The Clinical Nature of Medical-Surgical Nursing Care

Introduction: Integration of theoretical knowledge and nursing practice has led to the creation of four central concepts in nursing including individual, health, nursing, and environment. Currently, greater emphasis is placed on the two concepts of health and care as the core of nursing. Thus, the purpose of the present qualitative study was to explain the concept of clinical care in internal-surgical nursing and its changes through time. Method: This study was part of an extensive grounded theory research on 14 clinical nurses, clinical educators, and nursing students of the School of Nursing and Midwifery, Shahid Beheshti University, Tehran, Iran. The participants were selected, first, using purposive sampling method, and then, theoretical sampling. Data were collected through individual semi-structured, in-depth interviews. Data were codified using MAXQD 2007 software (VERBI GmbH, Berlin, Germany) and analyzed using grounded theory approach (Strauss & Corbin, 1998). Results: Data analysis revealed the 3 main themes of "essence of care in internal-surgical nursing", "clinical origin of care", and "the decline in nursing". Moreover, 9 subcategories were extracted including "clinical essence of internal-surgical nursing", "patient-centered care", "peaceful conscience of nurses", "meeting the basic needs of the patient", "perception of the patient", "specialization", "alienation with role", "detachment from clinical care", and "dependency". Conclusion: Care is the essence of nursing, in particular internal-surgical nursing, and the clinical environment is the care delivery site. The changes and challenges in providing nursing care necessitate the use of moral approaches, such as designing targeted educational programs and a student-centered curriculum, with emphasis on moral conscience Keywords: Care, Medical-surgical nursing, Clinical practice, Grounded theory, Qualitative researc

Effect of the rehabilitation program on the fatigue of patients with coronary artery diseases

Background: This study aimed to evaluate the changes in fatigue of patients with coronary artery diseases after the rehabilitation intervention based on demographic and clinical variables. Methods: This study was a single-arm clinical trial with a pre and post-intervention design. The statistical population of the study included patients with coronary artery diseases who underwent coronary artery bypass surgery or percutaneous coronary interventions, 4-6 weeks after discharge, referred to Khorramabad Cardiac Rehabilitation Center. They were selected by a purposeful sampling method. The data were collected through demographic and clinical information questionnaires and Piper Fatigue Measurement Questionnaire. Education on risk factors at home (weeks 4 and 8) was presented in the area of rehabilitation, the data were analyzed with descriptive and analytical statistics in SPSS software. Results: Most of the patients were male (54.4%), married (87%), and in the age group of 47-58 years (50%). Their mean age was 54.63 ± 8.87 years, and the mean duration of heart disease in the subjects (by months) was 33.24 ± 50.84. Comparing the mean changes in fatigue after the intervention based on some influencing demographic variables of the patients, including age, gender, type of treatment, and the duration of the disease showed no significant difference (p>0.05). Conclusion: The implementation of a home cardiac rehabilitation program by nurses, as a low-cost, accessible, and feasible intervention, can be considered an effective step in reducing the fatigue of patients with coronary artery disease and should be considered by managers

Correlation Between Health Status And Comfort In HIV/AIDS Patients Referred To Imam Khomeini hospital In 1391

is a very complicated process ,so affects different dimentions of physical health,social,spiritual andpsychological aspects of an individual. The aim of this study was determine the correlation betweengeneral(overall)comfort with health status in patients with HIV/AIDS was conducted in 1391.Methods and Material: This descriptive – correlation study was performed on 25 HIV/AIDS patient thatrefferd to Imam Khomeine Hospital in Tehran in 1391 by convenience sampling methods. A questionnairewith items related to demographic information,36-Item-Form Health Survey(SF-36) and general comfortquestionnaire was used for data collection. Its validity was assured by content validity method. Data wereanalyzed using SPSS 16 software . A Pearson correlation coefficient was calculated to determine therelationship between variables.Findings: Based on the finding average of ages was 36. 44±10. 43 who 60% were married and 64% werelived with their partner and children. The mean of physical status and psychological ,social- economic status,total health status and general comfort was 41. 68±13. 56,36. 84±17. 38,31±14. 61,109±34. 86,86. 48±22. 63.The relationship between stage of disease and physical health status and married and total health status, andPhysical health and psychological health status(p=0. 001,r = 0. 9)was significant(P= 0. 02, r = 0. 4),(P= 0.001, r=0. 6).Conclusion: According to the results, some features of AIDS can associated with different dimentions healthstatus which eventually may be affect general comfort in HIV/AIDS patients.Keywords: Health status, General Comfort, Comfort, HIV/AIDS

Assessment of the Risk of Falls Related to Imbalance among Patients with Multiple Sclerosis Referred to the MS Society of Tehran 2014

Introduction:Balance impairment in multiple sclerosis patients was found to be associated with an increased risk of falls. The aim ofthis study was to determine the risk of falls among multiple sclerosis patients who have referred to the MS Society ofTehran 2014.Materials and Methods:This was a prospective cohort study. 199 multiple sclerosis patients were selected by convenient method. The datacollection tools were Tinetti performance-oriented mobility assessment (POMA), demographic and self-reported fallquestionnaire. The patients were divided into three groups based on POMA scores. The face and content validity oftools was determined. The reliability of POMA was obtained by inter-rater method (0.95). The Cronbach's alpha forresearcher-made questionnaire was 0.97. The data were analyzed by using Chi-square test and Mann-Whitney U test.Results:There was a negative relationship between the occurrence of falls with the balance and gait scores among MS patients(p<0.001). The MS patients, who gain a lower balance point, had more fall events. According to the score rating sum ofPOMA, most multiple sclerosis patients had high and average score ratings. Also, all three balance motor ability andgait scores, the total balance and gait score had a significant relationship with MS patients’ fall events (p<0.001).Conclusion:In the present study, most of patient with multiple sclerosis had higher and average scores of gait and balance. POMAis a quick and easy test for identifying, classifying, and predicting the risk of falls among multiple sclerosis patients.Keywords:Falls, Imbalance, Multiple Sclerosis

Knowledge Assessment and Comparing the Performance of Intensive Care Unit Nurses in Regard to Tube Feeding with Existing Standards in Educational and Treatment Centers of Qom University of Medical Sciences, Iran

Background and Objectives: Tube feeding is one of the supportive nutritional methods in intensive care units (ICU), which is associated with some complications, despite numerous advantages for patients. Nurses&rsquo; knowledge and performance play an important role in preventing and causing tube feeding&rsquo;s complications. The present study was performed with the intention of determining knowledge and comparing the performance of ICU nurses in regard to tube feeding with existing standards in educational and treatment centers of Qom University of Medical Sciences. Methods: In this descriptive study, 68 eligible nurses working in ICUs of hospitals of Qom University of medical sciences (2014), were entered into the study using two-stage sampling. Data collection was carried out using a researcher-made questionnaire and and a standard checklist was used for. Data were analyzed by statistical tests of independent t, one sample t-, and analysis of variance. The significance level was considered 0.05. Results: The mean score of knowledge and performance in ICU nurses was average. There was a significant difference between the performance scores of male and female nurses (p<0.001). A significant statistical difference was observed in the performance scores of tube feeding between nurses below and above 30 years of age. The comparison of performance score with the standard showed that the mean score of performance (56&plusmn;15.2) had a significant difference from the standard score at level less than 0.001. Conclusion: The findings of this study indicated that the mean score of nurses&rsquo; performance for tube feeding was average and significantly lower than the standard. Therefore, training measures and in-service training seem to be necessary for nursing staffs

Fear of falling in older people with hypertension in Iran: Implications for clinical practice

Background: Older people commonly suffer from chronic diseases such as hypertension. Age-related changes and hypertension treatments put older people at risk of falling and fear of falling. This study was conducted to identify the predictors of fear of falling in older people with hypertension in Tehran, Iran. Method: This retrospective study was conducted on 301 older people with hypertension above age 60 in eight educational hospitals in Tehran, Iran. Data were collected using a demographic questionnaire and the Persian Falls Efficacy Scale-International. Data were analyzed with SPSS 25. Results: The mean age of the participants was 68.62 ± (6.82) years. The mean of systolic and diastolic blood pressure were 138.94 ± (13.35) and 87.18 ± (10.65) respectively. 31.8% of the participants had a medium and high level of fear of falling. The multiple regression results showed that fear of falling was significantly associated with gender (ß = 0.20, p<0.001), educational level (ß = 0.28, p<0.001), and history of falling (ß = -0.20, p<0.001). Conclusions: The results show that higher levels of fear of falling in older people with hypertension are in male participants, with a higher level of education, and without history of falling. Providers should develop programs to prevent and reduce fear of falling in those at risk and to reduce the consequences

Association between fear of falling and self-care behaviours of older people with hypertension

Aim: This study investigated the association between fear of falling and self-care behaviours of older people with hypertension. Design: A cross-sectional study. Methods: This study was conducted in 2019 on 301 older people with hypertension above the age of 60 years in Tehran, Iran. Data were collected using a demographic questionnaire, the Persian Falls Efficacy Scale-International, and a hypertension- related self-care behaviour questionnaire. Results: Analyses revealed that gender, educational level and history of falling were significant factors associated with fear of falling; and marital status, educational level and income source were significant factors associated with self-care behaviours (p< 0.05). Partial correlations controlling for education revealed a significant positive correlation showing that high fear of falling is associated with worse health promotion self-care behaviours and significant inverse correlations with psycho-emotional, social and daily self-care behaviours (p< 0.05), meaning that high fear of falling is associated with better self-care for these dimensions. Patient or Public Contribution: This study involved patients in order to evaluate the validity and reliability of the questionnaires. The study was conducted on older people with hypertension referred to hypertension clinics in hospitals

Correlation between health literacy and health-related quality of life in patients with hypertension, in Tehran, Iran, 2015–2016

Background and Objective: Hypertension is considered an important public health problem in developed and developing countries. This disease is closely associated with the quality of life of patients, and it seems that health literacy plays a role in this regard. Due to lack of information on the role of health literacy on the quality of life in patients with hypertension, this study has aimed to determine the correlation between health literacy and health-related quality of life in patients with hypertension. Methods: This study is cross-sectional. The sample consisted of 400 patients with hypertension who were enrolled if available. To collect data, a demographic questionnaire (SF-36), Short Form Health Survey, and Health Literacy for Iranian Adults (HELIA) Inventory were used. Data were analyzed using SPSS software version 21 for descriptive and inferential statistics (e.g., mean, standard deviation, t-test, and Pearson correlation coefficient). Results: The mean and standard deviation scores of health literacy and health-related quality of life were, respectively, 68.66 (±13.56) and 52.94 (±15.20). There was positive and significant correlation between health literacy and health-related quality of life (p<0.01, r=0.30). Conclusion: According to research findings, there was a significant positive correlation between health literacy and health-related quality of life. Given the importance of health literacy in the quality of life in patients with hypertension, it seems essential that nursing officials and policymakers take steps to promote patients’ health and quality of life by using training programs appropriate for the patients’ health literacy level

Correlation Between Stigma and Quality of Life in Leprosy Patients in Mehrab Khan Region of Mashhad

Leprosy is one of the oldest chronic diseases, and similar to other infectious diseases, it causes long-term physical and social effects on the lives of patients and their families. This was a cross-sectional study conducted with 103 patients with leprosy in Mashhad in the Mehrab Khan region in March 2016. The sampling method was convenience sampling. The data was analyzed using SPSS version 19. Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential tests (ANOVA, Pearson correlation, and independent t-test) were used. The results showed that the mean age of patients was 65.2±8.1 years and the mean age of developing leprosy was 15.3±7.03. There was an inverse correlation between the score of overall stigma, internal stigma, and all dimensions of quality of life that was statistically significant, except for the social dimension (r= -0.181…; P=0.067). There was an inverse correlation between the psychological dimension of quality of life and experienced stigma. The highest score of the overall quality of life was related to divorced patients with a mean score of 79.7, which was statistically significant (P=0.016) from those who were not divorced. In post-hoc test, just the difference between widow and divorced were significant regarding quality of life. According to results, there was a negative correlation between the quality of life and all aspects of stigma using the SARI tool