The Effect of Continuous Care Program on the Self-Efficacy of Patients with Implantable Cardioverter Defibrillator: A Randomized Control Trial.

Background: The majority of cardiac disorders resulting from ventricular dysrhythmias are fatal. The Implantable Cardioverter Defibrillator (ICD) is one of the most common treatments of ventricular dysrhythmias. Despite the benefits of ICD in preserving life, patients with ICD experience adverse physical, psychological, and social consequences. This study investigated the effects of the continuous care program on self-efficacy in patients with ICD. Materials and Methods: The present study was a randomized clinical trial. Based on the inclusion criteria, 80 patients attending an educational cardiovascular center in Tehran during 2017-2018, were randomly assigned to two intervention and control groups (40 in each). The intervention included the continuous care program, an educational session, and a follow-up program undertaken for the patients receiving the ICD. The control group received routine care. Self-efficacy was then measured by ICD (SE-ICD and OE-ICD) questionnaires and compared between the two groups. Results: The results showed no difference between the two groups before the intervention (p > 0.05). However, there was a significant difference in the mean self-efficacy score between the two groups after the intervention, being significantly higher in the intervention group (t77 = 4.9, p < 0.001). Conclusions: The results of the present study indicated that providing a continuous care program can increase self-efficacy in patients with ICD and can be used as an effective model in the nursing care of patients with ICD.

Effect of an Empowerment Program on Life Orientation and Optimism in Coronary Artery Disease Patients.

Background: Coronary Artery Disease (CAD) complications cause patients to experience a great deal of concerns and challenges that have adverse effects on their mental health. This study aimed to assess the effect of an empowerment program on life orientation and optimism in CAD patients. Materials and Methods: This randomized clinical trial was conducted on 84 CAD patients admitted to post-CCU wards of Tehran Heart Center during 2018-2019 Patients were allocated to intervention and control groups by block randomization method based on inclusion criteria. Demographic and disease characteristics, and optimism and Life Orientation Test-Revised (LOT-R) questionnaires were completed before and eight weeks after intervention. In the intervention group, an empowerment program was implemented. Data were analyzed by independent t-test, paired t-test, and Chi-square test. Results: The results showed that the mean of patients' age in the intervention and control group was Mean [Standard Deviation (SD)] 54.59 (7.93) and 55.92 (7.81) years, respectively. Most patients in both intervention (61.90%) and control (66.70%) groups were male. The majority of patients in the intervention group (92.90%) and the control group (95.20%) were married. There were no significant differences between the two groups in terms of demographic characteristics and disease history before the intervention (p > 0.05). After the intervention, a significant difference was observed in the life orientation and optimism scores between the intervention and control groups (p < 0.001). Conclusions: By stimulating self-awareness, providing knowledge and encouraging patients to control, and manage their disease, the empowerment program changes patients' view of their disease, and increases their optimism and positive life orientation.

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.

Blinding and Its Quality in Clinical Trials Conducted on Patients with Breast Cancer: A Systematic Review.

Background: Blinding is one of the critical criteria of clinical trials that prevents probable bias. Judgment regarding results of an intervention significantly depends on the quality of such studies, one of which is blinding. This study aimed to investigate blinding and its quality in clinical trials in patients with breast cancer. Materials and Methods: A systematic review was conducted on the online databases of PubMed, ScienceDirect and ProQuest using keywords, MeSH terms and grey literature. Articles were screened by predefined inclusion and exclusion criteria. They were evaluated based on the checklists introduced by Cochrane database. Results: From 22519 articles obtained at the initial stage, 20 articles remained after screening for the inclusion and exclusion criteria. Fifteen articles had used single, five: double and none had used triple or quadruple blinding. Seventeen studies had described the details of blinding. Of the 15 single blind articles, the blinded subjects were patients in five, patients and research assistants in three, research assistants in five studies, and two had not given any details. Conclusions: The majority of researchers had used the single blind method, though using double, triple or quadruple blinding increases the trustworthiness of results and increases the quality of clinical trials. The details of blinding should be explained to other researchers and for a better understanding of the method if it is to be repeated. Thereafter, nurses can apply new interventions and earn their patients' trust and help those with breast cancer by relieving them of their disease symptoms and its treatment complications.

Explaining nurses' experience of stresses and coping mechanisms in coronavirus pandemic.

INTRODUCTION: Nurses face several stresses during a pandemic. Therefore, it seems necessary to use appropriate adaptation and coping methods to reduce the destructive effects of physical and psychological stresses. This study aimed to explain nurses' experience of stresses and coping methods used for care of patients with Covid-19. METHOD: A qualitative approach with descriptive phenomenological method was applied in this study. Sixteen nurses working in hospitals were selected by purposeful sampling. Through in-depth, individual and semi-structured interviews, the nurses shared their experiences in caring for Covid patients. The transcripts of recorded interviews were typed verbatim and then analyzed based on Colaizzi's method. RESULTS: Four main categories and 12 subcategories, which were named conceptually based on their nature were shaped. The main categories included; self-support in the midst of crisis, sheltered by family from distance, hospital influence in the environment, and social support on both sides of infinity. CONCLUSION: Although healthcare workers have accepted the exposure to Covid-19 as part of their profession, provision of quality care in crisis situations is not possible without supporting the healthcare workers and paying attention to their mental health. It is recommended to take a precise approach to predict, recognize and manage psychological harms of healthcare workers.

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.

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.

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.

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.

Effect of Massage Therapy on Labor Pain Reduction in Primiparous Women: A Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials in Iran.

BACKGROUND: Pain is a common experience for women during labor. Therefore, pain relief care for mothers during labor is very important. This meta-analysis was conducted to evaluate the efficacy of massage therapy on labor pain reduction in primiparous women. MATERIALS AND METHODS: In this meta-analysis, the databases of Web of Knowledge, PubMed, Scopus, Cochrane, Iranmedex, Scientific Information Database (SID), and Magiran were searched for published articles in English and Persian language up to January 2016. Among the studies, with regard to the inclusion and exclusion criteria, 10 studies were selected. Data were analyzed by using Stata software version 11, and standard mean difference (SMD) of effects of massage therapy was calculated. The heterogeneity among studies was evaluated by the Chi-square based Q-test and I2 statistics. RESULTS: The results of Chi-square based on Q-test and I2 statistics showed heterogeneity among studies in the latent phase (Q = 63.52, P value < 0.001 and I2 = 87.4%), active phase (Q = 26.42, P value < 0.001, and I2 = 77.3%), and transitional phase (Q = 104.84, P value <0.001, and I2 = 95.2%). Results showed that massage therapy reduces labor pain in the latent phase (SMD = -1.23, 95% CI: -1.73 to -0.74), active phase (SMD = -1.59, 95% CI: -2.06 to -1.12), and transitional phase (SMD = -1.90, 95% CI: -3.09 to -0.71). CONCLUSIONS: This study provides valid evidence for the effect of massage therapy in Iran for labor pain relief. Therefore, the use of massage therapy can be recommended in the primiparous women.

Investigation effect of oral chamomilla on sleep quality in elderly people in Isfahan: A randomized control trial.

BACKGROUND: Elderly people often suffer from sleep disorders. Chamomile due to the many health benefits such as sedation may be effective in improving sleep quality in elderly people. This study aimed to determine the effect of Matricaria chamomilla extract on sleep quality in elderly people admitted to nursing homes of Isfahan in 2014. MATERIALS AND METHODS: The present study is a quasi-experimental clinical trial. The study population was 77 cases of elderly hospitalized in nursing homes. Participants were selected through random continuous sampling and divided into intervention and control groups. The intervention group received 400 mg oral capsules of chamomile twice daily, after lunch and after dinner for 4 weeks. The control group did not receive the intervention. Sleep quality in older adults before and after intervention were compared using the Pittsburgh Sleep Quality Index questionnaire. Data were analyzed using descriptive statistics and paired t- and independent t-tests, one-way analysis of variance and liner regression analysis, using SPSS software version 17. RESULTS: Before intervention, the mean score of sleep quality both experimental and control groups showed no significant difference (P > 0.05). After intervention, the mean score of sleep quality was a significant difference between experimental and control groups (P < 0.001). CONCLUSIONS: Oral administration of chamomile extract has sedative properties in sleep quality of hospitalized elderly patients in nursing homes. Therefore, it can be used in similar cases and nursing care.

Prevalence of premenstrual syndrome in Iran: A systematic review and meta-analysis.

BACKGROUND: Premenstrual syndrome (PMS) is a common disorder characterized by physical, mental and behavioral changes in the luteal phase of the menstrual cycle in the reproductive age women. OBJECTIVE: The present study aimed to determine the overall prevalence of PMS in Iran by a systematic review and meta-analysis study. MATERIALS AND METHODS: In this systematic review and meta-analysis, we searched international databases included ISI Web of Knowledge, PubMed/Medline, Scopus, Google Scholar, and also local databases including Iranmedex, Scientific Information Database, and Magiran for articles in English and Persian language published up to September 2016. We carried out data analysis with Stata version 11. We examined heterogeneity in the results of studies through I2 statistics and Chi-square based Q test. Also, we investigated the effects of potential heterogeneity factors in the prevalence of PMS by meta-regression. RESULTS: We studied a total of 9147 reproductive-age women from 24 articles which entered to meta-analysis. Based on the result of random effect model, we estimated the overall prevalence of PMS 70.8% [95% CI: 63.8-77.7]. The results of subgroup analysis revealed that prevalence of PMS was 80.4% (95% CI; 66.9-93.9) among high school students, 68.9% (95% CI; 59.2-78.6) among university students, and 54.9% (95% CI; 51.6-58.2) in general population. Univariate meta-regression model showed that prevalence of PMS was decreased by increasing the age of subjects but this was not statistically significant (p=0.155). CONCLUSION: Our finding showed that PMS was prevalent in Iranian reproductive age women especially among high school students. More epidemiological research for determining factors that affect PMS prevalence seems essential.

Investigating the effect of therapeutic touch on the intensity of acute chemotherapy-induced vomiting in breast cancer women under chemotherapy.

BACKGROUND: Nausea and vomiting are the worst and the most prevalent complications experienced by 70-80% of patients. Complementary treatments including therapeutic touch are cost-effective and low-risk, independent nursing interventions. Present research aims at investigating the effect of therapeutic touch on the intensity of acute chemotherapy-induced vomiting in these patients. MATERIALS AND METHODS: As a single-blind, randomized clinical trial, the present research was carried out on women with breast cancer undergoing chemotherapy in Isfahan, Iran. The subjects were divided into three groups of control, placebo, and intervention. The intervention was applied to each patient once for 20 min on the aura (human energy field) focusing on solar chakra. Data gathering instruments included demographic questionnaire and acute vomiting intensity scale. RESULTS: There was a significant difference among the three groups (and also after the intervention) (P < 0.0001). Paired comparisons among the groups using Mann-Whitney test showed that there was a statistically significant difference between the control group and the intervention group and between the control group and the placebo group (P < 0.0001). However, there was no significant difference between the placebo and intervention groups (P = 0.07). CONCLUSIONS: Therapeutic touch was effective in reducing vomiting in the intervention group. However, the patients experienced lower-intensity vomiting which may be because of presence of a therapist and probably the reduced anxiety related to an additional intervention. So, further research is recommended considering the placebo group and employing another person in addition to the therapist, who is not skilled for this technique.

Therapeutic touch for nausea in breast cancer patients receiving chemotherapy: Composing a treatment.

BACKGROUND AND OBJECTIVE: Therapeutic touch (TT) is independent nursing intervention which is effective on nausea induced by chemotherapy but technique, steps and variables affected by this therapy are not yet well known. The aim of this study was to elicit descriptions of how TT is used with cancer patients, providing a basis for the systematic use and evaluation of TT with patients. MATERIALS AND METHOD: In this research, 108 patients were examined with intentional sampling and random allocation in 3 groups (control, placebo and intervention) in 2013 (each group 36). Intervention received therapeutic touch (touching of first energy layer) and demographic form, visual analog scale (VAS) for intensity of nausea, check list for duration and times of nausea in the morning, noon, afternoon and night at acute phase were used. Data were analyzed by Kruskal Wallis, χ(2) and analysis of variance (ANOVA). RESULTS: Duration, frequency and intensity of nausea were significantly lower in the test group (P < 0.001, P < 0.001 and P < 0.001). The mean duration of intervention (whole process) was 21.38 min [SD 6.04]. In 69.4% of women there was a need for re-intervention after reassessment phase. CONCLUSION: Results of this randomized control trial showed that TT is effective on duration, times and intensity of nausea; therefore, TT can be used as an alternative method for patients who are willing to use this technique.

An investigation of the effects of therapeutic touch plan on acute chemotherapy-induced nausea in women with breast cancer in Isfahan, Iran, 2012-2013.

INTRODUCTION: Nausea is the worst and most prevalent chemotherapy-induced complication experienced by 70-80% of patients despite mediation therapy. Reduction of nausea is one of the most important roles of oncologist nurses. Today, complementary therapies in addition to classic medicine, because of their lower costs, receive much attention. Nonetheless, their safety and effectiveness are not yet proven. The purpose of this research was to investigate the effect of therapeutic touch plan as a complementary therapy on acute nausea in women with breast cancer in 2012-2013 in Isfahan, Iran. MATERIALS AND METHODS: A quasi-experimental, single-blind, randomized control trial with three groups (control, placebo and intervention) was performed at the Isfahan Seyedolshohada (AS) Teaching Hospital, Isfahan, in 2012-2013. The intervention was therapeutic touch plan on women with breast cancer, with the three groups receiving the same medicine regimen. Information was recorded by a checklist after infusion of chemotherapy drugs. Data analysis was performed by SPSS, ANOVA and Kruskal-Wallis tests. RESULTS: The ANOVA test showed that the therapeutic touch plan was significantly effective in reducing the duration of nausea compared with the control and placebo groups (P < 0.001). The Kruskal-Wallis test showed that the frequency of occurrence of nausea was also reduced in the intervention and placebo groups compared with the control group (P < 0.001). The therapeutic touch plan was significantly effective in delaying the onset of nausea compared with the control and placebo groups (P < 0.001). CONCLUSION: This research showed that the therapeutic touch plan is effective in reducing acute chemotherapy-induced nausea; thus, education and implementation of the therapeutic touch plan is proposed for clinical nurses.