randomized clinical trial was conducted on 85 patients hospitalized with 3 groups including acupressure group (n = 27), sham group (n = 28), and control group (n = 30) in the hematologic ward of Shahid Beheshti Hospital of Hamadan, Iran, in 2013. The sampling permuted-block randomization with triple block was used. The anxiety of the patients in the experimental, sham, and control groups were measured with Spielberger's State-Trait Anxiety Inventory (STAI). Then, real acupressure was performed in the experimental group and fake acupressure in the sham group, and only routine care was provided for the control group. Anxiety of the patients was also assessed at 5 and 10 days after the intervention. Statistical analysis of the data was performed by SPSS software using repeated measures analysis of variance (ANOVA) and post hoc least significant difference (LSD) test. RESULTS: According to the findings, the mean level of anxiety before the intervention between groups were matched (P > 0.05). Acupressure had a significant influence on the anxiety in the experimental group at 5 (45.30 ± 7.14) and 10 days (43.48 ± 6.82) after the intervention (P < 0.05). However, it did not have a significant impact on their covert anxiety (45.48 ± 7.92 at 5(th) day vs 45.63 ± 8.08 at 10th day, P > 0.05). No significant differences were observed in the fake points regarding overt and covert anxiety of patients in the sham group (overt anxiety; 47.57 ± 7.85 at 5(th) day vs. 46.71 ± 7.32 at 10(th) day, P > 0.05) (covert anxiety; 47.96 ± 6.33 at 5(th) day vs. 46.89 ± 6.94 at 10(th) day, P > 0.05). Moreover, the routine care provided for the control group did not have any effect on the overt and covert anxiety of the patients (P > 0.05). CONCLUSIONS: Acupressure is recommended as a complementary therapy to reduce anxiety in patients with cancer because of its low cost, safety, and simplicity.