Social Life After Hip Fracture: A Qualitative Study.

The return to social life after a hip fracture is a major concern for patients and a determinant factor in their recovery. However, patients' perceptions of social life after hip fracture are variable and context-dependent. By identifying these perceptions and strategies of patients, interventions can be strengthened and modified. The aim of this study was to identify patients' perceptions of their social life after hip fracture. This qualitative study used inductive content analysis. Twenty patients with hip fractures who were referred to Tehran University of Medical Sciences hospitals were purposefully selected and included in the study. Data were collected through individual, face-to-face, in-depth, semi-structured interviews conducted by a researcher experienced in carrying out such interviews. The interviews were recorded, immediately transcribed verbatim, and analyzed in MAXQDA-10. The interviewing process continued until data saturation was reached. The data analysis led to the extraction of three categories: Disruption of normal social life, Minimal social life, and Social isolation. The results indicated that the social life of these patients is influenced by physical conditions and contextual factors and progresses over time. All patients experienced meaningful disruption of their social life after experiencing hip fractures and movement limitations. The interdisciplinary perspectives provided by these findings can increase awareness of patients' post-fracture social life perceptions and conditions. These findings can also be used to design future programs for interdisciplinary interventions (involving sociology and medical sciences) to improve social life and increase the ability to return to a normal social life. Recovery management for patients with hip fractures should be preventive and organized by an all-around team (involving medicine, psychology, and sociology) based on patient-centered, community-based, and modern care strategies.

Efficacy of a self-monitoring traffic light diary on outcomes of patients with heart failure: A randomized controlled trial.

BACKGROUND AND OBJECTIVE: Patients with heart failure experience high hospitalization. However, patients cannot recognize symptoms according to current approaches, which needs to be improved by new self-monitoring instruments and strategies. Thus, we aimed to assess a self-monitoring traffic light diary on outcomes of patients with heart failure. METHODS: This was a single-blind, two-arm parallel group randomized controlled trial at the heart failure clinic of Tehran Heart Center (Tehran, Iran). Adult patients with a definitive diagnosis of heart failure with reduced ejection fraction (i.e., ejection fraction of less than 40 %), and New York Heart Association functional classes II-IV were included. A block-balanced randomization method was used to assign eligible subjects to the intervention or control group. Baseline data were collected before random allocation. Participants in the intervention group received a comprehensive intervention consisting of (1) self-care education by an Australian Heart Foundation booklet on heart failure, (2) regular self-monitoring of weight and shortness of breath at home, and (3) scheduled call follow-ups for three months. Patients in the control group received usual care. The primary outcome was heart failure self-care; the secondary outcomes were heart failure quality of life, knowledge, and all-cause hospitalization. RESULTS: From June to August 2017, 68 patients were included in the study. The overall age of participants was 55 (13.6) years old, and 71 % of patients were male. A significant association between the intervention and self-care maintenance (ß 5.1; 95 % CI 2.50 to 7.70, P < 0.001), self-care management (ß 10.6; 95 % CI 6.50 to 14.8, P < 0.001), self-care confidence (ß 8.0; 95 % CI 5.0 to 11.0, P < 0.001) and heart failure knowledge (ß 1.7; 95 % CI 1.30, 2.04; P < 0.001) was found. However, there was no association between the intervention and quality of life (ß 2.5; 95 % CI -0.79, 5.88, P 0.135) and hospitalization-free survival of the two groups (Log-Rank P 0.540). CONCLUSION: A self-monitoring traffic light diary can improve self-care behaviors and heart failure knowledge in patients with heart failure with reduced ejection fraction. RCT APPROVAL ID: Iranian Registry of Clinical Trials IRCT2017021032476N1. STUDY PROTOCOL: PMCID: PMC6262204.

The impact of an integrated early palliative care telehealth intervention on the quality of life of heart failure patients: a randomized controlled feasibility study.

BACKGROUND: While palliative care for patients with heart failure has gained global attention, in Iran most palliative care interventions have focused only on cancer patients. The purpose of this study is to determine the feasibility and acceptability of a telehealth palliative care intervention to improve the quality of life in patients with heart failure in Iran. METHODS: This single-site, pilot randomized controlled trial of a telehealth palliative care intervention versus usual care was conducted on patients with New York Heart Association class II/III heart failure recruited from a heart failure clinic in Iran. Under the supervision of a nurse interventionist, intervention participants received 6 weekly educational webinars and concurrent WhatsApp® group activities, with 6 weeks of follow-up. Feasibility was assessed by measuring recruitment, attrition, and questionnaire completion rates; acceptability was assessed via telephone interviews asking about satisfaction and attitudes. Secondary outcomes measured at baseline and 6 weeks included quality of life (PKCCQ and FACIT-Pal-14), anxiety and depression (HADS), and emergency department visits. RESULTS: We recruited and randomized 50 patients (mean age 47.5 years, 60% men). Among those approached for consent, 66% of patients agreed to participate and total study attrition was 10%. Also 68% of patients successfully completed at least 4 out of the 6 webinar sessions. Acceptability: 78% of patient participants expressed willingness to participate in the present study again or recommend other patients to participate. There was a trend towards improvement in anxiety and depression scores in the intervention group though the study was not powered to detect a statistical difference. CONCLUSION: This nurse-led, early telehealth-palliative care intervention demonstrated evidence of feasibility, acceptability, and potential improvement on quality of life in patients with heart failure in Iran. TRIAL REGISTRATION: The study was registered at the Iranian Registry of Clinical Trials (IRCT) at 14 November, 2021, and can be found on the Iranian Registry of Clinical Trials Platform. IRCT registration number: IRCT20100725004443N29.

Spiritual care competence, moral distress and job satisfaction among Iranian oncology nurses.

BACKGROUND: Nurses have a crucial role in identifying spiritual needs and providing spiritual care to patients living with cancer. AIM: This study evaluated Iranian oncology nurses' spiritual care competence and its relationship with job satisfaction and moral distress. METHOD: This cross-sectional study was conducted on 280 Iranian oncology nurses in 2020 using four questionnaires: demographic questionnaires, the Spiritual Care Competence Questionnaire (SCCQ), the Minnesota Job Satisfaction Questionnaire (MSQ) and the nurses' Moral Distress Questionnaire (MDS-R). FINDINGS: The mean scores indicated a medium to high Spiritual Care Competence (SCC), mild to moderate moral distress and high job satisfaction. There was a positive correlation between SCC and external job satisfaction (r=184, p<0.05) and a negative correlation between SCC and moral distress (r=-0.356, p<0.05). CONCLUSIONS: SCC diminishes with decreasing external job satisfaction and increasing moral distress. To improve the SCC of nurses working with patients living with cancer, it is recommended that nursing managers and policymakers revise the organisational policies to tackle the obstacles and consider the related factors to provide an ethical climate, implement quality spiritual care and increase job satisfaction.

The psychometric properties of the Persian version of the Multiple Sclerosis Self-Management Scale-Revised: A cross-sectional methodological study.

Backgrounds and Aims: Patients with multiple sclerosis (pwMS) need self-management (SM) skills to manage their symptoms and problems. An essential step to SM improvement is accurate SM assessment using valid and reliable instruments. The aim of this study was to evaluate the psychometric properties of the Persian version of the Multiple Sclerosis Self-Management Scale-Revised (MSSMS-R). Methods: This cross-sectional methodological study was conducted from December 2021 to June 2022. The face, content, and construct validity of MSSMS-R were evaluated. Construct validity was evaluated through confirmatory factor analysis (CFA) and evaluating convergent and discriminant validity using the data obtained from 210 randomly selected MS patients. The reliability of the scale was also evaluated through the test-retest stability and the internal consistency evaluation methods. Results: The face validity was confirmed and the content validity ratio and index values of all items were more than 0.62 and 0.79, respectively. CFA revealed the acceptable construct validity of the scale after omitting items 21 and 22. In convergent and discriminant validity evaluation, the total score of MSSMS-R had significant positive correlation with the total mean scores of the Multiple Sclerosis Self-Efficacy Scale (r = 0.36; p < 0.001) and the physical health composite (r = 0.31; p < 0.001) and the mental health composite (r = 0.39; p < 0.001) dimensions of the 54-item Multiple Sclerosis Quality of Life scale and significant inverse correlation with the total mean score of the Beck Depression Inventory (r = -0.28; p < 0.001). The Cronbach's alpha values of the scale and its subscales were 0.86 and 0.65-0.90 and their test-retest intraclass correlation coefficients were 0.97 and 0.95-0.99, respectively. Conclusion: The Persian MSSMS-R is a valid and reliable scale and can be used in future studies for SM assessment among pwMS.

Effectiveness of a comprehensive tele-empowerment programme on self-care behaviours, uncertainty and readmission of patients with heart failure: protocol for a randomised controlled trial.

INTRODUCTION: Heart failure (HF) as a long-term clinical syndrome is associated with inadequate self-care behaviours, a feeling of uncertainty and frequent hospitalisation. In recent years, empowerment has evolved for improving chronic disease management. Nevertheless, there is a lack of studies investigating remote care interventions such as a tele-empowerment programme in patients with HF. Therefore, this protocol proposes a randomised controlled trial which aims to evaluate the effectiveness of a comprehensive tele-empowerment programme on self-care behaviours, uncertainty and readmission in patients with HF. METHODS AND ANALYSIS: The study is a double-arm and parallel-group randomised controlled trial in which a 10-week intervention, including 6 weeks of a comprehensive tele-empowerment programme and 4 weeks of follow-up, will be compared with usual care. A total of 96 eligible patients with HF will be recruited and randomly assigned to the intervention or control group. The patients in the intervention group will join virtual groups and receive the five-step tele-empowerment programme through the internet. The primary outcomes include self-care behaviours and uncertainty which will be measured with valid instruments at baseline and 10th week. The secondary outcome is the number of patients' hospital readmissions and will be assessed at the end of the study. Descriptive statistics will be used to describe variables. According to the types of variables, appropriate statistical tests including two-sample t-tests, Χ2, analysis of covariance or linear regression will be performed. In addition, standardised intervention effect sizes will be calculated for each outcome. ETHICS AND DISSEMINATION: The trial has been approved by the Research Ethics Committee of School of Nursing and Midwifery & Rehabilitation at Tehran University of Medical Sciences. In this study, written consent will be obtained from all participants. The results will be presented to representative groups and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: Iranian Registry of Clinical Trials (IRCT20100725004443N30).

An Investigation of Undergraduate Nursing Students' Therapeutic Communication with Patients.

Background: Therapeutic Communication (TC) is the process of purposeful and understandable communication between patients and caregivers, which helps facilitate optimized care. Here, we assessed nursing students' interaction with patients and its related factors. Materials and Methods: In this descriptive-analytical study, a convenience sample of 240 undergraduate nursing students from Tehran University of Medical Sciences, Tehran, Iran, completed consent forms, a demographic information questionnaire, and a TC questionnaire in 2018. Data were analyzed using descriptive and inferential statistics. Results: TC score of most students was moderate and good, with the mean (SD) of 143.07 (12.86). Factors, including gender (Χ2 = 8.02, p ≤ 0.01), semester (Χ2 = 4.01, p ≤ 0.05), employment (r = 0.49, p ≤ 0.01), and workshop attendance (r = 0.80, p ≤ 0.01), influenced the students' TC knowledge and skills. Conclusions: Future nurses' TC can be improved by part-time employment and practical training. Conducting more research with a larger sample size from all nursing faculties is suggested.

The formation of health-related procrastination in patients with type-2 diabetes: a grounded theory research.

Considering the adverse effects of procrastination on the care and treatment of patients with type-2 diabetes, examining the how, why, and contributing factors of procrastination in this group of patients through in-depth studies seems essential. This is a grounded theory research in which 28 participants were selected by theoretical purposive sampling from patients with type-2 diabetes, their families, and healthcare personnel. Data were collected through interviews, observations, field notes and memos. The data were analyzed using Corbin and Strauss approach (2015) and MAXQDA 2010 software. The data obtained were classified into seven main categories. Health-related procrastination in patients with type-2 diabetes began to form in the patients when they perceived the hardships of self-care as their main concern. The ominous shadow of the disease, the prison of family care, patient-related factors, health system shortfalls, sociocultural background, and the onslaught of the COVID-19 pandemic laid the groundwork for abandoning diabetes self-care. Patients tried to abandon their diabetes self-care by adopting strategies such as escaping the reality of the disease, self-medication and procrastination. Wavering health-related procrastination was identified as the central category of this research. The formation of health-related procrastination in patients with type-2 diabetes is a multidimensional process depending on the patients' background that consists of their interactivity with their family, the health system, and the society. The findings of this research can be used for the design, implementation and monitoring of treatment and care programs for these patients.

Types of health-related procrastination in patients with type-2 diabetes: a qualitative content analysis.

Background and objectives: Health-related procrastination refers to a delay in the performance of health-related activities, which is a rather neglected subject despite being critical. Due to the adverse effects of procrastination on the care and treatment of patients with type-2 diabetes, it is necessary to explore procrastination among this group of patients through in-depth studies. The present research was conducted to explain different types of health-related procrastination in patients with type-2 diabetes. Materials and methods: This qualitative study applied content analysis with 13 patients with type-2 diabetes selected via purposive sampling. Data were collected through individual and semi-structured interviews. The data were then analyzed using Lundman and Graneheim content analysis method. Findings: Based on the analysis of the data, instances of health-related procrastination in patients with type-2 diabetes were classified into six main categories, including minimizing self-care, poor adherence to treatment, poor nutritional habits, poor adherence to drug regimen, disregard for disease monitoring, and a sedentary lifestyle. Conclusions: The results of this study provide an in-depth understanding of the various forms of health-related procrastination in patients with type-2 diabetes. These findings can be employed in the design, implementation, and monitoring of treatment and care programs targeting these patients.

Medical research council framework for designing and evaluating a re-integration into life care plan in patients following upper limb amputation in Iran: An interventional study.

BACKGROUND: Traumatic amputation can cause permanent disabilities. These patients have many difficulties in reintegration into life and work. This research was conducted to evaluate re-integration into life care plan in patients following upper limb amputation. METHODS: This study is a clinical trial with complex mixed method design. In this study, the effectiveness of finalized designed care plan was assessed between intervention and control group at 3 months follow-up. Reintegration into normal life index and Disability of arm, Shoulder and Hand (DASH) questionnaire were used for data collection, and the collected data were analyzed by SPSS statistical software version 26. FINDINGS: Results showed that, the reintegration into normal life care plan was significantly effective in the intervention group compare to control group (t=2.17, p,<0.001). Also, the score of disability of shoulder, arm and hand (DASH) after 3 month was significantly different between two groups (t=5.8), (p<0.05). CONCLUSION: Reintegration into life care plan as an effective care plan, can be implemented in patients with upper limb amputation by involving patients and their families, considering the key role of nurses as coordinator with long term follow up, after discharge.

Theory-Practice Gap: The Knowledge and Perception of Nigerian Nurses.

Background: The theory-practice gap can be described as a lack of ability to relate the knowledge acquired in academics and research work with practice. This study aims to assess the knowledge and the perception of Nigerian nurses on the theory-practice gap in Nursing. Materials and Methods: This cross-sectional correlational study was carried out with a sample of 196 nurses who were working in the Federal Medical Centre Keffi and Aminu Kano Teaching hospital in Kano, all from the northern part of Nigeria, from April to June 2019. The participants were selected using a convenient sampling technique, where a self-administered questionnaire was utilized to collect the data and analysis was undertaken using SPSS. Results: The results of this study showed that 83.80% of respondents had good knowledge and 89.10% of the respondents had good perceptions. The levels of knowledge were significantly different in correlation with the educational level of respondents (χ2 = 13.88, df = 6, p = 0.022), which was determined using a Fischer exact test. Also, the level of perception was significantly different when considering the nature of work participants undertook (X2 = 7.65, df = 2, p = 0.022). Conclusions: Given the participants' awareness and perceptions in this study, it is clear that they are well informed of the theory-practice gap. This is a call for all professionals at an individual and organizational level to work, as it will translate into gap minimization, thereby increasing the quality of health care delivery as nurses constitute the largest part of the health care team in Nigeria.

Psychometric properties of the Persian version of the quality of recovery-15 questionnaire.

BACKGROUND: Recovery after surgery is a complex process since it depends on many factors, such as the patient's sex, age, surgery type, and presence of other diseases. This study aimed to translate and evaluate the psychometric properties of the Persian version of the quality of recovery-15 (QoR-15) questionnaire in Iranian patients undergoing surgery. METHODS: The Persian version of the QoR-15 questionnaire was developed after translating and culturally validating the instrument. Content validity was assessed with a sample of clinicians (n = 15) and face validity was assessed in a sample of patients (n = 15) undergoing elective surgery. The final questionnaire was completed by 450 patients (n = 450) 24 h after surgery. Construct validity was assessed using exploratory factor analysis in patients (N = 250). Convergence and divergent validity were also assessed. Internal consistency was assessed using Cronbach's alpha and construct reliability was also assessed. Test-retest reliability was assessed on a randomly selected sub sample of 50 patients. Finally, the questionnaire was completed by a further sample of 200 patients 24 h after surgery and construct validity was assessed using confirmatory factor analysis. RESULTS: According to Lawshe, all items received at least an acceptable ratio for content validity ratio (CVR). Item content validity index (I-CVI) of each item was greater than 0.79. Construct validity indicated good fit statistics in the five components of CFA, and CFI was > 0.93. The reliability of the QoR-15 questionnaire was acceptable based on Cronbach's alpha score (> 0.001), test-retest reliability value (0.81), and CR (> 0.7). CONCLUSION: The Persian version of the QoR-15 questionnaire was equivalent to the original one regarding both conceptual and linguistic aspects. This study also confirmed the validity and reliability of the Persian version of the QoR-15 questionnaire. Therefore, the Persian version of the QoR-15 questionnaire can be a suitable and brief instrument to assess the recovery quality in Iranian patients undergoing surgery.

Integrated Care model: Transition from acute to chronic care.

OBJECTIVE: Description and discussion dimensions of Integrated Care Model. METHODS: A descriptive study is done that describe a technological innovation, intervention strategies for professional performance. RESULTS: Integrated Care Model (ICM) has two main categories include individual and Group-and disease-specific Model. First, is used for risky patients or with comorbidities. In second category; Chronic Care Model (CCM) is common form of Integrated Care Model to improve resultants in the patients with chronic condition, to move from acute care to integrate, regular, long-lasting, preventative and community-based nursing. FINAL CONSIDERATIONS: It is important to consider patient as an active member of the treatment team. It seems to be essential to monitor performance of care system. On the other hand, offer multidisciplinary care leads to present desirable care, tailored to the specific needs of patients regarding safety, patient-centered care and their culture.

The Role of the Patients' Companion in the Transitional Care from the Open Heart Surgery ICU to the Cardiac Surgery Ward: A Qualitative Content Analysis.

BACKGROUND: The patients' companions can help improve transitional care as an important missing link, but their role is not clear. The aim of this study was to explore the role of the patients' companion in the transitional care from the open heart surgery intensive care unit (OH-ICU) to the cardiac surgery ward. METHODS: This was a qualitative descriptive study using conventional content analysis that was conducted from September 2019 to February 2020 in Tehran, Iran. Purposeful sampling method with maximum variation was performed among the patients eligible for transfer to the cardiac surgery ward, their companions, nurses, and physicians in charge of transferring from the OH-ICU to the ward. 27 in-depth and semi-structured interviews were conducted with 25 participants , and data were analyzed using the Granheim and Lundman method. The data were managed using the MAXQDA software (version 10.0). RESULTS: Based on our analysis, the theme "Dual role of the patients' companion" and its two categories, "Companion as a facilitator" and "Companion as an inhibitor", were extracted. Emotional support, satisfaction of basic needs, care arm, alarm bell, and communication bridge were the sub-categories of the first category, and Interfering with care and creation of tension were those of the second category. CONCLUSION: We concluded that the patients' companions can play an important role in transitional care, especially as emotional support and system assistants due to the structure of the health care system and Iranian cultural context . Therefore, it is suggested that the patients' companion should be considered as a member of the transition team and accompany them in this process by informing and supporting them.

Integrated Care model: Transition from acute to chronic care / Modelo de cuidados integrados: transição de cuidados agudos para crônicos / Modelo de atención integral: transición de la atención aguda a la crónica

ABSTRACT Objective: Description and discussion dimensions of Integrated Care Model. Methods: A descriptive study is done that describe a technological innovation, intervention strategies for professional performance. Results: Integrated Care Model (ICM) has two main categories include individual and Group-and disease-specific Model. First, is used for risky patients or with comorbidities. In second category; Chronic Care Model (CCM) is common form of Integrated Care Model to improve resultants in the patients with chronic condition, to move from acute care to integrate, regular, long-lasting, preventative and community-based nursing. Final considerations: It is important to consider patient as an active member of the treatment team. It seems to be essential to monitor performance of care system. On the other hand, offer multidisciplinary care leads to present desirable care, tailored to the specific needs of patients regarding safety, patient-centered care and their culture.

RESUMO Objetivo: Descrever e discutir dimensões do Modelo Integrado de Atenção. Métodos: Estudo descritivo que descreve uma inovação tecnológica, estratégias de intervenção para atuação profissional. Resultados: O Modelo de Cuidados Integrados (ICM) tem duas categorias principais: Modelo individual e Modelo específico para grupos e doenças. Primeiro, é usado para pacientes de alto risco e / ou com várias doenças. Na segunda categoria; O Modelo de Cuidado Crônico (CCM) é a forma mais conhecida de Modelo de Cuidados Integrados para melhorar os resultados em pacientes com condição crônica, para passar do cuidado agudo para a enfermagem integrada, regular, duradoura, preventiva e baseada na comunidade. Considerações finais: É importante considerar o paciente como um membro ativo da equipe de tratamento. Parece ser essencial monitorar o desempenho do sistema de atendimento. Por outro lado, oferecer assistência multidisciplinar leva a apresentar cuidados desejáveis, adequados às necessidades específicas dos pacientes quanto à segurança, ao cuidado centrado no paciente e à sua cultura.

RESUMEN Objetivo: Descripción y dimensiones de discusión del Modelo de Atención Integrada. Métodos: Estudio descriptivo que describe una innovación tecnológica, estrategias de intervención para el desempeño profesional. Resultados: El modelo de atención integrada (ICM) tiene dos categorías principales, que incluyen el modelo individual y grupal y específico de la enfermedad. Primero, se usa para pacientes de alto riesgo y / o con múltiples condiciones. En segunda categoría; El Modelo de Cuidados Crónicos (CCM) es la forma más conocida de modelo de atención para mejorar los resultados en los pacientes con enfermedad crónica, para pasar de cuidados agudos a una enfermería integral, regular, duradera, preventiva y comunitaria. Consideraciones finales: Es importante considerar al paciente como un miembro activo del equipo de tratamiento. Parece esencial monitorear el desempeño del sistema de atención. Por otro lado, ofrecer una atención multidisciplinar conduce a presentar una atención deseable, adaptada a las necesidades específicas de los pacientes en cuanto a seguridad, atención centrada en el paciente y su cultura.

Vision-Related Quality of Life after Corneal Transplantation.

PURPOSE: To determine the vision-related quality of life (VR-QoL) and its dimensions in corneal transplant recipients. METHODS: This cross-sectional study was carried out on 100 patients who underwent penetrating keratoplasty. Data collection tools included a demographic questionnaire, satisfaction questionnaire, and Persian version of the 39-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ 39). RESULTS: The composite score of VR-QoL in corneal transplant recipients was 54.39 ± 9.22 (32.9-71.01). The highest mean score among subscales was related to color vision (74.75 ± 27.63) and the lowest related to dependency (31.06 ± 31.02). The results showed that there is a reverse correlation between VR-QoL with both age (r = -0.364; P < 0.001) and the numbers of years after the transplantation (r = -0.362; P < 0.001). However, there was a correlation between satisfaction and VR-QoL (r = 0.679; P < 0.001). Furthermore, the results showed that there is a significant difference in VR-QoL between men and women (P < 0.001) and also a significant difference in VR-QoL between unilateral and bilateral graft recipients (P < 0.001). CONCLUSIONS: The corneal transplant has the highest impact on color vision and the lowest on dependency. Moreover, the results of this study provide a comprehensive picture for the state of vision and overall health status of patients for health-care providers to enhance the patient care.

Upper limb amputation; Care needs for reintegration to life: An integrative review.

BACKGROUND AND AIMS: Upper limb amputations cause numerous physical and psychosocial challenges including disruptions to quality of life as well as limitations in participation in society. While there is a great deal of literature on patients undergoing lower limb amputation, information on upper limb amputation is limited. This study aimed, therefore, to explore care needs in patients undergoing upper limb amputation. MATERIALS AND METHODS: An integrative review was conducted. The five-stage framework introduced by Whittemore and Knafl was used: problem identification, literature search, data evaluation, data analysis and presentation of results. Searches were performed based on predefined inclusion and exclusion criteria for online and unpublished research between 2008 to 2018. Data was extracted using CASP and STROBE checklists and analyzed using conventional inductive content analysis. RESULTS: Conventional content analysis method, applied to the full texts of the final articles, included 21 articles (4 qualitative articles and 17 quantitative articles). The care needs identified included 33 care needs in 6 domains: social needs, health care system, rehabilitation program, necessity of self-care, assisting in timely and correct decision-making and patient and family education. CONCLUSION: Rehabilitation plans should be made for all patients, with special attention to male workers. This should begin at the time of admission and continue after their discharge. Routine follow up after discharge is essential. Care must be provided by a multidisciplinary team with timely and accurate referral and with consideration of culture and individual factors.

Development and validation of a therapeutic communication questionnaire for nursing students.

Background: Therapeutic communication (TC) between nursing students and patients is essential for providing high-quality care. Purpose: This study aimed to introduce a questionnaire for the assessment of TC among Iranian nursing students and to examine its psychometric properties. Methods: This mixed-method research was conducted in two phases of developing tool content and validation of the scale. Results: Five factors were specified, explaining 42.89% of the total variance. The confirmatory factor analysis confirmed the structure of the scale. Cronbach's alpha coefficient of the scale was 0.83. Conclusions: The final questionnaire was a valid and reliable scale for the self-assessment of TC among nursing students. Furthermore, scholars can use this instrument to compare students' TC before and after educational interventions. Impact statement: Nursing students' TC questionnaire is a suitable instrument for assessing nursing trainees' TC and enhancing their engagement in learning.

Nurses' adaptation instrument in the oncology wards: Development and psychometric testing.

INTRODUCTION: Understanding adaptation is strongly influenced by the culture and beliefs of every society. By increasing knowledge about the different dimensions which require the adaptation in different aspects requiring the nurse adaptation in oncology, a clear definition of the problem can be stated. Because of the lack of a standard and appropriate tool for the culture of the Iranian society, this aimed at developing and validating the nurse adaptation tool in the oncology departments. METHODS: This research is a methodological study and an exploratory mixed method being conducted in three main steps of conceptualization, production of items, and field test. Inductive conceptualization was performed through qualitative methodology and conventional content analysis approach; in the second step, developed instrument was evaluated in terms of face validity, content validity, and construct validity. In the third step, sampling of oncology nurses was done and exploratory factor analysis was performed for evaluating the construct validity, adequacy of sampling, and dimensioning. Cronbach's alpha was calculated for checking the reliability of the instrument. RESULTS: The oncology nurse adaptation questionnaire was formed with twenty items in four main dimensions, including "emotional factors," "supportive factors," "work-related factors in the ward," and "factors related to job conditions." The reliability of the tool was confirmed by evaluating the internal consistency with Cronbach's alpha, which was above 0.7 for each dimension and 0.82 for the whole instrument. CONCLUSION: This instrument can be used as a practical tool for determining the adaptation of oncology nurses for providing evidence to improve the work conditions of nurses by improving the working conditions in the workplace and providing facilities with individual intervention, and the outcome will be care of patients with high quality.