Caring Burden and Quality of Life of Family Caregivers in Patients Undergoing Hemodialysis: A Descriptive-Analytic Study

Background: Caring role, especially in chronic diseases, has a negative impact on the health of family caregivers and can affect their quality of life. Therefore, this study aimed to investigate the care burden and quality of life in family caregivers of hemodialysis patients and their relationship with some characteristics of caregivers and patients. Methods: This study was conducted as a descriptive-analytic study in Isfahan from January to February 2017. Sampling was done using census. The number of participants was 254. The data gathering tools consisted of a three-part questionnaire including demographic characteristics, the Zarit questionnaire for caring burden, and SF-36 quality of life questionnaire. Data were analyzed using descriptive statistics, Pearson correlation coefficient test, Spearman’s coefficient, ANOVA, and univariate general linear regression. A significant level of 5% was considered. Results: The mean scores of the quality of life and caring burden were 30.54±9.89 and 44.98±6.82, respectively in caregivers. The age of the patient under care (P<0.001), cost of medications (P=0.008), and hours of care in 24 hours (P<0.001) had a significant relationship with care givers’ quality of life. Also, univariate general linear regression revealed that care burden had a significant relationship with the quality of life (P=0.003). Conclusion: Family caregivers who experienced more caring burden had a low quality of life. The researchers suggest that supportive and educational programs should be designed and implemented for this group of patients and their caregivers

Perspective of Nurses toward the Patient Safety Culture in Neonatal Intensive Care Units

Background: Infants hospitalized in neonatal intensive care units (NICUs) are often severely ill, highly prone to various diseases, and exposed to complex and prolonged intensive care interventions. Consequently, they are susceptible to the lapses in teamwork and patient safety. Patient safety culture a fundamental step to improve patient safety. The present study aimed to evaluate the perspective of NICU nurses toward the patient safety culture. Methods: This cross-sectional study was conducted in 2016. Participants were selected via census sampling, including 156 nurses working in the NICU of the teaching hospitals affiliated to Isfahan University of Medical Sciences in Isfahan, Iran. Data were collected using a demographic questionnaire and Hospital Survey on Patient Safety Culture (HSOPSC). Data analysis was performed in SPSS version 16 (SPSS Inc, Chicago, IL, USA) using descriptive statistics (mean and standard deviation). Results: Among the 12 dimensions of the patient safety culture, the highest scores were observed in the ‘teamwork within units’ (98.5%),’organizational learning-continuous development’ (87.8%), ‘feedback and communication about errors’ (80.3%), and ‘frequency of events reported’ (78.8%). The lowest scores belonged to the dimensions of ‘handoffs and transitions’ (15.3%), ‘non-punitive response to error’ (21.5%), and ‘staffing’ (37.1%). Conclusion: According to the results, adherence to the dimensions of the patient safety culture was poor in the studied hospitals. Therefore, the patient safety culture requires special attention by providing proper facilities, adequate staff, developing checklists for handoffs and transitions, and surveillance and continuous monitoring by healthcare centers. Furthermore, a system-based approach should be implemented to deal with errors, while a persuasive reporting approach is needed to promote the patient safety culture in the NICUs of these hospitals

Structural Model of the Effect of Psychological Capital on Self-Care with Mediating Role of Self-Compassion in Patients with Heart Diseases

Background: Cardiovascular diseases (CVDs) are the most common diseases in societies and are associated with high mortality. The aim of this study was to investigate the structural pattern of psychological capital on self-care with the mediating role of self-compassion in patients with heart diseases. Methods: The research method was a descriptive kind of structural equation modeling (SEM). The study population consisted of patients with heart diseases [ischemic heart disease (IHD) and congestive heart failure (CHF)] aged 25-70 years who referred to the educational-medical centers of Isfahan University of Medical Sciences, Isfahan, Iran. From among them, 400 people were selected by convenience sampling method. Research instruments included Luthans Psychological Capital Questionnaire (PCQ), Neff Self-Compassion Scale, and Jarasma et al. Self-Care Behavior Questionnaire for Heart Failure Patients. Data were analyzed using SPSS software through Pearson correlation and simultaneous hierarchical regression. Findings: According to the direct impact coefficient of β = 0.509, indirect impact coefficient of β = 0.046, direct critical value of t = 5.857, and indirect critical value of 0.051, the variable of self-compassion can explain the role of the mediating variable between the predictive variable of psychological capital and the criterion variable of self-care. Conclusion: Self-compassion as a mediator in the relationship between psychological capital and self-care has an important role in improving the mental health of patients with heart diseases

Patient safety culture in intensive care units from the perspective of nurses: A cross-sectional study

Background: One of the goals of nursing is providing safe care, prevention of injury, and health promotion of patients. Patient safety in intensive care units is threatened for various reasons. This study aimed to survey patient safety culture from the perspective of nurses in intensive care units. Materials and Methods: This cross-sectional study was conducted in 2016. Sampling was done using the convenience method. The sample consisted of 367 nurses working in intensive care units of teaching hospitals affiliated to Isfahan University of Medical Sciences. Data collection was performed using a two-part questionnaire that included demographic and hospital survey on Patient Safety Culture (HSOPSC) questionnaire. Data analysis was done using descriptive statistics (mean and standard deviation). Results: Among the 12 dimensions of safety culture, the nurses assigned the highest score to “team work within units” (97.3%) and “Organizational learning-continuous improvement” (84%). They assigned the least score to “handoffs and transitions”(21.1%), “non-punitive response to errors” (24.7%), “Staffing” (35.6%), “Communication openness” (47.5%), and “Teamwork across units” (49.4%). Conclusions: The patient safety culture dimensions have low levels that require adequate attention and essential measures of health care centers including facilitating teamwork, providing adequate staff, and developing a checklist of handoffs and transitions. Furthermore, to increase reporting error and to promote a patient safety culture in intensive care units, some strategies should be adopted including a system-based approach to deal with the error

Medication safety climate from the perspectives of healthcare providers: A cross-sectional study

BACKGROUND: Medication safety as an indicator of care quality is the measures taken by healthcare team members to prevent or adjust adverse drug events at the time of medication administration. This study was conducted to investigate the medication safety climate from healthcare providers' perspectives. MATERIALS AND METHODS: This cross-sectional descriptive study was conducted in a selected educational hospital affiliated with the Isfahan University of Medical Sciences, Isfahan, Iran, in 2021. Participants were healthcare providers who are involved in the medication process. The sampling was done using the quota method. The study instruments were a demographic questionnaire and the Medication Safety Climate (MSC). RESULTS: The total mean of positive responses to MSC items was 64.11%, denoting a moderate-level MSC. Collected data were managed using the SPSS software (v. 16.0) and were summarized using the measures of descriptive statistics, namely mean, standard deviation, frequency, and percentage. The lowest and the highest dimensional mean scores were related to the management support for medication safety dimension (mean: 48.42%) and the Teamwork dimension (mean: 80.43%), respectively. CONCLUSION: Managers' inattention and insufficient understanding of safety provide the basis for medication errors and threaten patient safety. Healthcare team members are highly motivated to provide quality and safe care by observing the managers' positive performance regarding patient safety. To improve the medication safety climate, healthcare team members are required to work in a safe workplace and have sufficient job satisfaction. Health center managers need to employ a proactive approach to prevent errors

Challenges to Family Caregivers in Caring for Gastric Cancer Patients from Perspectives of Family Caregivers, Patients, and Healthcare Providers: A Qualitative Study

Objectives: Cancer affects both patients and their families. Sometimes, the effects of cancer on families are greater than its effects on patients. Family caregivers play significant roles in care for patients with cancer. Nonetheless, the data on the challenges they face in caregiving are limited. The present study explored the perspectives of patients with gastric cancer (GC), their family caregivers, and healthcare providers regarding family caregivers’ challenges in caregiving to patients with GC. Materials and Methods: This descriptive exploratory qualitative study was conducted in 2019–2020. Six GC patients, six family caregivers, three physicians, and five nurses took part for a total of twenty participants. Purposive sampling was performed, and data were collected through semi-structured interviews and continued up to data saturation. Conventional content analysis was used for data analysis. Results: Caregivers’ challenges in caregiving to patients with GC were grouped into five main categories, namely, lengthy process of GC diagnosis, delivery of bad news, management of physical symptoms, altered relationships, and psychological consequences, and 14 subcategories. Conclusion: Educating the public about the primary symptoms of GC and the importance of timely seeking medical care as well as using culturally appropriate protocols for delivering bad news is recommended. Empowering family caregivers for the effective management of GC symptoms and caregiving-related challenges are also recommended to reduce their caregiver burden. </jats:sec