Prevalence of obsessive-compulsive disorder in the older person: a systematic review and meta-analysis.

BACKGROUND: The process of aging is a phenomenon that occurs universally in all living organisms. It begins during intrauterine life and persists until death. Obsessive-compulsive disorder (OCD) can significantly impact the lives of older adults, especially in their relationships with others, including spouses or partners. These relationships often involve conflicts or may be affected by the individual's OCD symptoms, such as rituals. Hence, the present study aimed to investigate the prevalence of OCD among the older person population. METHODS: The systematic review and meta-analysis were carried out without a time limit until March 2024. To identify articles pertinent to the study's objectives, searches were conducted on Embase, PubMed, Scopus, WOS, and Google Scholar databases using appropriate keywords and validated with MeSH/Emtree. The I2 index was utilized to assess heterogeneity among the studies. RESULTS: Ultimately, 10 articles meeting all the inclusion criteria had a sample size of 54,377. The estimated prevalence of OCD in the older person worldwide is 2.4% (95% confidence interval: 1.8%-3.3). The Asian continent showed the highest prevalence of OCD in the older person at 3.5% (95% confidence interval: 2.4-5.1), while the female population had an estimated prevalence of 2.7% (95% confidence interval: 1.9-3.8). As the publication year increased, there was an upward trend in the quality assessment score and the age of OCD prevalence in the older person (P < 0.05). CONCLUSION: The results of the present study indicate a high prevalence of OCD among the older person. Hence, it is advised that greater attention be directed towards this issue by experts, authorities, and health policymakers.

Strategies to prevent medical errors by nursing interns: a qualitative content analysis.

BACKGROUND: Nursing interns often face the serious challenges and stress of clinical training. Identifying effective strategies in reducing medical errors can improve student performance and decrease patient risk and injury from errors. The purpose of this study was to identify strategies to prevent medical errors by nursing interns in Medical Universities in Sistan and Baluchistan, Southeast of Iran. METHODS: This is a qualitative study using a content analysis approach. Purposive sampling was used. The study was conducted in 3 medical universities. Ten nursing interns participated in this study. Open-ended, semi-structured, and face-to-face, interviews were used to explore the experience of nursing interns about strategies to prevent medical errors during their internship. RESULTS: Findings include 20 subcategories, 6 categories and one theme. The main theme is "strategies to prevent medical errors during internship". Six categories included "strategies to prevent medical errors during internship". These included "Professional acceptance and support", "Revision of the implementation of the educational curriculum", "Retraining courses for challenging skills", "Creating learning opportunities" "Professionalization", and "Facilities and requirements". CONCLUSIONS: Preventing medical errors requires different strategies before and during nursing internship. Error prevention strategies include retraining and preparatory courses for challenging areas, evaluation of students' performance, and accepting students as members of the health care team, respecting and supporting them and protecting their rights. Learning from medical errors, analysis and reflection on errors should be part of the curriculum during the internship.

Schizophrenia: jinn, magic or disease? Experiences of family caregivers of patients with schizophrenia in Baloch ethnicity.

BACKGROUND: Cultural and religious beliefs are effective on people's attitudes towards schizophrenia and their help-seeking behaviors. This study aimed to explain the experiences of family caregivers of patients with schizophrenia in Baloch ethnicity. METHODS: This is a qualitative study with conventional content analysis approach. Purposive sampling was used and 21 participants, including family caregiver for patients with schizophrenia, a psychologist, a prayer-writer, and a normal person were interviewed in Sistan and Balochistan province in the southeast of Iran. Qualitative data were analyzed by Granheim and Lundman method. RESULTS: One main theme, three categories, and 10 Sub-categories were extracted from analysis of interviews. "Immersion in the cultural beliefs" was the main theme of the study with categories of "Belief in the superstitious and supernatural nature of the psychological disease", "Superstitious beliefs, an attempt to free the patient", and "Conflict between cultural beliefs and science". CONCLUSIONS: Help-seeking behaviors of family caregivers in Baloch ethnicity are influenced by their religious, superstitious, and cultural beliefs. Psycho-education should be part of all mental health education programs in these communities, as delays in treatment worsen the prognosis of people with schizophrenia. Training the medical staff to consider the culture, religion and therapeutic preferences of the Baloch people can be effective in advancing the goals. In addition, local influencers should stress the importance of health care alongside harmless local remedies.

The effect of education based on PEN-3 cultural model on students' menstrual health behaviors: a mixed method study.

Menstruation is a natural process in girls, but sometimes it is accompanied by beliefs and behaviors with cultural roots that result in poor health consequences; this study aimed to consider perceptions of individual, families and community to current cultural beliefs, and to determine the effect of education based on the PEN-3 cultural model on students' menstrual health behaviors in Iran. Study had a mixed method design. In the qualitative phase, data were collected from students, their mothers and teachers through focused group discussion and in-depth interviews. In the quantitative phase, training was done in four 2-h sessions for intervention group. The data were collected immediately and 2 months after the training by a questionnaire and they were analyzed by Friedman and Wilcoxon non-parametric tests. Training was effective on all of the model structures and significantly increased mean score of the health behavior after training and 2 months later by 8.74 and 13.86, respectively, in intervention group (P<0.05). The perception and behavior of the others and access to sanitary services and products, especially cultural factors affect girls'' menstrual health behaviors, therefore, it is necessary to design the health plans regarding each of these factors, and the cultural context of each community.

Home care for burn survivors: A phenomenological study of lived experiences.

Background: Burn injuries have negative impacts on all dimensions of the quality of life of burn victims. This study aimed to explore the lived experiences of burn survivors after a 6-month period of home care following hospital discharge.Method: This is a qualitative study with a phenomenological approach. Sixteen burn survivors from a university hospital in Kermanshah province participated in the study. Qualitative data were analyzed by Colaizzi's descriptive phenomenological approach.Results: "Rehabilitation in the process of life" was the main theme of the study with four sub-themes, including "conducting process", "caring bridge", "humanitarian commitment for human revival", and "healing care".Conclusions: Home care is necessary for burn survivors after discharge from the hospital. The connection of healthcare services between home and hospital, safety feeling in the patient and his/her family, cost-effectiveness of healthcare services, and encouraging the patient to perform self-care can be achieved by home care follow-ups.

Primiparous women's experiences of normal vaginal delivery in Iran: a qualitative study.

BACKGROUND: Childbirth is considered as the most challenging psychological event in a woman's life. It has a major effect on women's lives with long-term positive or negative impacts. Cultural, religious, and socioeconomic differences can affect women's perception about normal vaginal delivery (NVD) experience. Therefore, it is necessary to explore the primiparous women's perception about it. METHODS: This qualitative study, with a descriptive content analysis approach, was conducted in Kashan, a city in the center of Iran. Purposive sampling was used to recruit the participants of the current study. Data was gathered by semi-structured interviews during 24 h after normal vaginal birth among primiparous women. The sampling started from June to October in 2016. Interviews continued until data saturation which was achieved in the 14th interview but for assurance, it continued until the 17th one. RESULTS: The following three main themes were extracted "immersion in stress", "pain, the essence of NVD" and "strategies for situation management". Furthermore, seven subthemes were obtained including 'loss threat', 'stressful context', temporary impairment in physiologic harmony, paradoxical emotions, self-management, emotional support, and spiritual support. CONCLUSIONS: This study showed that stress and pain were two highlighted issues in NVD process. Increasing women's awareness about NVD process, familiarizing the primiparous women with the simulated delivery room, accompanying these women for emotional support, and providing spiritual support can be effective in situation management to make the child delivery a pleasant and satisfying experience.

Effect of Telenursing and Face-to-Face Training Techniques on Quality of Life in Burn Patients: A Clinical Trial.

OBJECTIVE: To compare the effect of telenursing and face-to-face training on the quality of life (QOL) of patients with a burn injury. DESIGN: This clinical trial with pretest-posttest design on 3 groups was conducted in Kermanshah, Iran, from 2017 to 2018. Convenience sampling was used. SETTING: A tertiary hospital in Kermanshah, west of Iran. PARTICIPANTS: A total of 90 patients with burns of grade 2 and 3 after discharge from the hospital were randomly assigned to 3 groups including telenursing (30), face-to-face training (30), and control (30). INTERVENTIONS: Each intervention group received 1-on-1 telephone training and face-to-face training in 8 sessions (2 sessions of 15 to 20min/wk). The control group received regular care. MAIN OUTCOME MEASURES: QOL was evaluated by the Burn Specific Health Scale-Brief (BSHS-B). RESULTS: The mean BSHS-B scores before and after intervention for telenursing, face-to-face, and the control group were 71.43±21.92 and 133.06±11.97; 64.83±26.16 and 124.83±23.05; and 58.63±20.89 and 73.13±33.04, respectively. There was a statistically significant difference among the 3 groups with respect to the training methods after intervention (P<.001). In addition, post hoc test did not show a significant difference between the telenursing and face-to-face groups (P=.244). CONCLUSIONS: Educational methods in the form of telenursing and face-to-face training were effective and promoted QOL in survivors of burn injuries. Both telenursing and face-to-face training can be used to improve the QOL of survivors of burn injuries during the rehabilitation phase.

Lived experiences of burn survivors regarding the challenges of home care follow-ups: a phenomenological study.

Burn victims often require long-term treatments. Patients prefer to be at home while receiving care services but there are some deficiencies in conducting home care. To explore the challenges of nurse-led follow-up, 16 burn survivors who received home care for 6 months were interviewed. The theme, "barriers of care," was extracted. It included two subthemes entitled "Barriers related to implementation of home care and "Barriers of ideality." Providing home care for burn survivors encounters several barriers that were classified into two categories including modifiable and nonmodifiable barriers. Suitable infrastructure and policies are necessary to conduct home care for burn survivors.

Opportunities and Challenges of E-learning for Nursing Students at the Beginning of the COVID-19 Pandemic in Iran: A Qualitative Content Analysis.

Background: Given the limited presence of students in universities and the closure of educational centers, including nursing schools, during the COVID-19 outbreak, there has been a significant shift toward e-learning. However, there is a lack of research in this area. Therefore, this study aimed to explore the experiences of undergraduate nursing students with e-learning during the COVID-19 outbreak in 2020. Materials and Methods: This qualitative-descriptive study focused on 12 undergraduate nursing students from the School of Nursing and Midwifery at Isfahan University of Medical Sciences. The participants were selected using purposive sampling. In-depth and semi-structured interviews were conducted to collect the data. The collected data were analyzed using MAXQDA10 and conventional content analysis. The study was conducted between May and September 2020. Results: Analysis of the findings led to the emergence of 11 subcategories and two main categories: E-Learning opportunities and Challenges of E-Learning, providing a comprehensive description of the experiences reported by the participants. Conclusions: Unforeseen crises, such as the current COVID-19 pandemic, can significantly affect the quality of education by disrupting face-to-face learning. To mitigate such disruptions, it is crucial to plan and establish infrastructure that supports alternative modes of education, such as e-learning. Additionally, providing training to students and educators on effectively utilizing digital platforms and producing electronic content can help ensure a smoother transition during crises.

Effect of continuous workshop training of the helping babies breathe program on the retention of midwives' knowledge and skills: A clinical trial study.

AIM: To investigate the impact of ongoing workshop training of the "Helping Babies Breathe" program on the durability of midwives' knowledge and skills. BACKGROUND: Implementing the Helping Babies Breathe (HBB) program is crucial as a simple protocol for neonatal resuscitation in low-resource healthcare settings to decrease the rate of asphyxia and perinatal mortality by the initial healthcare providers. In addition to training in this program, it is also essential to guarantee the retention of the acquired knowledge and skills. DESIGN: A quasi-experimental clinical trial study with a single-group, pre-test-and-post-test design. METHODS: This study was conducted throughout the year 2022, with a sample size of 61 midwives selected through a census sampling from those working in the delivery and operating rooms of X Hospital in x City. The midwives participated in 3-hour workshops. This study was performed in two stages: intervention and follow-up. The evaluation Instruments included the HBB educational package, which consisted of a questionnaire and 3 Objective Structured Clinical Exams. During the intervention phase, the HBB program training was conducted through a series of workshops held at four different time points over a span of six months. In the follow-up stage, the learners were not provided with any further training. The evaluation was done immediately after the initial training workshop of the HBB program, at the end of the final workshop in the sixth month and at the end of the follow-up period. RESULTS: The mean knowledge score of the baseline, at six months and at twelve months after the initial workshop were documented as (17 SD1.2), (17.79 SD 0.4) and (17.73 SD 0.5), respectively. There was a statistically significant difference in the mean knowledge scores between the baseline and the six and twelve months (P<0.05), but no statistically significant difference was observed between six and twelve months (P>0.05). The mean skill scores showed a significant improvement and were maintained after six months compared with the initial assessment (P<0.05); however, there was a significant decrease in skill score twelve months later, in comparison to both the initial assessment and the first six months (P<0.05). CONCLUSIONS: Healthcare workers can maintain their knowledge and skills by participating in ongoing training workshops. However, without continuous training, their skills may diminish. Therefore, it is essential to implement training programs that emphasize regular practice and repetition to ensure knowledge and skills retention. REGISTRATION NUMBER: The present research was a part of the research work with the ethics ID IR.IRSHUMS.REC.1400.019.

Nursing educators' experiences of cultural competence in the nursing education program: A qualitative descriptive study.

BACKGROUND: To meet the population's increasing diversity and the health system's needs, it is necessary to prepare nursing schools to produce culturally qualified students. PURPOSE: This study aimed to extract the experiences of nursing educators about the cultural competence of nursing students. METHOD: In this qualitative descriptive study, data were collected through in-depth, semi-structured interviews with 15 nursing educators affiliated with three medical sciences universities in southeastern Iran. Purposive data sampling and analysis were performed using Graneheim and Lundman's conventional content analysis methods. RESULTS: One main theme, 5 categories, and 18 subcategories were extracted. The main theme was "cultural equality, the essence of care and education". Categories included "Toward culturally-based caring and education", "Charter of cultural rights", "The need for cultural competence facilitators", "Cultural exposure", and "Modifying the curriculum policies". CONCLUSION: This study shows that nursing educators strive to take into account students' cultural competence, even though cultural competence is not explicitly integrated into nursing curricula. The acquisition of cultural competence requires multifaceted changes in education, in clinical centers, and in the creation of cultural infrastructure.

Exploring Lived Experiences of Vulnerability in Nursing Management during the Coronavirus Disease 2019 Pandemic: A Phenomenological Study of Nurse Managers and Nurses.

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic placed enormous pressure on healthcare systems around the world, but it also provided valuable insights for healthcare organizations during this challenging period. Objective: This study aimed to explore nurses' lived experiences of vulnerability in hospital nursing management during the COVID-19 pandemic, and reflect on the lessons learned. Methods: In this phenomenological study, 14 participants, including nurse managers at different levels and staff nurses, were selected by purposive sampling from one center university hospital. Data collection was done through in-depth individual semistructured interviews with participants and a review of weekly reports of crisis management meetings at the university hospital. Interviews were analyzed using Colaizzi's method in seven phases by MAXQDA software Version 10. Results: One overarching theme, four themes, and 15 subthemes were obtained from analyses of interviews. Four themes of "nurses' attrition," "distrust of society to the organization," "fragility in the organization's performance," and "intensified inequalities" were extracted as threats to nursing management at the hospital. Subsequently, the weekly reports of crisis management meetings at the university hospital were analyzed to extract the solutions and lessons. Conclusion: The unpreparedness of the healthcare system against a crisis can led to the loss of organizational assets, including medical staff and the credibility of the healthcare system. Limitations of the infrastructure at hospital became more obvious during the pandemic and caused serious threats to the healthcare system. Despite severe challenges along with the pandemic, it offered four valuable lessons in nursing management.

Nurses' lived experiences of caring for patients with COVID-19: a phenomenological study.

Background: COVID-19 is an infectious disease caused by a novel Coronavirus which transmits from person to person throughout the world. This study aimed to explore the lived experiences of nurses' caring for patients with COVID-2019 in the context of the healthcare system of Iran. Methods: This is a phenomenological study with 13 participant nurses (6 men and 7 women) who were caring for COVID-19 patients in one of the university hospitals in Southeast of Iran. Qualitative data were analysed by the seven steps of Colaizzi's method. Results: Participants reported around a five-month history of caring for COVID-19 patients. After analysis, 597 codes, 16 categories, four sub-themes, and one theme were extracted. "Caring from self-sacrifice to avoidance" was the main theme of the study with sub-themes of "Anxiety Chain", "Manifestation of Humanitarian Caring", "Ethical Challenges", and "Challenges of Overcoming Crisis". Conclusions: Nurses explained their caring experiences with patients on a continuum from humanitarian caring and self-sacrifice to caring avoidance. Because of the multi-sources of psychological stress and ethical challenges together with this infection, healthcare managers should plan for holistic regular psychological support services, prevention of job inequalities, and do strategic planning for access to enough resources in the healthcare system.

Effect of Post-Hospital Discharge Follow-up on Health Status in Patients with Burn Injuries: A Randomized Clinical Trial.

BACKGROUND: Patients with burn injuries still face various burn-related challenges after being discharged from the hospital. Hence, a follow-up program for such patients is essential. The present study aimed to evaluate the health status of burn victims after 1.5 months follow-up. METHODS: The present randomized clinical trial was of a pretest-posttest design, carried out in Kermanshah (Iran) from July 2016 to September 2017. A total of 117 participants were recruited out of which 86 were included in the analysis. The participants were randomly assigned into two groups, namely the intervention group (N=42) and the control group (N=44). All participants were evaluated both at the time of hospital discharge and at 1.5 months post-discharge. The follow-up plan for the intervention group included home visits, telenursing, and referral to specialists or health education centers. To evaluate the physical and psychological status of the participants, five different instruments were used; namely the Burn Specific Health Scale-Brief (BSHS-B), the General Health Questionnaire-28 (GHQ-28), the Brief Pain Inventory (BPI), the Vancouver Scar Scale (VSS), and the Visual Analogue Scale (VAS). All statistical analyses were performed using the SPSS software (version 17.0). Data were analyzed using the Chi-square test, independent t-test, and paired t-test. P<0.05 was considered statistically significant. RESULTS: The mean score of the BSHS-B questionnaire at both the time of discharge and 1.5 months post-discharge follow-up for the control and intervention groups was 61.22±19.07, 57.14±18.92; 83.70±24.73 and 105.16±29.17, respectively. There was a significant difference between the groups at 1.5 months post-discharge follow-up (P<0.001). At 1.5 months, the VSS score was 5.16±1.68 and 6.77±3.46 for the intervention and control groups, respectively. The GHQ-28 score was 28.69±12.39 and 40.79±16.20 for the intervention and control groups, respectively. The VAS and BPI scores of the control group were 5.56±3.11 and 21.93±29.25, respectively. For the intervention group, these scores were 4.85±3.49 and 15.61±27.47, respectively. There was a significant difference between the groups as to the GHQ and VSS scores (P<0.05). However, no significant difference was noted in the BPI and VAS scores (P<0.05). CONCLUSION: Health status, psychological status, and scar management were improved due to post-discharge follow-up. However, burn patients required continued care for pain, psychological health, and itching problems. Trial Registration Number: IRCT2016110630712N.