The patients' lived experiences with equitable nursing care.

BACKGROUND: Equitable care is a fundamental value in the nursing profession. Healthcare workers have both a moral and professional duty to ensure that they do not discriminate. AIM: This study aimed to explore how patients perceive equitable nursing care. RESEARCH DESIGN, PARTICIPANTS, AND RESEARCH CONTEXT: This descriptive phenomenological qualitative research study used purposeful sampling to select 17 patients from various departments of a general hospital in southern Iran. The participants were then interviewed using a semi-structured in-depth interview format, which aimed to delve into their experiences with equitable nursing care. The collected data were analyzed using Colaizzi's seven-step method and MAXQDA20 software. ETHICAL CONSIDERATIONS: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Ethics Committee of Jiroft University of Medical Sciences. FINDINGS: The data analysis of the study identified three main themes and six subthemes that were related to the experiences of patients with equitable nursing care. The first theme, equitable care, encompassed subthemes such as nurses' dedicated efforts to facilitate patient recovery and adherence to ethical behavior. The second theme, unconscious causes of inequitable nursing care, included subthemes such as unintentional discrimination stemming from organizational constraints and unconscious biases resulting from a lack of knowledge and skills. The third theme, discriminatory care, comprised subthemes such as deliberate discrimination based on personal traits and selective discrimination. CONCLUSION: The study findings indicate that achieving equitable nursing care requires a multifaceted approach. This includes effective hospital management, organizational reforms, and regulatory enhancements. Additionally, it is crucial to pay close attention to the needs of patients, enhance nurses' theoretical and practical skills in providing equitable care, fostering a culture of equality within healthcare settings, and consider the personality dimensions and moral characteristics of nurses.

Prevalence of self-medication among the elderly: A systematic review and meta-analysis.

BACKGROUND: Self-medication is the use of unprescribed drugs to treat a disease. Elderly self-medication can be more dangerous compared to other age groups because of changes in organ functions that occur due to senescence. This study aimed to estimate the prevalence of self-medication in the elderly, its related factors, and common drugs used in this regard. MATERIALS AND METHODS: Electronic databases such as PubMed, Scopus, and Web of Science were searched between January 2016 and June 2021. The search strategy was built on two core concepts: "self-medication" and "aged". The search was limited to original articles in the English language. A random effect model was used to estimate the pooled prevalence of self-medication. Heterogeneity among studies was assessed using both the I2 statistic and the χ 2 test. Also, a meta-regression model was used to investigate the potential sources of heterogeneity of the studies. RESULTS: Out of 520 non-duplicate studies, 38 were included in the meta-analysis. Self-medication in the elderly ranged from 0.3% to 82%. The pooled proportion of self-medication was 36% (95% CI: 27%-45%). The result of the χ 2 test and the I2 index (P < 0.001, I2= 99.90%) revealed notable heterogeneity among the included studies in the meta-analysis. The meta-regression showed a significant association between the sample size (adjusted ß = -0.01; P = 0.043) and the pooled proportion of self-medication. CONCLUSION: The prevalence of self-medication in the elderly is high. Education through mass media to raise awareness about the dangers of self-medication can help solve this problem.

Examining the relationship between health literacy and quality of life: evidence from older people admitted to the hospital.

INTRODUCTION: Literacy has become an increasingly serious problem, especially as it relates to health care. In this regard, health literacy (HL), as a cognitive skill, has proven to be an influential factor to improve of the quality of life (QOL). This study aimed to examine the level of HL and its relationship with the QOL of older people at the time of discharge from the hospital in the south of Iran. METHODS: This descriptive-analytical cross-sectional study included 300 older people admitted and treated in 10 teaching-therapeutic hospitals affiliated with the Shiraz University of Medical Sciences in 2021. The standard Health Literacy for Iranian Adults (HELIA) questionnaire and the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) were used to collect the required data. Data were analyzed with SPSS software version 23 software using descriptive and inferential statistics, Pearson's correlation coefficient, T-test, ANOVA, and multiple linear regression at p = 0.05. RESULTS: The mean scores of Hl and QOL for older people were 48.22 ± 9.63 (out of 100) and 61.59 ± 12.43 (out of 120), respectively. Moreover, there was a significant direct correlation between the participants' HL and their QOL (r=0.388, p<0.001). All dimensions of HL, including comprehension (ß=0.461, p<0.001), decision-making and behavior (ß=0.434, p<0.001), access (ß=0.397, p<0.001), reading skill (ß=0.362, p=0.002), and assessment (ß=0.278, p=0.004), were significant relationship with QOL. A statistically significant difference was revealed between the mean scores of HL regarding the participants' gender (p=0.04) and level of education (p=0.001). Furthermore, the mean scores of QOL were significantly different with regard to older people's gender (p=0.02), marital status (p=0.03), level of education (p=0.002), and income (p=0.01). CONCLUSION: The findings revealed the participants' inadequate HL and average QOL. Considering the relationship of HL with QOL, it is recommended to develop comprehensive programs and effective interventions to develop HL skills and subsequently improve QOL among older people.

Exploring the experiences of nurses caring for patients with COVID-19: a qualitative study in Iran.

BACKGROUND: The coronavirus disease (COVID-19) is now a major public health emergency in the world. Nurses as key members of the COVID-19 patient care team are exposed to most challenges caused by the disease. As exploring the experiences of nurses as patient supporters and caregivers can play an important role in improving the quality of care for patients with COVID-19 disease, the present study explored the experiences of nurses caring for patients with COVID-19. METHODS: The study employed a qualitative design. This study employed purposive sampling to select 10 nurses with bachelors and master's degrees in nursing who were taking care of patients with COVID-19 in ICUs or inpatient wards in southern Iran. Data were collected through semi-structured interviews. The collected data were analyzed using the qualitative content analysis procedure proposed by Graneheim and Lundman. RESULTS: The analysis of the data revealed four main themes and ten sub-themes: A) physical, psychological, and social burden of care (excessive workload; fear, anxiety, worry; unpleasant social experiences; compassion fatigue) B) unmet needs (personal needs and professional needs) C) positive experiences (pleasant social experiences and inner satisfaction), and D) strategies (problem-solving strategies and stress symptom mitigation strategies). CONCLUSIONS: An analysis of the themes and subthemes extracted in this study suggested that the nurses who participated in this study faced many personal and professional challenges. Therefore, health officials and specialists need to pay special attention to nurses' challenges and needs.

Knowledge, attitude, practice and clinical recommendations of health care workers towards COVID-19: a systematic review.

OBJECTIVES: This study aimed to evaluate the knowledge, attitude, practice, and clinical recommendations of health care workers (HCWs) towards COVID-19. METHODS: In this systematic review study, international databases (Web of Science, PubMed, and Scopus) were searched for the relevant studies published in English from the inception of databases until July 30, 2020. Hoy et al.'s tool was used to evaluate the quality of studies. All search steps, screening, selection of studies, quality assessment, and data extraction were performed separately by two researchers. RESULTS: Out of 3460 articles searched, 28 articles conducted on 16,427 HCWs were included in the study. Most of the HCWs had good knowledge (72.2%), a positive attitude (70.9%), and good practice (78.8%) towards COVID-19. The most important clinical recommendation to improve knowledge, attitude, and practice (KAP) was to provide HCWs with a periodic training program regarding COVID-19. The most important source of information for HCWs on COVID-19 was social networks. CONCLUSIONS: Despite HCWs' good knowledge, attitude, and practice (KAP), it is recommended to periodically review KAP and carry out further studies in different countries as well. It is also recommended to use social media to improve KAP.

The Effect of Self-Management Education by the Teach-Back Method on Uncertainty of Patients with Breast Cancer: a Quasi-Experimental Study.

The present study aimed to determine the effect of self-management education by the teach-back method on uncertainty of patients with breast cancer. This quasi-experimental study (before and after) investigated 50 patients with breast cancer who referred to Surgery Clinic in Kerman from December 2015 to March 2016. The convenient sampling method was used for participants' selection. Participants were randomly divided into intervention and control groups. The questionnaire was completed before and after training by the teach-back method in both groups. Data were analyzed by SPSS software version 20. The results of the study showed that teach-back training in the intervention group improved self-management compared to the control group and the total score decreased from 106 to 73 (p = 0.01). Even after controlling confounders, such as place of residence and history of cancer education, the differences between the above groups remained statistically significant. Self-management education program by the teach-back method can help reduce uncertainty in patients with breast cancer. Therefore, it is recommended to use this educational method to improve self-management and reduce uncertainty in these patients.

Effect of foot reflexology and slow stroke back massage on the severity of fatigue in patients undergoing hemodialysis: A semi-experimental study.

Background Fatigue is one of the most disturbing and the most common symptoms reported by patients dialyzed. There are methods available on complementary and alternative medicine, through which nurses can help patients to promote their health. Reflexology is a treatment which has a long history and is considered as one of the most popular and the most widespread methods of alternative medicine. In this study, the effects of foot reflexology and slow stroke back massage on the severity of fatigue in patients treated with hemodialysis were measured. Methods This is a quasi-experimental study that performed on 52 patients chosen from Imam Khomeini dialysis center in Zabol and divided into control and intervention groups by randomize allocation method. Required information collected from a demographic and fatigue severity questionnaire. After completing questionnaires by the study subjects, foot massage and slow stroke back massage was performed during three weeks, two sessions each week (5 sessions in total). At the end of intervention data of two groups was collected. Data was analyzed using independent sample t-Test, Chi-squared test, Fisher exact test, oneway ANOVA with repeated measures and Bonferroni test by SPSS software version 21. Results The mean [±SD] fatigue in patients with foot reflexology massage and slow stroke back massage reflect on the 53.61[±10.12] and 52.20 [±10.37], and the differences were not significant, but after the intervention, fatigue in the group receiving foot reflexology massage was reduced significantly compared to slow stroke back massage group (p<0.0001). Conclusions The result of this study showed that reflexology massage is a safe and economical nursing intervention for decreasing fatigue in hemodialysis patients.

Effectiveness of Teach-Back Self-Management Training Program on Happiness of Breast Cancer Patients

Self-management training is one of the ways to empower patients to cope with disease. The aim of this before-and-after quasi-experimental study was to determine effects of a teach-back self-management training method on breast cancer patient happiness. Fifty breast cancer patients who visited the Park-e Neshat Limited Surgery Clinic in Kerman, Iran were randomly divided into intervention and control groups after convenience sampling and checking for inclusion eligibility. Data were collected using a demographic questionnaire and the Oxford Happiness Inventory before and after teach-back training and analyzed using SPSS 23. Findings showed no significant difference between mean happiness scores in the two groups before the intervention. However, after the intervention, the mean happiness score in the intervention group increased from 37.2 to 62.9, while it decreased from 41.4 to 29.8 in the control group. These changes were statistically significant (p<0.001). Even after controlling for the effect of confounding factors such as residence location and history of cancer education, the observed differences between the groups were statistically significant (p<0.001). A teach-back self-management training program can increase happiness levels in breast cancer patients. Therefore, the use of this method is recommended to improve self-management and increase happiness.

Effect of Heparin on Coagulation Tests: A Comparison of Continuous and Bolus Infusion in Haemodialysis Patients.

INTRODUCTION: Haemodialysis is one of the most conventional treatments of chronic renal failure. The risk of clot formation is high during haemodialysis due to regular contact of blood with the surfaces of foreign objects such as catheters, dialyzers' membrane, and other materials used for dialysis. Therefore, to prevent clot formation during haemodialysis, the dialysis system requires anticoagulation; this is usually done by heparin. AIM: The present study aimed to compare two heparinization methods and determine the proper impacts of these methods. MATERIALS AND METHODS: In this quasi-experimental study, 80 haemodialysis patients covered by the dialysis center of Amir-al-momenin Hospital of Zabol were studied in two 40-member groups of heparin therapy methods of bolus injection and continuous infusion. PT and PTT were measured in blood samples collected from all patients before starting haemodialysis. The first group received 3000 units of heparin once the haemodialysis machine started to work and 2000 units of heparin two hours later as bolus injection. In the second group, 1500 units of heparin was injected at the start of dialysis after then, 5000 units of heparin (one mL) were mixed with 11 mL of distilled water and infused using a heparin injection pump up to half an hour before the end of dialysis. At 30 minutes after starting dialysis and at the end of 4 hours of haemodialysis, PT and PTT were measured and compared between the two groups. RESULTS: According to the results, the mean partial thromboplastin time in the bolus and continuous heparin-receiving group was 41.75±6.29 and 37.90±4.77, respectively, which was statistically significant (p=0.036). But PT was 14.45±1.82 in the bolus heparin group and 13.95±1.39 in the continuous heparin group, which was not significant according to the results of independent t-test (p=0.336). CONCLUSION: The results indicated a statistically significant difference between the bolus heparin injection and the continuous heparin infusion groups in terms of coagulation tests in haemodialysis patients (p=0.036). Therefore, given the effects of heparin on coagulation, it was more effective in the bolus heparin group than the continuous infusion group. It is recommended to use the bolus method for heparin therapy during haemodialysis.

Knowledge, Attitude, and Performance of Nurses toward Hand Hygiene in Hospitals.

INTRODUCTION: The proper hand hygiene is one of the foremost techniques to reduce Nosocomial infections. The hand hygiene is deemed as the simplest method for control of Nosocomial infections if it is done properly it may prevent from a lot of costs and fatalities. Due to constant relationship with patients, nurses play paramount role in proper execution of hand hygiene among clinical personnel. The current study was carried out in order to analyze knowledge, attitude, and performance of nurses regarding hand hygiene. MATERIALS & METHODOLOGY: A cross-sectional study was conducted on 200 (of 240) nurses from three hospitals in Kerman city at east of Iran in 2015. The standardized questionnaire was the tool for data collection. These data entered in SPSS (V.22). The frequency and percentage of frequency in descriptive statistics was employed for data analysis. The confidence interval was considered as 95%. RESULTS: The results showed that the majority of participants were male173 (86.5%), had BA degree 161 (80.5%) and were married 155 (70.5%). Most of nurses 77 (38.5%) had working experience (5-10years). The majority of nurses had good knowledge 149 (74.5%), positive attitude 141 (70.5%) and good performance 175 (87.5%). DISCUSSION & CONCLUSION: The nurses are good level in terms of knowledge, attitude, and performance but improvement of their knowledge and knowledge seems to be more necessary by holding educational classes and courses in cases where they have less knowledge.

The Frequency, Causes and Prevention of Needlestick Injuries in Nurses of Kerman: A Cross-Sectional Study.

INTRODUCTION: The needlestick injuries can cause the transmission of infectious diseases. Compared to other members of the community of health care nurses are at great risk of needle stick injury because of their frequent performance with vein punctures and taking care of patients suffering from different infectious diseases. AIM: The main aim of this study was to assess Prevalence, causes and preventive of Needle Sticks injuries among nurses in Kerman (south of Iran). MATERIALS AND METHODS: This cross-sectional study was conducted from December 2014 to March 2015 on 240 nurses employed in two hospitals of Kerman. Sampling was performed through simple random sampling. Data gathered through a researcher made questioner. Data analysed by use descriptive analytical testes. RESULTS: From the nurses' perspective the main physical and human causes of needlestick injuries were syringe needles (82) and crowded wards (74). The majority of the nurses believed the most effective method to prevent needlestick were training (82). CONCLUSION: Due to the high prevalence of injuries caused by sharp objects in nurses, needlestick injuries are suggested to be recorded in special forms and their causes to be checked by the Infection Control Committee. Since syringe needle heads and angiocatheter are the main causes of needlestick injuries, providing safe medical equipment should also be emphasized.