Medication Errors among Iranian Intensive Care Nurses: A Systematic Review.

Background: Medication Error (ME) is a major patient safety concern in Intensive Care Units (ICUs). Critical care nurses play a crucial role in the safe administration of medication. This study was conducted to comprehensively review the literature concerning the prevalence of ME and associated factors and outcomes in Iranian ICU nurses. Materials and Methods: An extensive search of the literature was carried in international databases including PubMed, Web of Science, Scopus, and Google Scholar, as well as Persian databases such as Magiran and Scientific Information Database (SID) using ME-related keywords and the Persian equivalent of these keywords, from the first article written in this field to artcles published on March 30, 2021. The appraisal tool (AXIS tool) was used to assess the quality of the included studies. Results: Fifteen studies were included in this systematic review. The prevalence of MEs made by ICU nurses was 53.34%. The most common types of MEs were wrong infusion rate (14.12%), unauthorized medication (11.76%), and wrong time (8.49%) errors, respectively. MEs occurred more frequently in morning work shifts (44.44%). MEs happened more frequently for heparin, vancomycin, ranitidine, and amikacin. The most important influential factor in the occurrence of MEs in ICUs was management and human factors. Conclusions: The prevalence of MEs made by Iranian ICU nurses is high. Therefore, nurse managers and policymakers should develop appropriate strategies, including training programs, to reduce the occurrence of MEs made by nurses in ICUs.

Perceived factors influencing menstrual hygiene management among adolescent girls: a qualitative study in the West Gonja Municipality of the Savannah Region, Ghana.

Introduction: menstrual hygiene (MH) is important for all women, yet it is still a neglected issue in many parts of the world. In most traditional African contexts, including Ghana, menstruation is largely treated as a taboo and humiliating topic that is rarely discussed openly. The main aim of this study is to assess perceived factors influencing menstrual hygiene management among adolescent girls in Ghana´s Savannah Region, West Gonja Municipality. Methods: we conducted a descriptive exploratory qualitative study among adolescents who had reached menarche. Purposive sampling was used to conduct 24 interviews with 18 teenagers and 6 mothers. Data were analyzed using the thematic content analysis. Results: the majority (55.5%) of respondents were ≥15 years with maximum and minimum ages being 19 and 13 years respectively. The mean age was 15.7, with a standard deviation of 1.8. A higher proportion (38.9%) of respondents were in their final year (JHS 3). Before menarche, all adolescent girls had heard about menstruation, mostly from their mothers, then from instructors and friends. During menstruation, all of the girls in this study used absorbent products. The cost, comfort, heaviness of menstrual flow, and accessibility influenced the choice of absorbent material, with some respondents utilizing multiple absorbent materials. Some girls were forced to dry their reusable absorbent material in their room because of shyness. Girls thought that reusing absorbent materials after drying them in the sun would have killed germs and removed unpleasant odours. During menstruation, girls are barred from participating in social and religious activities. Conclusion: culture and religion have very dire consequences on effective menstrual hygiene management. There is therefore urgent need to dispel the growing myths and misconception on menstrual hygiene as well as providing support for adolescent girls for practicing good menstrual hygiene.

Fatalism, distrust, and breast cancer treatment refusal in Ghana.

Following recent advancements in science and technology, cancer treatment options have increased remarkably alongside improved survival rates. Yet, some individuals diagnosed with breast cancer refuse treatment. This study aimed to explore how breast cancer patients' personal beliefs and ideas influence their decision to refuse medical treatment. Thirteen participant interviews were selected from a larger cohort for a secondary analysis using the grounded theory approach. The decision to forgo medical treatment was influenced mainly by personal beliefs, which were framed as: 1. Triangle of religion, superstition, and ignorance, 2. Ghanaian traditional belief system, 3. My destiny, 4. Frail patient-staff relationships, 5. Futile appointments, and 6. Endless journey. Together, these fit into two overall themes-fatalism and poor communication patterns between healthcare providers and patients. Personal beliefs and managerial gaps within the health system mainly influence the growing trend of refusal of medical treatment among breast cancer patients in Ghana. These findings highlight the need for breast cancer education, professional counselling, and psychological support services.

The relationship between moral sensitivity and caring behavior among nurses in iran during COVID-19 pandemic.

BACKGROUND: Caring for patients during a pandemic can be difficult for healthcare workers, the patients themselves, and healthcare systems. Nurses are expected to recognize ethical dilemmas and make sound judgments when confronted with them. Sensitizing nurses to ethical issues strengthen their ability to identify ethical dilemmas and make ethical choices. As a result, this study aimed to determine a relationship between moral sensitivity and caring behavior among nurses during the coronavirus (COVID-19) pandemic. METHOD: The current study is a cross-sectional study of 406 nurses who worked in a single hospital during the COVID-19 epidemic. We used a demographic questionnaire and the caring behavior inventory (CBI) tool to collect data online. The data were analyzed using descriptive and correlational statistics. FINDINGS: Eighty-three point seven percent of participants in this study were female, and 71.9% were married. 47.5% reported caring for a COVID-19 patient for longer than a month; their average work experience was 13.1 years. Additionally, Moral Sensitivity correlated positively with caring behavior and its dimensions (r = 0.164, P = 0.001). However, a significant and inverse link existed between the dimension "following the rules" and the nurse's caring conduct (r = -0.117, P = 0.019). CONCLUSION: During the pandemic, nurses' moral sensitivity was moderate and significantly connected with their caring behavior. Because nurses encounter numerous obstacles while caring for patients in critical conditions, they require ethical empowerment to perform correctly, as caring behavior improves with increased moral sensitivity.

The role of socioeconomic status in the relationship between social support and burden among cancer caregivers.

While much research has focused on the direct impact of socioeconomic status on cancer patients, what is not clear is the impact of socioeconomic status on social support and the burden of care for caregivers. In this study, a cross-sectional method, using a convenience sampling approach, was adopted to collect the data of 191 caregivers of cancer patients who were referred to the oncology clinic and cancer institute of hospitals affiliated with Tehran University of Medical Sciences, Iran. The participants completed a questionnaire on basic demographics, the short version of the Burden Scale for Family Caregivers, and Zimet Multidimensional Perceived Social Support. A maximum likelihood exploratory factor analysis with oblique rotation to assess the factor structure of the constructs and the measurement model was conducted. The two-factor model consisting of 22 items explained 65.116% of the variance. There was a significant negative relationship between social support and burden (b = -0.771, P < 0.001) and also between economic status and burden (b = -0.308, P < 0.01). Moreover, there was a significant positive association between the interaction of social support and economic status and burden (b = 0.138, P < 0.05). More specifically, the negative relationship between social support and burden was statistically stronger for participants with weak economic status (b = -0.663, P < 0.001) than those with good economic status (b = -0.356, P < 0.01). Social support and an individual's economic status are essential determinants of caregiver burden. Further studies are recommended to better inform the precise support needed by caregivers to enhance their quality of life, and ultimately, that of the patients under their care.

Identifying and Ranking the Factors Affecting the Choice of Nursing Discipline Among Nursing Students in Iran: A Fuzzy Hierarchical Analysis.

BACKGROUND: Choosing a career in nursing is frequently a complicated decision that is influenced by multiple factors. PURPOSE: This study was designed to identify and rank the main factors that influence individuals to choose to pursue a career in nursing. METHODS: This cross-sectional study was conducted at Mazandaran University of Medical Sciences, Iran. A comprehensive review of the literature was conducted to identify the factors that people consider when making a choice to pursue a career in nursing. The face and content validities of these factors were evaluated. A sample of 250 participants was invited to assess the factors using exploratory factor analysis. Finally, the analytical hierarchy process, in combination with fuzzy logic, was used to rank the criteria and related factors. RESULTS: Twenty factors were identified and extracted from 50 published studies. After confirming the face and content validity of each, these 20 factors were distinguished into four criteria, including (a) external motivation, (b) social dignity, (c) internal motivation, and (d) usefulness of discipline. Each criterion had an eigenvalue greater than 1. External motivation and usefulness of discipline were respectively identified as the most and least important criteria (38.60% vs. 16.11%) in terms of influencing individuals to pursue a nursing career. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results of this study show that exposure to positive recommendations from family and friends, receiving positive information about studying nursing, positive perceptions regarding the general usefulness of nursing knowledge, and migration opportunities to other countries are the primary factors that influence individuals in Iran to pursue a career in nursing.

The Association between Changes in Coronary Artery Calcium Scores, Dietary Intake, Physical Activity, and Depression Symptoms among the Population of Gaza Strip, Palestine.

BACKGROUND: This study aimed to identify the association between macronutrient intake, physical activity, and depressive symptoms and changes in coronary artery calcium score among the population of Gaza Strip. METHOD: The study sample consisted of 269 individuals who underwent non-enhanced coronary computed tomography using 64-slice MDCT (Siemens, Germany) at Al-Shifa medical complex between September 2017 and January 2018. The study participants were divided into two groups; group one, consisting of coronary calcium calcification scoring (CAC) of greater than zero (CAC score > 0), and group two, CAC less than or equal to zero (CAC score ≤ 0). Data about macronutrient intake, physical activity, and depressive symptoms were collected using a validated self-administered questionnaire. Additionally, the participants' anthropometric characteristics and blood biochemical markers were measured. RESULTS: Out of 269 participants, 45-recorded CAC score > 0; 72% of them were males with a mean age of 52.6 ± 5.4 years. Significant differences between the two groups in terms of total energy, lipid intake, and carbohydrate were found (P-value of 0.020, 0.012, and 0.034, respectively). No significant differences were recorded in protein intake, physical activity, and depression. Multivariate logistic regression analysis under adjustment for possible confounding factors revealed that macronutrient intake, physical activity, and depressive symptoms were not associated with the development of CAC in two models. CONCLUSION: Based on our findings, macronutrient intake, physical activity, and depressive symptoms are not associated with the development of CAC among the population of Gaza.

War on Two Fronts: Experience of Children with Cancer and Their Family During COVID-19 Pandemic in Iran.

INTRODUCTION: The COVID-19 pandemic affects all age groups and presents differently in children from adults. Children who contract the virus while suffering from cancer may face unique health challenges than their counterparts. This study aimed to investigate the perspectives of children with cancer and their family in this era of the COVID-19 pandemic. METHODS: In this qualitative study, a total of 21 participants were interviewed. They include five children, thirteen mothers, a father and three pediatric oncology nurses. The study setting was a Pediatric Hospital in Tehran, Iran. RESULTS: Three main themes were identified through thematic analysis. 1) Swinging on the path of fear to adaptation, 2) Left-alone at emotional distances, 3) Care system confusion, and decreased quality of care. CONCLUSIONS: The COVID-19 pandemic has burdened children living with cancer and their families in varying ways. Their experiences show a new insight on how to improve their quality of life during these difficult times.

Limited access to care for persons with breast cancer in Africa: A systematic review.

PURPOSE: To systematically review the available evidence and examine the factors that may limit patients' access to breast cancer care in Africa. METHODS: We searched six databases (Google Scholar, Web of Science, PubMed, EMBASE, CINAHL, and Scopus) for studies conducted among breast cancer patients in Africa, highlighting patient challenges and barriers to care or treatment. The search was limited to studies published in the English language and from January 2000 until August 2019. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. There were no limitations to the methodological design of the included studies. RESULTS: In total, 18,154 articles were retrieved through electronic search; twenty-five were eligible for inclusion after quality appraisal. We analyzed the data using the deductive content analysis approach. Three categories emerged as barriers to breast cancer care: Socio-economic challenges, Institutional shortfalls, and Distinctiveness. CONCLUSIONS: The findings support that economic hardships, fear, and scarcity of cancer treatments/equipment are critical in limiting access to breast cancer care. Sustainable strategies aimed at scaling-up breast cancer care in the region are necessary. The results also highlight the need for reduced treatment cost and aggressive educational campaigns across healthcare facilities and the local communities.

Medication errors among Iranian emergency nurses: A systematic review.

OBJECTIVES: Medication errors (MEs) made by nurses are the most common errors in emergency departments (EDs). Identifying the factors responsible for MEs is crucial in designing optimal strategies for reducing such occurrences. The present study aimed to review the literature describing the prevalence and factors affecting MEs among emergency ward nurses in Iran. METHODS: We searched electronic databases, including the Scientific Information Database, PubMed, Cochrane Library, Web of Science, Scopus, and Google Scholar, for scientific studies conducted among emergency ward nurses in Iran. The studies were restricted to full-text, peer-reviewed studies published from inception to December 2019, in the Persian and English languages, that evaluated MEs among emergency ward nurses in Iran. RESULTS: Eight studies met the inclusion criteria. Most of the nurses (58.9%) had committed MEs only once. The overall mean rate of MEs was 46.2%, and errors made during drug administration accounted for 41.7% of MEs. The most common type of administration error was drug omission (17.8%), followed by administering drugs at the wrong time (17.5%) and at an incorrect dosage (10.6%). The lack of an adequate nursing workforce during shifts and improper nurse-patient ratios were the most critical factors affecting the occurrence of MEs by nurses. CONCLUSIONS: Despite the increased attention on patient safety in Iran, MEs by nurses remain a significant concern in EDs. Therefore, nurse managers and policy-makers must take adequate measures to reduce the incidence of MEs and their potential negative consequences.

The experiences of nurses and midwives regarding nursing education in Ghana: A qualitative content analysis.

BACKGROUND: The nursing education in Ghana has only witnessed minimal advancement though one of the earliest in Africa. This study aimed to explore nursing education in Ghana at the bachelor degree level in terms of the program's strengths, weaknesses, opportunities, and threats from the perspectives of nurses and midwives. METHODS: A qualitative design based on the content analysis approach was used in this study. We purposefully sampled and interviewed thirty-five nurses and midwives at the Tamale Teaching in Ghana from September 2018 to May 2019. RESULTS: The data analysis revealed five main categories; professionally developed, diverse implementation, insufficient resources, applied opportunities, and threatening policies. The findings highlight the strengths, weaknesses, opportunities, and threats of nursing education at the bachelor degree level in Ghana. CONCLUSION: The nursing education in Ghana has some internal capabilities in the form of strengths and weaknesses, such as the program being professionally regulated and operates on a well-developed curriculum, yet challenged with insufficient faculty and resources. The external opportunities and threats present as global recognition and career opportunities, amidst the proliferation of adjunct nursing programs. Recommendations have been highlighted.

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine.

Breast self-examination (BSE) is one of many first-line screening practices aimed at early detection and prevention of fatal outcomes of breast cancer. The present study aimed to identify Palestinian women's practices, awareness, and barriers to BSE. Using descriptive-analytical methods, a previously validated questionnaire was administered to a conveniently selected sample of women. The study was conducted among women who visited primary health clinics (PHCs) in Gaza City. A total of 390 participants who met the selection criteria answered the self-administered questionnaires. We used SPSS version 24.0 to analyze the data. The findings suggest that the practice of BSE among women in Gaza is low, with only 40% of the study participants reporting that they never practiced BSE before, even though 76.7% reported that they were aware of BSE. In general, the main barriers to BSE practices were that participants had wrong perceptions and lacked knowledge about BSE. Others also reported fear of detecting breast cancer as a barrier. The practice of BSE among Palestinian women in the Gaza Strip is low and marred with trivial issues as barriers that could be eliminated with dedicated and extensive educational campaigns in the area.

Challenges and facilitators of professional socialization: A systematic review.

AIMS: This current study aimed to present a review of the challenges and facilitators of professional socialization among undergraduate nursing students. DESIGN: Systematic review. METHODS: A literature search was conducted in Embase, Google Scholar, PubMed and Scopus in April and May 2018 for studies published in the English language. Four thousand three hundred fifty-two articles were retrieved. We conducted further screening for full-text articles after discarding duplicates and irrelevant studies. Finally, eight studies were included. The Joanna Briggs appraisal tools were used to appraise and evaluate study quality. The PRISMA guidelines were followed and a narrative synthesis used for data analysis. RESULTS: Challenges and facilitators of professional socialization were identified and categorized into two major themes. Under each theme, results were grouped into three sub-themes: professional, personal and educational challenges/facilitators.

Children's description of pain through drawings and dialogs: A concept analysis.

AIM: To present a concept analysis of pain in children's drawings and dialogs. INTRODUCTION: The complexity and subjectivity of the concept of pain in children remain ambiguous. As a result, children are exposed to inappropriate diagnosis and inadequate treatment. Children can describe or draw their painful experiences. Analysing the concept of pain based on children's experiences can help identify, assess and properly manage and treat pain in children. DESIGN: Concept analysis. METHODS: Walker and Avant's framework for concept analysis was used in this current study. RESULTS: Major aspects of pain revealed in this concept analysis are affected by children's different concerns about pain. The description of pain in children with chronic diseases or chronic pain is completely different from that in healthy children. Children perceive pain to be internal, external and emotional. Pain in children is associated with poor psychological and emotional conditions, which add new features and aspects to the concept of pain. Children's descriptions and drawings of pain indicate different concepts of pain in their minds. From the perspective of children, pain has an identity that is formed based on reality. CONCLUSION: When developing pain evaluation tools, it is necessary to address the characteristics of pain. In the case of chronic pain, emotional effects of pain on children's psyche need extra attention. Child-based pain management guidelines can then be formulated with the results of relevant concept analyses. Pain assessment is a major part of pain management in children. By considering the characteristics of the concept of pain, the efficiency and usefulness of developed tools can be enhanced to create advancement in paediatric pain management.

Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review.

BACKGROUND: Adolescent pregnancy has been persistently high in sub-Saharan Africa. The objective of this review is to identify factors influencing adolescent pregnancies in sub-Saharan Africa in order to design appropriate intervention program. METHODS: A search in MEDLINE, Scopus, Web of science, and Google Scholar databases with the following keywords: determinants, factors, reasons, sociocultural factors, adolescent pregnancy, unintended pregnancies, and sub- Saharan Africa. Qualitative and cross-sectional studies intended to assess factors influencing adolescent pregnancies as the primary outcome variable in sub- Saharan Africa were included. Our search was limited to, articles published from the year 2000 to 2017 in English. Twenty-four (24) original articles met the inclusion criteria. RESULTS: The study identified Sociocultural, environmental and Economic factors (Peer influence, unwanted sexual advances from adult males, coercive sexual relations, unequal gender power relations, poverty, religion, early marriage, lack of parental counseling and guidance, parental neglect, absence of affordable or free education, lack of comprehensive sexuality education, non-use of contraceptives, male's responsibility to buy condoms, early sexual debut and inappropriate forms of recreation). Individual factors (excessive use of alcohol, substance abuse, educational status, low self-esteem, and inability to resist sexual temptation, curiosity, and cell phone usage). Health service-related factors (cost of contraceptives, Inadequate and unskilled health workers, long waiting time and lack of privacy at clinics, lack of comprehensive sexuality education, misconceptions about contraceptives, and non-friendly adolescent reproductive services,) as influencing adolescent pregnancies in Sub-Saharan Africa CONCLUSION: High levels of adolescent pregnancies in Sub-Saharan Africa is attributable to multiple factors. Our study, however, categorized these factors into three major themes; sociocultural and economic, individual, and health service related factors as influencing adolescent pregnancies. Community sensitization, comprehensive sexuality education and ensuring girls enroll and stay in schools could reduce adolescent pregnancy rates. Also, provision of adolescent-friendly health services in schools and healthcare centers and initiating adolescent empowerment programs could have a positive impact.