Concept analysis of adoption: A hybrid model.

BACKGROUND: Adoption is a multidimensional concept affected by cultural and social factors. On the other hand, the number of adoptees has recently increased indicating the need to pay more attention to this issue. However, no clear definition of this concept has been provided so far. OBJECTIVE: The objective of this study was to analyze the concept of adoption. METHODS: The present study was an analysis using a hybrid model in three phases. During the theoretical phase, using the keyword "adoption," pertinent articles published between 2010 and 2022 were searched. In the field work phase, eight adoptive parents as the participants were interviewed and the data were analyzed using conventional content analysis method. In the final analysis phase, a general analysis of the two previous phases was performed and a final definition was presented. RESULTS: Adoption is one of the ways of having children that helps infertile couples to experience parental pleasure. If adoption is done wisely based on the abilities of parents, it can provide the best care setting for the child's growth leading to the consolidation of the family and a purposeful life. In adoption, all of the rights and responsibilities of the child are transferred from the biological parents to the adoptive parents, which is affected by religious and cultural beliefs. CONCLUSION: The analysis of the concept of adoption provided a good basis for identifying the various dimensions of adoption and its challenges. The parents need to pay attention to all dimensions of adoption before selecting this path. It also provided a good platform for future research in the field of adoption.

Patients' Lived Experiences of the Paternalistic Care Behavior: A Qualitative study.

Introduction: The major role of nurses in caring for patients puts them in a position where they can feel a sense of independence or lack of autonomy in dealing with patients throughout their actions. The present study aimed to explain patients' lived experiences of paternalistic care behaviors. Methods: This qualitative research was conducted with the design of hermeneutic phenomenology consistent with Heidegger's philosophical view and using the purposeful sampling method. Data richness was achieved after 13 interviews with 7 patients who had been hospitalized and received care in the hospitals of Tehran, Iran. The data were collected during 8 months (November 2020-June 2021) using an unstructured interview and analyzed using Diekelmann et al seven step approach with MAXQDA version 10 software. Results: Data analyses revealed four themes, thirteen sub-themes, and one constitutive pattern (duality of support and suppression of independence) forming the structure of patients' lived experience of paternalistic caring behaviors. The themes included (1) Support at helplessness, (2) Inflexibility (3) Vague awareness, and (4) Despair due to lack of autonomy. Conclusion: The meanings discovered in this research revealed that patients have dual emotions regarding paternalistic care behavior. On the one hand, they are pleased with the care provided, but on the other hand, they feel desperate and unable to make decisions due to being deprived of their independence. We can see the creation of new ethical values in care behaviors. Performing supportive care behavior with emphasis on patient participation should be considered as a key ethical principle in patient care.

Childbearing culture: a prominent context in the process of maternal role attainment in Iranian mothers with preterm neonates.

Transition to the role of mothering is one of the most important events in a woman's life. While childbirth is a biological event, pregnancy and the experiences around it are more influenced by social structure, which is shaped by cultural perceptions and practices. The aim of this study was to explore cultural context during maternal role attainment in neonatal intensive care units (NICUs) in Iran. The study was part of a grounded theory study on how the mothers of preterm neonates go through maternal role attainment. Data collection was carried out by purposeful sampling from 20 participants (15 mothers of preterm neonates and 5 NICU nurses). Data were analysed according to Corbin and Strauss's (2015) approach. Four categories of childbearing culture emerged: 'The necessity of childbearing', 'Childbearing rituals', 'Maternal persistent presence' and 'Attitudes and religious beliefs'. The findings showed that the special beliefs and practices in Iranian culture affected all of the participants' reactions to mothering process. Culture is one of the most important factors affecting the development of motherhood in Iran. In order to provide sensitive and culturally appropriate care, nurses should be aware of the general impact of cultural norms and values on the process of maternal role attainment and strive to meet the cultural needs of all mothers.

The worldwide prevalence of anxiety in acquired immune deficiency syndrome patients: A systematic review and meta-analysis.

Background: Anxiety affects social, economic, and physical aspects of daily life in patients with AIDS. Therefore, it is necessary to take preventive measures and design plans to maintain their general health. The present study was the first comprehensive systematic literature review research that examined the worldwide prevalence rate of anxiety in patients with AIDS. Methods: We searched for papers published in the English language in the major databases including Embase, PubMed, Web of Science, Scopus, Cochrane, and Google Scholar from 2000 to October 2018. There were 40 studies which found to be eligible. These studies were independently evaluated and the collected data were entered in a data extraction form, which was then analyzed by two authors and a third author if necessary. Der Simonian-Laird model was used to estimate the prevalence rate on a Forest plot at the interval confidence of 95%. Results: The total sample size was 24111, and the total number of people with anxiety was 5546. The results based on the random-effects model showed that the rate of anxiety prevalence in the patients was 25% (CI: 95%, 21% -30%) with heterogeneity of 97.9% and a significance level of p<0.001. The South America continent with a prevalence of 38% (95% CI, 34%-42%) had the highest anxiety prevalence rates and Africa with 19% (95% CI, 12% -29%) had the lowest anxiety prevalence rates. Conclusion: Based on findings, the prevalence of anxiety in developed countries was partially higher than in underdeveloped countries and the obtained mean in the present study. It can be a significant point for policymakers. Therefore, WHO and the world community should have special plans for these countries.

Burn care strategy in the covid-19 pandemic: a narrative review study.

INTRODUCTION: The COVID-19 pandemic has changed the world and intensified health management in many parts of the world. Sensitivity in burn patients' care and prevalence of COVID-19 have a major impact on this group's healthcare system and infection control strategies. The purpose of this study is to review burn care strategies during the COVID-19 outbreak. MATERIALS AND METHODS: The present study is a narrative review study. In writing this paper, to access information, the keywords of Coronavirus, COVID-19, burn, strategy, care, and SARS were used. Due to the emergence of COVID disease, searches in Science Direct, PubMed, Scopus, Web of Science, Google Scholar, SID, Magiran, Springer, and Elsevier databases were performed without time limit. Research articles were purposefully selected and approved to be investigated based on the criteria for entering the research. A total of 14 articles had a full text related to the research scope. The researchers used qualitative content analysis to analyze the data. Data analysis was conducted as a comprehensive review of articles, qualitative conclusions, and results. RESULTS: In this study, 14 articles related to burn care strategies in the COVID-19 epidemic were selected. Their results were reviewed in two areas of staff care strategies and burn patients during the COVID-19 outbreak. Findings indicate that appropriate prevention and protection strategies and measures should be followed to prevent the transmission of the COVID-19 virus to burn care professionals. In addition, burn patient care strategies were proposed in two levels of minor and moderate to severe burns, so that patients with burns receive adequate burn care during the COVID-19 outbreak. CONCLUSION: Implementation of staff and burn patient care strategies during the COVID-19 pandemic is essential to treat burn patients and prevent the spread of the COVID virus.

Self-reinforcement: Coping strategies of Iranian mothers with preterm neonate during maternal role attainment in NICU; A qualitative study.

INTRODUCTION: Having a preterm neonate in the neonatal intensive care unit (NICU) is one of the most stressful experience for parents. In facing these stressors, mothers need to find ways to adapt and control resources to maintain stability. The aim of this paper is to report coping strategies of mothers with preterm neonate during maternal role attainment in NICU. METHODS: This paper reports a part of the findings of a grounded theory study that investigated how the mothers of preterm neonates go through maternal role attainment. The data were collected through in-depth semi-structured interviews with 12 mothers with preterm neonate admitted to the NICU and 5 nurses working in NICU. Data were analyzed according to Corbin and Strauss's (2015) approach using constant comparative analysis technique. FINDINGS: Four themes, emerged from experiences of the participants, formed the concept of "Self-reinforcement" as the prominent strategy of mothers: "support seeking", "Spiritual getting in the mood", "Hope creation" and "Getting energy from the baby". CONCLUSION: These findings showed that mothers use strategies to calm and support themselves and their neonates, and recognize that their lives had changed and need to adjust to their new circumstances.

Emotional disorganization: The prominent experience of Iranian mothers with preterm neonate: A qualitative study.

When a preterm neonate is born and needs to be taken care of in the neonatal intensive care unit (NICU), the mother experiences a different process of mothering. A grounded theory study was conducted to explore the maternal role attainment in mothers of preterm infants. The authors of this paper report the most prominent experience of Iranian mothers with preterm neonates during their stay in the NICU that emerged as part of the process of maternal role attainment. Data were collected through in-depth semi-structured interviews with mothers in the NICU. We found four categories as emerged from experiences that formed the concept of "emotional disorganization". We argue that these findings can help caregivers and nurses to provide sensitive and supportive care to mothers of preterm neonates.

Strategies for bridging the theory-practice gap from the perspective of nursing experts.

The gap between education and the clinical practice has always been challenge for educational experts in the field. This article aims to explore the perspective of Iranian nursing experts about strategies used for coordinating education and clinical performance in nursing. This qualitative study was conducted by using a conventional content analysis approach; individual interviews were conducted at the participants' work place; while focus group discussions took place at the Nursing and Midwifery Faculty of Iran University of Medical Sciences. Participants in this study included nursing instructors, educational supervisors and nursing managers with a clinical background and teaching experience of at least five years. In addition, a graduate nursing student and a nursing PhD candidate were also interviewed to ensure data saturation. Purposive sampling was conducted between April 2016-October 2017 among scholars and nursing professional experts who were highly experienced in this field. The two focus groups, obtained the views of nursing managers and educational supervisors working in educational hospitals. Analysis involved open stepwise coding with an emphasis on continuous comparison of data, and reference to written notes of the interviews. The analysis process was carried out in three main phases of preparation, organization, and reporting. The results of this study were classified in three main categories: developing context base curriculum, interactive collaboration among nurses and faculties, the Design and Implementation of a Standard Clinical Guideline. It seems that strong intention and active participation of all beneficiaries are needed to bridge the gap between theory and practice. Creating an appropriate context for nurses and nursing trainers for mutual learning along with the use of pragmatic language in the form of clinical guidelines can help decrease this gap.

The Effect of the Family-Centered Empowerment Model (FCEM) on the Care Burden of the Parents of Children Diagnosed with Cancer.

Background: Families face multiple problems after their children are diagnosed with cancer. This study aims to determine the effect of the Family-Centered Empowerment Model (FCEM) on the care burden of the parents of children, diagnosed with cancer. Methods: This quasi-experimental study was conducted with 78 parents, having children with cancer. The FCEM was implemented in the intervention group in four stages, namely perceived a threat, self-efficacy, educational participation, and evaluation during four sessions of 20-40 minutes. The control group only received the usual care. The burden of care of the control and intervention groups were measured one month after filling out the initial questionnaire, and one month after the end of the intervention, respectively. Results: The two groups were similar in terms of demographic variables and level of burden of care. However, a statistically significant difference was observed between the two groups, in terms of the level of burden (p<0.001). Conclusion: The results of this study showed that the empowerment of parents of children with cancer has an impact on reducing their care burden, and using this empowerment model is recommended to the treatment team, especially nurses.

The Effects of Massage by Mothers on Mother-Infant Attachment.

Context • Transferring a newborn to the intensive care unit due to a premature birth is a major obstacle in the establishment of emotional attachment between a mother and her child. Researchers believe that the formation and continuation of such an attachment have a profound effect on the child's mental development and behavior in the coming years of life. Not all studies have agreed, however, that skin contact alone, such as massage provides, can improve attachment. Objective • The aim of this study was to determine the effects on maternal attachment behaviors of infants hospitalized in a neonatal intensive care unit (NICU) of massage provided by mothers for their premature neonates. Design • The research team designed a randomized, controlled trial. Setting • The study took place at the Hazrat Ali Asghar Hospital of the Iran University of Medical Sciences (Tehran, Iran). Participants • Participants were 40 mothers and 40 newborns admitted to the NICU at the hospital. Intervention • The study divided participants randomly into a massage (intervention) group and a control group receiving no massages. Mothers in the intervention group trained by watching educational videos and practicing the massage on infant manikins. Subsequently, the intervention group massaged its infants according to a 5-d program, in which each neonate received a 15-min massage session per day. Outcome Measures • Mother-infant attachment behaviors were assessed in both groups 4 times. The maternal attachment scale was used for data collection. Results • According to the statistical analyses, the between-groups difference was not significant at baseline (P > .05). The study showed a statistically significant difference between baseline and postintervention in the mean frequencies of maternal attachment behaviors for both groups (P < .001). In addition, a significant between-group difference existed postintervention between the means for maternal attachment between the intervention and control groups (P = .000). Conclusion • Massage given to premature neonates by their mothers on a daily basis can promote and maintain emotional attachment between the mother and her infant. The findings of the present study can be used to investigate the effects of other family members massaging newborns on the emotional attachment between them.

The Effect of Foot Reflexology on Anxiety, Pain, and Outcomes of the Labor in Primigravida Women.

Reflexology is a technique used widely as one of non-pharmacological pain management techniques. The present study aimed to review and determine the effect of foot reflexology on anxiety, pain and outcomes of the labor in primigravida women. This clinical trial study was conducted on 80 primigravida mothers who were divided randomly into an intervention group (Foot reflexology applied for 40 min, n=40) and control group (n=40). The pain intensity was scored immediately after the end of intervention and at 30,60 and 120 min after the intervention in both groups, based on McGill Questionnaire for Pain Rating Index (PRI). Spielberger State-Trait Anxiety Inventory (STAI) was completed before and after intervention in both groups. Duration of labor phases, the type of labor and Apgar scores of the infant at the first and fifth minute were recorded in both groups. Descriptive and inferential statistics methods (t-test and chi-square test) were applied in analyzing data. Application of reflexology technique decreased pain intensity (at 30, 60 and 120 min after intervention) and duration of labor as well as anxiety level significantly (P<0.001). Furthermore, a significant difference was observed between two groups in terms of the frequency distribution of the type of labor and Apgar score (P<0.001). Results of this study show that reflexology reduces labor pain intensity, duration of labor, anxiety, frequency distribution of natural delivery and increases Apgar scores. Using this non-invasive technique, obstetricians can achieve, to some extent, to one of the most important goals of midwifery as pain relief and reducing anxiety during labor and encourage the mothers to have a vaginal delivery.

Ethical challenges of researchers in qualitative studies: the necessity to develop a specific guideline.

Considering the nature of qualitative studies, the interaction between researchers and participants can be ethically challenging for the former, as they are personally involved in different stages of the study. Therefore, formulation of specific ethical guidelines in this respect seems to be essential. The present paper aimed to discuss the necessity to develop explicit guidelines for conducting qualitative studies with regard to the researchers' role. For this purpose, a literature review was carried out in domestic and international databases by related keywords. Health care providers who carry out qualitative research have an immense responsibility. As there is no statistical analysis in qualitative studies, the researcher has to both evaluate what he or she observes and to interpret it. Providing researchers with the necessary skills and applying stringent supervision can lead to better extraction of reliable information from qualitative studies. This article presents a debate in order to illustrate how researchers could cover the ethical challenges of qualitative studies and provide applicable and trustworthy outcomes. Researchers face ethical challenges in all stages of the study, from designing to reporting. These include anonymity, confidentiality, informed consent, researchers' potential impact on the participants and vice versa. It seems of paramount importance that health care providers, educators and clinicians be well informed of all the different aspects of their roles when acting as qualitative researchers. Hence, these adroit roles need to be well defined, and the use of practical guidelines and protocols in all stages of qualitative studies should be encouraged.

Caring for a child with cancer: impact on mother's health.

The life of a mother undergoes a dramatic change after a child is diagnosed with cancer. The present study aimed to determine effects on the everyday life process and health status of mothers with children suffering from leukemia. This qualitative study was based on a grounded theory approach with sixteen mothers. The results indicate that after onset of disease in their children, they marginalized their own health and tied their identities to taking care of the child and keeping the child healthy by ignoring themselves, becoming imprisoned in a taking-care-of-the-child position, and trying very hard for seek balance and stability Enduring physical pressures on the one hand, and constantly attempting to achieve balance and stability in family processes on the other hand, gradually cause exhaustion. It seems that health care providers and nurses should pay much more attention to the health status of this group of mothers.

Psychometric properties of the Persian version of the self- assessed support needs questionnaire for breast cancer cases.

BACKGROUND: It has been found that support given to women with breast cancer has a positive effect upon their reactions to the illness and may even prolong their survival. Perceived support needs assessment in breast cancer women could be considered as a necessary part of nursing function. AIM: The purpose of this study was to translate and culturally adapt the self-assessed support needs (SASN) questionnaire into Persian language and to investigate its psychometric properties. MATERIALS AND METHODS: After forward-backward translation of the questionnaire and making appropriate changes, we selected 160 women with breast cancer as our study sample. The psychometric properties of the SASN, including its internal consistency, test retest reliability, and construct validity were evaluated through the known-groups technique. RESULTS: The calculated Kaiser Meyer Olkin was 0.756, indicating that the sample was sufficiently large to perform a satisfactory factor analysis. The six factors all together explained 50.7% of the variance; the first factor (diagnosing) explaining the biggest part of variance (10.9). Internal consistency reliability was 0.83 for the whole scale and the stability of test was 0.78. For the first factor, Cronbach's alpha was 0.90 and factor loadings of scale's items were found to deal with diagnosis subscale. The domains described patients' diagnosis, treatment, support, femininity and body image, family and friends and information. CONCLUSIONS: The reliability and validity of the adapted version of the SASN was shown to be satisfactory. Thus, it can be used to investigate self-assessed support needs of Iranian women suffering from breast cancer since the SASN is a multi-domain scale.

The Association between Sleep and Injury among School-Aged Children in Iran.

Background. A good night's sleep plays a key role in diseases resistance, injury prevention, and mood stability. The objective of this study was to examine relationship between sleep problems and accidental injury occurrences in school-aged children. Method. A retrospective study was conducted for comparing two groups of children. Children who have experienced injuries for at least two times during an academic year are the participants in the injury group (IG) and those who have not experienced any kind of injuries are placed in the noninjury group (NIG). Data was collected through parent-reported sleep patterns and problems using Children's Sleep Habits Questionnaire (CSHQ). Findings. The findings showed that global sleep problems were more in the IG than in the NIG. Multivariate logistic regression analysis showed that the daytime sleepiness and sleep duration are the two major reasons for accidental injury. In addition, significant difference was seen between the sleep patterns of the two groups. Sleep duration was also shorter in the IG, and this group had a greater percentage (63% versus 41.1%) of "short sleepers" (<9 h). Conclusion. There is a significant relationship between injury occurrence and sleep problems and sleep duration in Iranian school-aged children.

Nursing support for parents of hospitalized children.

BACKGROUND: Having a child in hospital is a stressful experience for most parents. Support from nurses can assist parents to maintain their parenting role and promote quality pediatric nursing care. AIMS AND OBJECTIVES: The aim of the study is to describe the quality of nurse-parent support in Iranian parents of hospitalized children in pediatric sites. METHODS: This was a descriptive study using a convenience sample. Two hundred and thirty parents (183 mothers and 47 fathers) with hospitalized children took part in this survey that used the Nurse Parent Support Tool (NPST). This validated instrument has 21 items and 4 subscales (Informational Giving and Communication Support; Emotional Support; Appraisal Support and Instrumental Support), and was translated into Farsi. RESULTS: The total mean of the NPST was M = 4.1 (SD = 0.7). There was a significant difference between gender of the parents and the Instrumental Support subscale. Also, there was significant difference between among education level of parents and Emotional Support. In addition, there was significant difference related to the gender of the child and Information Giving and Communication Support and Appraisal Support. There was no significant difference in any of the subscales when analyzed for length of hospitalization, kind of diseases and age of children. CONCLUSIONS: The findings indicate that parents received a high level of support from nurses. Nurses can promote the quality of family care and should be aware of the importance of the several types of nursing support in meeting the requests of parents. It is important that nurses continue to develop their knowledge about types of communication with the family, especially in providing support for the parent role.

Workplace violence and abuse against nurses in hospitals in iran.

PURPOSE: The rising rate of violence and abuse in health care centers has become a major problem for nurses. The purpose of this cross-sectional study was to explore the prevalence of assaults during nurses' careers in the Islamic Republic of Iran. METHODS: Self-report questionnaires were filled out by 1,317 nurses. RESULTS: Verbal abuse was experienced by 87.4% of the population during a 6-month period, and physical violence by 27.6% during the same period of time. No physical harm was reported in 66.4% of cases. Only 35.9% cases of verbal abuse and 49.9% cases of physical violence were actually reported. The majority of cases reported that abuse was followed by either inaction or by actions which failed to satisfy the victim. According to the findings, men were exposed to more abuse than women, and the risk of experiencing abuse was higher in nurses with more job experience or who worked more hours. Also, nurses who are responsible for first aid were subjected to more abuse than those in other positions. CONCLUSION: The findings showed a noticeable trend of a rising number of assaults against nurses. The findings of this study may help hospital staff and nurses to avoid, reduce and control violence and abuse.