The Effect of a Non-Pharmacological Multicomponent Pain Management Program on Pain Intensity and Quality of Life in Community-Dwelling Elderly Men With Chronic Musculoskeletal Pain.

BACKGROUND AND AIM: Improving the level of care for the elderly with musculoskeletal pain requires pharmacological and non-pharmacological pain control methods. This study aimed to investigate the effect of a non-pharmacological pain management intervention on pain intensity and quality of life in community-dwelling older men with musculoskeletal pain who were referred to comprehensive healthcare centers in the city of Ilam, Iran. MATERIALS AND METHODS: A quasi-experimental study with pre and post-test design was performed on 65 older men with chronic musculoskeletal pain. The samples were selected regarding inclusion criteria as available and randomly assigned to either the control (usual care) or the experimental group (educational intervention plus physical exercises). Baseline characteristics of participants, the Visual Analogue Scale, and the CASP-19 Quality of Life were used to collect data. Data were analyzed by SPSS software using the ANCOVA, independent and paired t-test, and chi-square test at the statistically significant level of 5 %. RESULTS: According to the findings, there was a significant difference between the experimental and control groups in terms of quality of life (p < .05) and pain intensity (p < .05) after the intervention. No relevant differences were found between groups regarding demographic characteristics at baseline. CONCLUSIONS: A six-week physical activity and education program for community-dwelling older men with chronic musculoskeletal pain could improve quality of life and decrease pain intensity after a one-month follow-up compared with usual care. Therefore, it seems necessary to consider pain management programs in the elderly care program and familiarize health care professionals with these pain control methods.

Significant influencing factors and practical solutions in improvement of clinical nursing services: a Delphi study.

BACKGROUND: Clinical services evaluation with specific indicators are very helpful to identify improvable points. This study was conducted to analyze the factors affecting the quality of clinical nursing services and offer practical solutions for accreditation of clinical nursing services. METHODS: The present study was conducted using Delphi method with two rounds. At the beginning of the study a questionnaire was prepared using results of another project (clinical nursing services audit). This questionnaire was sent to 47 nursing and accreditation professionals. After the first round, causes and solutions were categorized. Then participants were asked to comment on the significance of each strategy on the prepared questionnaire. RESULTS: In the first round of Delphi in response to the question about the main causes and solutions of low quality of nursing clinical services, 394 causes and 212 solutions were mentioned by the participants. In the second round, considering moralists and specialization in the selection of nursing managers, staffing according to workload and attendance in comprehensive exam after graduation and before entering clinical fields attained the most importance. CONCLUSION: Mismatch of human resources with workload and lack of clarity with regard to duties have maximum correlation with poor quality of care. Organizational structure and communication program categories gained the highest and lowest importance respectively. This information could be used by nursing managers and policy makers to plan programs in order to improve the quality of clinical nursing services.

Cultural Safety: An Evolutionary Concept Analysis.

Healing occurs in a safe milieu, and patients feel safe when service providers view them as whole persons, recognizing the multiple underlying factors that cause illness. Cultural safety can lead to service delivery in this way, but most nurses have no clear understanding of this concept. This study aimed to clarify cultural safety on the basis of Rodgers' evolutionary concept analysis. Cultural sensitivity and cultural awareness are the antecedents of cultural safety. These concepts include a nurse's flexibility toward his or her patients with different perspectives, creating an atmosphere free from intimidation and judgment of the patients, with an overall promotion of health in multicultural communities.

Evolutionary concept analysis of health seeking behavior in nursing: a systematic review.

BACKGROUND: Although the research in health seeking behavior has been evolving, its concept remains ambiguous. Concept clarification, as a central basis of developing knowledge, plays an undeniable role in the formation of nursing sciences. As the initial step toward the development of theories and theoretical models, concept analysis is broadly used through which the goals can be used and tested. The aim of this study was to report an analysis of the concept of "health seeking behavior". METHOD: Employing a rigorous evolutionary concept analysis approach, the concept of health seeking behavior was examined for its implications, use, and significance in the discipline of nursing between 2000 and 2012. After applying inclusion and exclusion criteria, a total of 40 articles and 3 books were selected for the final analysis. RESULTS: The definition of attributes, antecedents, and consequences of health seeking behavior was performed through concept analysis. Core attributes (interactional, processing, intellectual, active, decision making based and measurable) were studied. The antecedents of concept were categorized as social, cultural, economic, disease pattern and issues related to health services. Health-seeking behavior resulted in health promotion and disease risk reduction. In addition, it led to predicting the future probable burden of the diseases, facilitation of the health status, early diagnosis, complete and effective treatment, and complication control. CONCLUSION: Health-seeking behavior, as a multi-dimensional concept, relies on time and context. An awareness of health-seeking behavior attributes antecedents and consequences results in promoting the status, importance and application of this concept in the nursing profession.

Professional Quality of Life among Iranian Clinical Nurses at the Forefront of the Fight against COVID-19: A Multicenter Cross-Sectional Study.

Background: With the prolonged COVID-19 disease control time, concerns about the caring ability of clinically exposed nurses have increased. This study aimed to investigate Compassion Satisfaction (CS), Burnout (BO), and Secondary Traumatic Stress (STS) as elements of Professional Quality of Life among nurses in COVID-19 settings. Materials and Methods: In this descriptive online national survey, 427 clinical nurses who had worked in the COVID-19 wards from all Iran provinces answered the Persian version of the Professional Quality of Life Scale as the profile tool with three subscales, including CS, BO, and STS. Data were collected using email, Short Message Service (SMS), and social networks from December 2020 to February 2021. Results: The mean (SD) score of CS was 38.86 (9.00), the mean (SD) score of BO was 18.60 (4.08), and STS was 34.74 (7.02). STS was substantially more prevalent among married nurses whose Polymerase Chain Reaction (PCR) tests were positive for themselves or at least one family member (p < 0.05). Conclusions: Clinical nurses who respond to the COVID-19 crisis are at risk of STS and BO. In pandemic situations like COVID-19, it is necessary to consider supportive interventions to increase satisfaction and reduce burnout and secondary traumatic stress in nurses.

Psychometric validation of the nursing care behavior questionnaire during emerging disease epidemics: A theory of planned behavior approach.

Background and objective: The Covid-19 pandemic could compromise the quality of care by impacting nurses' intention to provide care. Hence, investigating nurses' behavioral intentions when caring for patients during epidemics is essential. This research aims to assess the psychometrics of the "Nursing Care Behavior in Epidemics of Emerging Diseases" questionnaire, based on the constructs of the Theory of Planned Behavior. Methods: This cross-sectional study involved 311 nurses working in Covid-19 wards of selected hospitals in Ilam City, all of whom were enrolled through a census in 2021. The questionnaire underwent initial translation from English to Persian, followed by evaluations of its face, content, and construct validities. The nursing caring behavior questionnaire, comprising 46 items, was designed to assess behavioral beliefs, normative beliefs, control beliefs, behavioral attitudes, subjective norms, perceived behavioral control, and nurses' intentions to care for Covid-19 patients. Data were analyzed for face, content, and construct validity using the Theory of Planned Behavior and Pearson correlation. Reliability was determined by calculating the Cronbach's alpha coefficient. Results: The intention to care dimension demonstrated an inverse correlation with the behavioral attitude dimension (p < 0.001). The most robust correlations were observed between the following paired dimensions: behavioral attitude and perceived power (p < 0.001), subjective norms and intention to care (p < 0.001), perceived behavioral control and subjective norms (p < 0.001), care intention and behavioral beliefs (p < 0.001), behavioral beliefs and behavioral outcome evaluation (p < 0.001), and normative beliefs with motivation to comply (p = 0.001). The Cronbach's alpha coefficient of the instrument exceeded 0.75. Conclusion: According to the Theory of Planned Behavior, the nursing care behavior questionnaire proved to be a valid and reliable tool for evaluating nurses' care behaviors amidst emerging disease epidemics.

Sociopolitical development of the nursing profession in Iran: a historical review.

Significant sociopolitical changes in recent decades have not only influenced the nursing profession, but also the entire Iranian healthcare system. This study describes the historical evolution of the nursing profession within a sociopolitical context. This historical review of unpublished and published literature endorsed personal accounts of historic events by 14 of the oldest nurses in Iran chosen through purposive sampling method, as they shared their nursing experiences. Individual recollections were collected through in-depth and semi-structured interviews and later analyzed through oral history analysis method. From the results, the 3 categories of the White Revolution, the Islamic Revolution, and Iran-Iraq war and 8 subcategories emerged, where participants identified factors that fundamentally changed the Iranian nursing profession. The nursing profession continues to develop and help revise policies to improve the healthcare system and quality of care. The findings of this study facilitate the better understanding of the influence of sociopolitical events on the nursing profession and guide the revision or development of new healthcare policies.

The Effect of Orem's Self-Care Model on Quality of Life in Patients with Migraine: a Randomized Clinical Trial.

Many aspects of the lives of migraineurs are commonly affected by the condition, including occupational affairs, social and family life, responsibilities and ultimately the quality of life. This study was designed to determine the effect of orem's self-care nursing model on quality of life in patients with a migraine. This study was carried out in Tehran, Iran. According to the pre-post design of the randomized clinical trial, 88 patients were selected. After obtaining approval from the ethics committee of the Baqiyatallah Medical Sciences University's Research Deputy; Patients who signed the informed consent aged 20-55 years and without any more disease or disability affecting the quality of life were selected and randomly assigned to a group. Data collection tools were a demographic questionnaire, general health survey short form (SF36), and Orem cognition form and self-care checklist. Self-care model were held as four 30-45 minutes training sessions based on self-care deficit needs for the experimental group. The quality of life scores was measured in two stages, before and three months after intervention then were compared in both groups. Data were analyzed with statistical software SPSS and use of descriptive analysis tests, Chi-square, Mann-Whitney u and Wilcoxon. The final analysis was performed on 43 experimental and 40 controls. No significant difference was detected in the two groups in terms of demographic variables (P>0.05). All dimensions of quality of life including physical functioning, physical role limitation, body pain, general health, vitality, social functioning and emotional role limitation and mental health in the experimental group showed a significant increase after intervention compared to the control group (P<0.05). It was concluded that performing Orem's self-care nursing model improves function and overall quality of life and reduces the high cost of a migraine and migraine-related disability to individuals and society.

The effectiveness of Orem's self-care program on headache-related disability in migraine patients.

Background: Providing a self-care program appropriate for patient needs in a supportive educative nursing system format could reduce migraine-induced disability. This study was designed to determine the effectiveness of Orem's self-care program on headache related disability in migraine patients. Methods: In this randomized clinical trial, episodic migraine patients with or without aura who signed the informed consent were randomly assigned to two groups (44 patients each). The data collection tools included a demographic questionnaire, the Migraine Disability Assessment (MIDAS) questionnaire, an Orem cognition form, and a self-care checklist. The programs were held as four 30 to 45 minutes training sessions for experimental group. The MIDAS were filled out before and three months after program in two groups. Data were analyzed with SPSS statistical software, version 16 and using chi-square, Mann-Whitney and Wilcoxon tests. Results: There was no statistically significant difference between the two groups in terms of demographic variables (P > 0.05). The mean total MIDAS score in the experimental group, before and after the intervention was 28.1 ± 17.5 and 6.03 ± 4.52, respectively (P = 0.001); and for the control group, it was 37.6 ± 16.4 and 55.6 ± 14.5, respectively (P < 0.001). Also, there was a statistically significant difference in disability indices between the two groups after the intervention (P < 0.001). Conclusion: Self-care program was suitable for needs assessment and provided basis for acquiring positive results in order to decrease disability and saved patient treatment costs.

Antecedents of organizational citizenship behavior among Iranian nurses: a multicenter study.

BACKGROUND: Organizational citizenship behavior (OCB) improves efficiency and employees' participation and generally provides a good ambiance. This study was conducted to determine the role of job satisfaction (JS), organizational commitment (OC) and procedural justice (PJ) in explaining OCB among nurses working in fifteen educational-treatment centers in Tehran-Iran, to provide guidelines for health care managers' further understanding of how to encourage citizenship behavior among nurses. METHODS: In this multi-center descriptive-correlational study 373 nurses were evaluated through a Multi-stage cluster sampling method after obtaining approval from the Ethics Committee of Islamic Azad University, Tehran Medical Branch and Tehran University of Medical Sciences Research Deputy. Nurses who signed the informed consent and holding a bachelor or master degree, having a minimum one year of job experience and not having organizational management position during the questionnaire distribution were included in the study. In order to collect data, Demographic questionnaire, Podsakoff et al. (Leadersh Q 1(2):107-142, 1990) OCB questionnaire, OC questionnaire, Aelterman et al. (Educ Stud 33(3):285-297, 2007) JS questionnaire and PJ questionnaire were used. These questionnaires were translated into Persian and content validity was confirmed by an expert group; their reliability was calculated by the internal consistency Cronbach alpha coefficient and it was satisfied. Data were analyzed by descriptive statistics, Comparative mean tests, correlation coefficient and multiple-regression in the SPSS software version 11. RESULT: The general mean and all five aspects of OCB that ranked higher than 3 were evaluated in a "quite desired" state. The mean for perceived procedural justice, the general mean for JS and the mean of general grade for OC from the nurses' was in "quite desired" state. Finding from multiple regression indicated that OC and PJ exhibit about 19 % of OCB variance totally which is statistically significant (P < 0.01). JS had no significant impact on explaining OCB. CONCLUSION: OC was the strongest predictor of nurses' OCB followed by perceived procedural justice. So, improving these factors can initiate better citizenship behavior among nurses.

Effect of applying continuous care model on quality of life among kidney transplant patients: a randomized clinical trial.

INTRODUCTION: The aim of this study was to compare the effect of continuous care model with routine care on the quality of life among patients who receive a kidney transplant. MATERIALS AND METHODS: In a randomized clinical trial, 90 kidney transplant patients were selected from 4 hospitals in Tehran, Iran, and were randomly assigned to 2 group. In the experimental group, continuous care model was applied for 3 months and the control group received routine care. The scale scores of the Kidney Transplant Questionnaire concerning quality of life were monthly compared between the two groups. RESULTS: Of 90 patients, 4 in the experimental and 8 in the control group were excluded from the study. Final analysis was performed on 41 in the experimental and 37 in the control groups. No significant difference was found between the two groups in terms of demographic variables. Although the quality of life scores increased in both groups, the mean scores of the experimental group were significantly higher than those in the control group at 1, 2, and 3 months. CONCLUSIONS: Continuous care model may improve the kidney transplant patients' quality of life.

Measuring health related quality of life (hrqol) in renal transplant patients: psychometric properties and cross-cultural adaptation of kidney transplant questionnaire (ktq-25) in persian.

BACKGROUND: Different measuring tools have been used to understand the outcomes of renal replacement therapies. The goal of renal transplantation is both to ensure survival, and to promote quality of life in the patients. One of the widely used disease-specific instruments to measure the quality of life is the Kidney Transplant Questionnaire (KTQ-25). OBJECTIVES: The current study aimed to perform a cross-cultural adaptation and assess the psychometric properties of the KTQ-25 to Persian. MATERIALS AND METHODS: The KTQ-25 was trasnlated according to International Quality of Life Assessment (IQOLA) translation methodology. Cronbach's alpha coefficient, and test-re-test were used to determine internal consistency, and reliability respectively. RESULTS: In the test-re-test reliability of all questionnaire items, Pearson correlation was r = 0.96 (P < 0.001). Cronbach's alpha coefficient estimated the internal consistency for each scale andalpha equal or more than 0.73 was considered satisfactory. Criterion-related validity, measured by the correlation coefficients between the KTQ-25 and the SF-36 Health Survey, was r = 0.63 (P < 0.001). CONCLUSIONS: The psychometric properties of the Kidney Transplant Questionnaire (KTQ-25) in Persian have proven to be satisfactory, therefore the application of this questionnaire in clinical practice can be recommended.