Application of Neuman,s Systems Model on Anxiety of Older Adults Waiting for Colonoscopy

Background: Older adults waiting for colonoscopy are anxious due to the lack of knowledge about the procedure, its preparations, and aftercare. Objectives: The aim of this study was to evaluate the effect of the Neuman systems model (NSM) on anxiety of older adults waiting for colonoscopy. Methods: A pre- and postintervention study was conducted on 72 older adults who were waiting for colonoscopy. The participants were randomly allocated to either a control (n = 36) or an intervention group (n = 36). The intervention was performed in four steps, namely determining the potential and actual stressors, setting the goals, nursing interventions, and evaluation, according to the four-step nursing process in the NSM. A need assessment checklist based on the NSM and the Geriatric Anxiety Scale was completed before and after the intervention. Data analysis was performed using Fishers exact, independent, and paired t-tests. Results: At baseline, the mean score of total anxiety was 35.66 ± 7.58 in the intervention group and 35.29 ± 6.52 in the control group. After the intervention, these values changed to 26.71 ± 7.48 and 34.06 ± 7.23. Before the intervention, there was no statistically significant difference between the anxiety scores of the two groups in cognitive, affective, and somatic dimensions and total anxiety scores (P > 0.05). However, after the intervention, statistically significant differences were found between the two groups in the mean scores of the aforementioned components (P < 0.001). Conclusion: Implementing an educational program based on NSM reduced anxiety in older adults waiting for colonoscopy. Nurses should be trained about the NSM to be able to use similar programs in reducing the anxiety of patients waiting for colonoscopy

The effect of H7 acupressure on amniocentesis anxiety in pregnant women: A randomized controlled trial

Background: Amniocentesis is the most common invasive procedure for diagnosing fetal abnormalities. Most pregnant women are anxious about fetal abnormalities and screening tests. Objectives: This study was conducted to determine the effect of H7 acupressure on amniocentesis anxiety in pregnant women. Methods: This clinical trial was conducted on 56 pregnant women candidates for amniocentesis. In the intervention group, acupressure was performed at H7 acupoint for 5 min in each hand, 30 min before amniocentesis, and then daily for 10 days. The control group did not receive any intervention. Data collection was done using a demographic questionnaire, the Spielberger state-trait anxiety inventory, and a daily acupressure recording checklist. Data were analyzed using the independent samples t-test, Chi-square test, repeated measures analysis, Bonferroni post hoc test, and paired t-test. Results: The mean state anxiety scores in the intervention group were 38.70 ± 5.64 and 30.22 ± 6.70 immediately and 10 days after amniocentesis. However, at the same times, the mean state anxiety scores in the control groups were 49.03 ± 2.30 and 50.86 ± 2.01, respectively, which were significantly higher than the intervention group (P < 0.001). The mean scores of trait anxiety were significantly lower in the participants of the acupressure group than the control group 10 days after amniocentesis (P < 0.001). Conclusion: The H7 acupressure could be effective in reducing state and trait anxiety in pregnant women during amniocentesis and when they are waiting for the test results

Nursing Students' Attitude toward the Importance of Patient Privacy

Background: Observing patient privacy is one of the most important nurses' ethical responsibilities. Objective: This study is aimed to investigate nursing students' attitudes toward the importance of patient privacy in nursing care. Methods: This cross-sectional study was conducted between September 2018 and April 2019 in the School of Nursing and Midwifery of Guilan University of Medical Sciences, Iran. One hundred and fifty nursing students responded to the study questionnaires. Descriptive statistics were used to analyze the data. Results: A total of 142 nursing students with a mean age of 21.91 ± 4.67 years participated in this study. A majority of the students (63.5) were female, 82.2 were single and 31.8 had clinical experience. The mean students' attitudes scores were, respectively, 8.36 ± 1.53, 6.84 ± 2.04, 6.24 ± 2.23, and 11.42 ± 2.17 for the physical, psychological, spatial, and informational dimensions of patient privacy. Conclusion: The mean students' attitude toward patient privacy was at a moderate level. Nurse educators and all the authorities of nursing education should instruct nursing students to pay special attention to the observance of patient privacy

Being with and for mother: From perceived difficulties to rebalancing the mothering role in women with breast cancer

Background: Breast cancer is the most common cancer and the 5-th leading cause of death in Iranian women. Many of these women are at the age of fertility and have dependent children. Objectives: This study aimed to explore the experiences of mothers with breast cancer of the support they receive for playing and rebalancing their mothering role. Methods: This qualitative content analysis study was conducted from 2018 to 2019. Participants were 22 mothers with breast cancer purposively recruited from Shahid Ghazi Tabatabaee Hospital in Tabriz, Iran. Data were collected through semi-structured interviews and analyzed through a conventional content analysis method. Results: Participants experiences were categorized into three main categories, namely, perceived difficulties, being with and for mother, and rebalancing family functions. The four subcategories of the first category were the physical limitations in performing the mothering role, the psychological burden of the disease, role strain in playing the mothering role, and childrens social difficulties. The second category included five subcategories, namely, assistance with the mothering role, emotional attachment to the mother, provision of family expenses and medical costs, normalization of appearance following cancer-induced changes, and social support resources. Finally, the third category included two subcategories, namely, the stability of the mothers roles and promoting a health-oriented perspective in the family. Conclusion: Mothers with breast cancer face difficulties in performing their role as mothers. Identifying and providing supportive interventions for them by the health-care providers not only can be effective in achieving role stability for the mother but also in rebalancing family functions

The effects of virtual-augmented reality training on anxiety among operating room students attending coronary artery bypass graft surgery

Background: Operating room (OR) students experience varying levels of anxiety during their internship program in the OR. Educational technology has the potential for reducing anxiety. Objectives: This study aimed at assessing the effects of training based on virtual-augmented reality (VAR) on anxiety among OR students attending coronary artery bypass graft (CABG) surgery. Methods: This randomized controlled trial was conducted in 2020. Thirty-six OR students were conveniently recruited and randomly allocated to an intervention (n = 18) and a control (n = 18) group. Participants in the control group received conventional training, whereas their counterparts in the intervention group received VAR training through watching a 360-degree VAR video of CABG surgery in addition to conventional training. The State-Trait Anxiety Inventory was used for anxiety assessment in both groups at three time points, namely before entering the OR on the first day of the internship program, after entering the OR but before scrub, and on the last day of the program. The data were analyzed through the independent-samples t-test, the Chi-square test, and the repeated-measures analysis of variance. Results: There was no significant difference between the intervention and the control groups regarding the pretest mean scores of state anxiety (40.61 ± 7.63 vs. 41.59 ± 5.09; P = 0.66) and trait anxiety (39.17 ± 7.39 vs. 39.29 ± 6.05; P = 0.96). However, the mean scores of state and trait anxiety in the intervention group were significantly less than the control group at both the first posttest (33.17 ± 6.16 vs. 45.06 ± 8.69 and 33.56 ± 6.19 vs. 42.59 ± 6.62; P < 0.001) and the second posttest (32.39 ± 4.62 vs. 42.35 ± 6.14 and 32.94 ± 5.20 vs. 41.0 ± 5.58; P < 0.001). Conclusion: VAR training is effective in significantly reducing anxiety among OR students attending CABG surgery

The outcomes of humanistic nursing for critical care nurses: A qualitative study

Background: Despite the importance and the necessity of humanistic approaches to care, there are limited studies into their outcomes for nurses. Objectives: The aim of this study was to explore the outcomes of humanistic nursing for critical care nurses (CCNs). Methods: This qualitative study was conducted through conventional content analysis. Data were collected through semi-structured interviews with 16 CCNs purposively selected from hospitals in Ahvaz, Iran. Trustworthiness of the data was ensured using Lincoln and Guba's criteria. Results: The outcomes of humanistic nursing were grouped into three main categories, namely personal growth and self-actualization, protection of personal dignity, and greater satisfaction and comfort. Each of these categories had three subcategories which were development of abilities, self-concept and self-worth, spiritual transcendence; greater popularity, improved social status of nursing, appreciation, respect, and support for nurses; and happiness, satisfaction, and motivation, respectively. Conclusion: Humanistic approaches to care help fulfill the needs of both patients and nurses. The findings of this study provide a deeper understanding about how to reinforce humanistic behaviors and can be used in nursing education and practice

The effect of local warming before vascular access on vascular access indicators in adult patients receiving chemotherapy: A systematic review

Background: Intravenous (IV) cannulation is difficult, especially in patients undergoing chemotherapy due to frequent exposure to venous catheterization as well as the destructive effects of chemotherapy drugs on the vessel wall. Therefore, an easy, accessible, and fast method is needed to facilitate venous cannula insertion. Objectives: This study aimed to systematically review studies on the effects of local warming before insertion of peripheral venous cannulas on vascular access in adult patients receiving chemotherapy. Methods: This systematic review was conducted by searching databases including PubMed, Scopus, Cochrane, Embase, CINAHL, and ProQuest. The full search of information sources was conducted from the inception of the databases up to December 7, 2020, using the keywords namely warming, heat, chemotherap, cancer, vein score, catheterization, visibility, and palpability. All randomized and nonrandomized trials that were in English language and full text were included. The search was based on the PRISMA guidelines, and finally, six articles were selected for the review. The 8-item JADAD scale was used to evaluate the quality of the included articles. Results: After a complete search, 244 articles were recovered and reviewed. Finally, six articles, including 516 samples, met the criteria for entering the study. Findings indicated that local warming at the IV insertion site increased insertion success rate at the first attempt, increased vein score, increased patient satisfaction and relaxation and reduced the catheterization time, reduced pain intensity, reduced pain perceived by the nurse, and reduced the number of pricks. Conclusion: Findings suggest that using local warming at the IV insertion sites in patients receiving chemotherapy is an effective, easy, and cost-effective method that can be performed using very simple tools and is recommended for all health care providers

The effects of the 1-min preceptor and problem-based clinical educations on nursing students critical thinking

Background:There are inconsistencies about the best clinical teaching method for strengthening nursing students critical thinking (CT). Objective:This study is aimed to compare the effects of the one-min preceptor (OMP) and problem-based learning (PBL) clinical education on nursing students CT. Methods: This was a randomized controlled trial. All forty 3rd-year nursing students who had taken the Medical-Surgical Nursing III clinical course were recruited to the study through the census method in 2016 in Kashan University of Medical Sciences, Kashan, Iran. The students were randomly allocated into three groups of 13 to pass their clinical course via the OMP, the PBL, or the conventional clinical education methods, respectively. In the first session and at the end of the last session, the students completed the California CT Skills Test Form B. The one-way analysis of variance and the Kruskal-Wallis and Mann-Whitney tests were used to analyze the data. Results: Students mean age was 21.77 ± 1.32 years. There were no significant differences in baseline CT score among the conventional (11.17 ± 1.64), OMP (10.58 ± 1.34), and PBL (10.79 ± 1.18) groups (P = 0.894). However, at the end of the study, the difference among the groups regarding CT score was significant (12.17 ± 1.89, 13.69 ± 1.10, and 13.64 ± 1.44; P = 0.049). Conclusion: OMP and PBL can be potentially effective in improving students CT ability. Therefore, these methods can be used in clinical nursing education to improve students CT ability

Lockdown stress and burnout of public health personnel during the coronavirus disease 2019 outbreak in Southern Thailand

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected people around the world. Therefore, this situation has caused stress and burnout among the people and public health staff in Thailand. Objective: This study aimed to compare the stress and burnout levels among public health personnel during the lockdown and un-lockdown periods of the COVID-19 pandemic in Thailand. The secondary objective was to identify the factors associated with stress and burnout. Methods: This research was a cross-sectional survey study with online self-rated questionnaires. The sample size was 158 participants. Using convenience sampling, participants who worked in 12th health region, Southern Thailand took the questionnaire twice. The first time was during May-June 2020, which was the lockdown period from the COVID-19 outbreak in Thailand, and the participants completed the questionnaires again during July-August in the same year, which was the un-lockdown period. The non-parametric sign test, Spearmans correlation, and logistic regression analyses were performed for testing the hypotheses. Results: The average total scores for stress during the lockdown and un-lockdown periods were 4.139 ± 3.534 and 3.398 ± 3.344, respectively. Moreover, the average total scores for burnout during the lockdown and un-lockdown periods were 1.573 ± 0.777 and 1.519 ± 0.702, respectively. The stress scores during the lockdown period were significantly higher than those during the un-lockdown period (sign test, P = 0.02). The stress correlated with the burnout by using Spearmans correlation (P < 0.001). Binary logistic regression showed that the stress score (odds ratio 1.75; 95 confidence interval 1.41-2.91) was a risk factor for burnout. Conclusion: During the outbreak, the stress and burnout were high; the health organizations should have interventions or activities to reduce stress and burnout

Iranian nurses self-reported mastery and use of musculoskeletal assessment skills

Background: Nurses are the key members of the health-care team and play an important role in the assessment of the patients, problems. Objectives: This study aimed to investigate Iranian nurses, self-reported mastery and use of musculoskeletal assessment skills. Methods: This cross-sectional study was conducted from October 2018 to January 2019 on 200 nurses in Shahid Beheshti Hospital of Kashan, Iran. Data were collected using a two-part questionnaire including a demographic data form and 16 self-report items on nurses, mastery in the assessment of the musculoskeletal system. The levels of self-reported mastery and use of the musculoskeletal assessment skills in patient care were assessed. Data analysis was done using descriptive statistics, independent samples t-tests, analysis of variance, and the Pearson correlation analysis. Results: Nurses obtained 83.25 of the score in the area of using health history taking skills, while they obtained 86.94 of the score of mastery in this field. Furthermore, nurses gained 33.77 of the score in the area of using physical examination skills, while they gained 44.53 of the score of mastery in this area. The most commonly used musculoskeletal assessment skills were checking the range of motion of the joints and checking muscle strength that were used in 20.5 of cases. However, nurses rarely used specific tests such as the Patrick,s, ballottement, and Lasegue tests. A significant direct correlation was found between nurses self-reported mastery in musculoskeletal assessment skills and the use of these skills (r = 0.44, P = 0.001). Conclusion: Despite the desirable levels of nurses, self-reported mastery and use of history taking skills, the level of their self-reported mastery and use of musculoskeletal assessment skills are not satisfactory