Evidence-Based Design in the Hospital Environment: A Staff's Burnout Study in the COVID-19 Era.

OBJECTIVE: This study aimed to evaluate the evidence-based design of the hospital physical space effect on the burnout of nurses and physicians during COVID-19. The research question was to identify the connection between daylight, nature-view windows, and hospital staff burnout during Covid-19. BACKGROUND: The evidence-based design in the hospital environment affects the health of the medical staff. The promotion of the hospital environment has a significant effect on healthcare system improvement. METHODS: This cross-sectional study was performed on 406 nurses and physician's burnout in Guilan province in 2020. Three questionnaires were used: demographic, physical space of the hospital, daylight, nature-view windows, and Maslach Burnout Inventory. Logistic regression (LR) analysis was used to determine the association between burnout and the hospital environment. The significance level was considered with p < .05. RESULTS: The results showed statistically significant correlations between patient units and the environmental characteristics of the hospitals with staff's burnout (p < .001). Of note, 62.9% of physicians and 71.9% of nurses had moderate work-related burnout. The highest burnout score was seen among staffs of emergency departments adjusted multivariate LR model revealed that 27.1% of work-related burnout in nurses and physicians was predictable with age, light, marital status, and hospitals. Our results showed that accessing more daylight could reduce burnout (p = .018, odds ratio [OR] = 0.910). CONCLUSION: Based on the result, the daylight impact on burnout reduction is more significant than other factors. It is suggested that adequate lighting, proper environmental design, and nature-view windows could create appropriate space for enhancing medical staff satisfaction and reducing burnout.

Evaluation of the relationship between prestin serum biomarker and sensorineural hearing loss: a case-control study.

RESEARCH BACKGROUND AND AIM: There is not any routine serum biomarker for diagnosing hearing loss (HL). An inner ear-specific protein, prestin can be measured as a serum biochemical marker for HL diagnosis. The present study investigates, for the first time, the relationship between prestin serum levels and sensorineural HL (SNHL) in an Iranian population. MATERIALS AND METHODS: In this case-control study, 176 samples were examined in four groups including two control and two SNHL groups of 20-50 and ≥ 50 years with different severities of SNHL. Plasma prestin concentration was measured using Human Prestin (SLC26A5) ELISA Kit. Data analysis was conducted using SPSS v.23 with level of significance as 0.05. RESULTS: Groups with SNHL had higher prestin levels (Mean = 182.29, SD = 71.24) compared to the control groups (Mean = 122.50, SD = 57.1) (P < 0.001). Results of the multinomial logistic regression of relationship between prestin level and SNHL remained significant after controlling intervening variables (P < 0.001 and odds ratio = 1.017 and 95% CI OR: 1.01-1.024). Results of the ordinal logistic regression model revealed that prestin level was significantly associated with the degree of HL (P < 0.001 and Odds ratio = 1.009 and 95% CI and OR: 1.005-1.013), so that the likelihood of HL increased with the rise in prestin levels. The best cutoff point for the 20-50 group was the prestin content of 132.5 pg/ml (sensitivity: 75%, specificity: 70.05%), while for the group of ≥ 50 was as 130 pg/ml (sensitivity: 84.1%, specificity: 68.2%). CONCLUSIONS: Results of the present study revealed that prestin acts as a valuable biomarker for SNHL.

Effect of a forensic nursing virtual education course on knowledge and clinical decision-making of master's nursing students in Iran: a non-equivalent control group pre- and post-test study

PURPOSE: Forensic nursing is a specialty in the nursing profession based on legal procedures. This study aimed to assess the effect of a forensic nursing virtual education course on knowledge and clinical decision-making among master's nursing students. METHODS: In a quasi-experimental study with a pre- and post-test, 106 master's nursing students at Guilan (n=65) and Mazandaran (n=41) Universities of Medical Sciences, Iran were enrolled. Data were collected using census sampling from March to April 2021. Participants in the intervention group received a forensic nursing virtual education course in three 90-minute sessions for 2 days. RESULTS: A total of 88 out of 106 master's nursing students were enrolled in this study. The mean post-education score for knowledge in the intervention group was significantly higher than in the control group (12.52 vs. 7.67, P<0.001). The mean post-education score for clinical decision-making in the intervention group was significantly higher than in the control group (16.96 vs. 13.64, P<0.001). CONCLUSION: The level of knowledge and clinical decision-making of master's nursing students regarding forensic evidence improved after the forensic nursing virtual education course in the intervention group compared to the control group. Nursing managers and policymakers can develop appropriate strategies to improve the knowledge and clinical decision-making of nursing students by using forensic nursing education courses in the curricula of nursing programs, especially in postgraduate education as an elective or mandatory course.

Prevalence of anxiety and depression in Meniere's disease; a comparative analytical study.

BACKGROUND: Psychological problems are of most significant issues in patients with Meniere's disease (MD). This study aimed to reveal the frequency of anxiety and depression in MD patients compared to healthy individuals and patients with benign positional paroxysmal vertigo (BPPV) referred to a university hospital. METHODS: This case-control study was conducted on individuals between 18 and 65 years old assigned to three groups: the control, MD, and BPPV groups. The data collecting instruments included a demographic information form, along with Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) questionnaires. Data were analyzed using SPSS software v.23, and the significance level was considered as p < 0.05. RESULTS: A total of 177 participants enrolled. The average scores of anxiety and depression and the severity of anxiety and depression were higher in MD and BPPV groups than in the control group (P < 0.001). The average anxiety score and anxiety severity in the MD group was higher than in the BPPV group (P < 0.001). However, in the case of depression, only severity was higher in the MD group (P < 0.001), and the average depression score showed no significant difference between MD and BPPV groups. After controlling for underlying variables, the impacts of MD (P < 0.001; regression coefficient = 16.5) and also BPPV (P = 0.025; regression coefficient = 4.6) on anxiety were significant compared to the control group. CONCLUSION: Our results suggest that the prevalence of anxiety and depression is higher in MD and BPPV patients than the healthy people, and MD has a higher effect on the incidence of depression and anxiety compared to BPPV.

Waist Circumference and Spirometric Measurements in Chronic Obstructive Pulmonary Disease.

OBJECTIVES: The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function. METHODS: There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated. RESULTS: The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( p = 0.031). A positive correlation with body mass index ( p < 0.001), smoking ( p = 0.027), and global initiative for chronic obstructive lung disease score ( p = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD. CONCLUSION: WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.

Unplanned readmission after hospital discharge in burn patients in Iran.

INTRODUCTION: Burns are considered as one of the most serious health problems throughout the world. They may lead to adverse consequences and outcomes. One of these outcomes is unplanned readmission. Unplanned readmission has been commonly used as a quality indicator by hospitals and governments. This study aimed to determine the predictors of unplanned readmission in patients with burns hospitalized in a burn center in the North of Iran (Guilan province, Rasht). METHODS: This retrospective analytic study has been done on the medical records of hospitalized patients with burns in Velayat Sub-Specialty Burn and Plastic Surgery Center, Rasht, Iran during 2008-2013. In general, 703 medical records have been reviewed but statistical analysis was performed on 626 medical records. All data were entered in SPSS (version 16) and analyzed by descriptive and inferential statistics. RESULTS: Among 626 patients with burns, the overall readmission rate was 5.1%. Predictors of readmission included total body surface area (OR 1.030, CI 1.011-1.049), hypertension (OR 2.923, CI 1.089-7.845) and skin graft (OR 7.045, CI 2.718-18.258). CONCLUSION: Considering the outcome, predictors following burn have a crucial role in the allocation of treatment cost for patients with burns and they can be used as one of the quality indicators for health care providers and governments.

Predictors of quality of life in patients with colorectal cancer in Iran.

BACKGROUND: Colorectal cancer (CRC) is one of the most common invasive cancers and is responsible for physical and psychosocial morbidity. Quality of life (QOL) is an important outcome for these patients. The aim of this study was to determine the predictive factors of QOL in patients with CRC. MATERIALS AND METHODS: A cross-sectional design was used to assess 110 patients with CRC who referred to Oncology Department of Razi Hospital, Guilan. Data were collected by structured interview with patients and review of medical records. Generic and specific QOL were evaluated by short form-36 and functional assessment of cancer therapy-colorectal, respectively. Generalized linear models identified variables significantly associated with QOL. RESULTS: Out of 110 patients with CRC, 58.2% were men. Mean age of patients was 58.33 ± 12.39 years. Mean of Generic and specific QOL were 70.92 ± 15.56 and 95.72 ± 19.18, respectively. In regression analysis, age, sex, living condition, health insurance, hospitalization frequency, Karnofsky performance status, and co-morbidity were predictors of generic QOL and age, sex, living condition, health insurance, monthly income, family history of CRC, Karnofsky performance status, and co-morbidity were predictors of specific QOL in patients. CONCLUSION: There are nine socio-demographic and clinical factors that are significant predictors of QOL in patients with CRC which should be considered in treatment and care of patients. The findings of this study should be the target of future research, emphasizing the need for interventional studies that minimize the adverse impact of the disease symptoms on the QOL in patients with CRC.