Compassionate Care Among Iranian Nurses Caring for Candidate Brain Death Organ Donor Patients: A hermeneutic study

Apart of cares provided at the end oflife of patients in intensive care unitsis allocated to the care of brain deathpatients, which is considered under title of one caringunit. Many nurses tend to provide high-quality and compassionatecare. However, studies indicated that almost allpatients do not receive compassionate cares. This researchwas carried out to explain the living experiences of nursesin intensive units providing care for brain death patients.In this hermeneutic phenomenological study, van Manen’smethodology was used. Ten nurses (9 women and 1 man)working in Intensive Care Units were interviewed usingsemi-structured interviews. The data derived from the interviewswas analyzed after recording and transcribing.The main theme of this study, which manifested the importantand innovative aspect of caring the brain deathpatients, was “compassionate care”. It included two subthemesof commitment and devotion with sub subthemesof responsible caring and kindness in caring and sympatheticsupport with sub subthemes of providing emotionalsupport to family and emotional influence.According to the results of this research, it can be concludedthat providing care for brain death patients, whowere candidate for donation, despite imposing psychologicalburden on nurses, has provided a compassionate carefor patient and family. This care is due to commitment,professional responsibility and deep emotional effects inthem. The research results provide the conditions for educationalplanners to train nurses in order to improve theircare provided for the patients and support the nurses

Exploring the Use of White Lies in Patient Care Process by Triangulation Method

Introduction: Being in a situation to use white lie is a challenging experience for healthcare providers. Recognizing the situations that facilitate white lies and providing solutions to them are effective in providing patients with the truth about their treatment and reducing white lies. The objective of this study was to explore the experiences of patients’ families, nurses, and physicians in using white lies during care process. Methods: This study, with a triangulation approach, was conducted in 2018 at the hospitals affiliated to Tehran University of Medical Sciences. Data were collected in two qualitative and quantitative phases from three sources including patients’ families, nurses, and physicians. In the quantitative phase, 300 samples were selected by random sampling to complete a researcher-made questionnaire. Descriptive statistics and frequency tables were used to analyze the quantitative data with SPSS (version 16). In the qualitative phase, 30 individuals from above-mentioned sources were selected by purposive sampling to participate in the face-to-face and semi-structured interviews. Data analysis in qualitative phase was done by Graneheim and Lundman’s conventional content analysis with MAXQDA software (version 12). In the final step, quantitative and qualitative data were compared and interpreted. Results: The findings of qualitative phase were summarized in four categories (inappropriate situation, patient expediency, surrounding frameworks, and communication bridges) and eight subcategories. In the quantitative phase, the highest score was related to the category of patient expediency. It was also found that the findings of qualitative and quantitative phases were consistent and complementary to each other. Conclusion: According to the findings, the use of white lies was for patient’s benefit and to create an appropriate situation for telling the truth. In this regard, providing appropriate guidelines in accordance with the culture, therapeutic goal, and understanding of patients can enhance caregivers’ skills in rendering information to patient. The findings of this study can be used as a guide in other qualitative and quantitative researches regarding the use of white lie in patient care and its consequences

Advanced Directives in Older Adults with Dementia: Ethical Challenges and Advocacy Role of Nurses

This article has no abstract. Corresponding Author: Elham Navab View Orcid in Profile You can search for this author in PubMed     Google Scholar Profil

Family Stigma Associated With Epilepsy: A Qualitative Study

Introduction: Harmful nature of epilepsy can affect the patient and their parent. Stigma, arising from it, affects the patient and their family. To relieve it understanding the experiences of the parent are useful. This study was aimed at understanding the experiences of parent of child with epilepsy in Iran. Methods: In this interpretative phenomenological study, 10 parents who took care of their child with epilepsy were participated. Data were collected through in-depth semi-structured interviews. After transcription, data were analyzed using Van Manen’s method. Results: Family stigma emerged as a main theme in data analysis with three subthemes including becoming verbally abusive, a dull and heavy shadowed look, and associates interference. Conclusion: Family stigma is a major challenge for parents of child with epilepsy need to special attention by health system. Nurses, as a big part of the system, can play an important role to manage this problem

Investigating Nurses’ Knowledge, Attitude, and Performance Regarding Pain Management of Non-verbal Critically-Ill Patients in Tanzania Intensive Care Units

Background: Although patients› self-report is the gold standard for pain, many patients admitted to the intensive care units are unable to communicate and express their pain. Accordingly, the nurse must have special abilities to diagnose and manage pain in such conditions. This study assesses nurses’ knowledge, attitude, and performance regarding pain management of non-verbal critically ill adult patients in intensive care units. Methods: This cross-sectional descriptive study was conducted from February to May 2020 among nurses working in four national referral hospitals in Dar es Salaam, Tanzania. The study sample included 202 intensive care unit nurses who were recruited by the census. The data was collected using pre-validated questionnaires, including the knowledge and attitudes survey regarding pain tools, and a performance tool by Eunkyoung. The data were analyzed using the chi-square test, one sample t-test, and Spearman correlation coefficient in the SPSS software, version 20. The significance level was set at P<0.05. Results: The mean knowledge and attitude score was 13.26±2.75, indicating inadequate knowledge and negative attitude. The mean performance score was 2.08±0.16, indicating low performance. No significant relationship was detected between nurses’ knowledge and attitude and their performance according to the t-test (t=2.84, P=0.09) and the Spearman correlation coefficient (r=0.12, P=0.102). Meanwhile, no significant relationships were found between the nurses’ knowledge, attitude, and performance and their demographic characteristics. Conclusion: Planning to increase knowledge and improve the attitude and performance of ICU nurses for better pain management of non-verbal patients is necessary. It is recommended to evaluate the pain of these patients based on the observation of behavioral indicators of pain and choose the appropriate tool for pain assessment

The social network among the elderly and its relationship with quality of life

Introduction: Attention to the needs of the elderly is a social necessity, and it seems that evaluating the social network and quality of life of the elderly can be useful in a better understanding of their needs. This study was performed to determine the relationship between the social network and the quality of life of the elderly in the city of Bojnoord in Iran. Methods: In this cross-sectional study, 201 elderly people aged 60 years or more were selected by continuous and consecutive sampling method in Bojnoord, Iran in 2014. Data were collected using demographic questionnaire, Lubben social network scale and LEIPAD elderly quality of life questionnaire. Data were analyzed by SPSS 16 and using descriptive statistics and independent-samples t-test, ANOVA and Pearson product- moment coefficient. Results: The results showed that 30.3% of elderly people studied, were subjected to a high risk of isolation. The highest mean in social network dimensions was in the family (19.68%), friends (12.01%) and the neighbors (9.90%), respectively. The mean score for quality of life of the elderly was as moderate to high (63.90±13.73), and among the quality of life dimensions, the highest mean was related to the self-care dimension (15.59%), and the lowest mean was related to the sexual functioning dimension (1.53%). The findings suggested a positive and significant relationship between social network and quality of life in the elderly who were studied (p<0.000, r=0.468). Conclusion: This study was a step toward understanding the social network status and quality of life of the elderly. It is necessary to say that health care professionals, especially nurses, display a significant role in the community to help people in this regard

Iranian Patients’ Experiences of the Internal Cardioverter Defibrillator Device Shocks: a Qualitative Study

Introduction: Implantable Cardioverter Defibrillator (ICD) is a valuable treatment for the patients at risk of sudden cardiac death. In this method, after diagnosis of pathological cardiac rhythms, shock is automatically applied to normalize the rhythms. Shock is discharged when the patients are conscious, but the patients’ experiences of shock have remained unknown. Thus, this study aimed to identify and describe the patients’ experiences of shocks received from ICD. Methods: The present qualitative study was conducted through thematic analysis and semi-structured interviews on 9 patients mean age 41.55 (1.57) with ICD from November 2013 to July 2014. Data analysis was also performed simultaneously using constant comparative analysis. Results: In this study, two main themes, namely "with a parachute for life" and "Faced with nuisance", were obtained representing the patients’ experiences regarding ICD shock. With a parachute for life included subthemes, such as "Rebirth", "Comforter and healing", and "Life assurance". In addition, "Faced with nuisance" consisted of 2 subthemes of "Discomfort in moments of shock" and "Displeasure after shock". Conclusion: This study provided a basis for evaluation of patients nursing after discharge. By identification of the patients’ experiences regarding shock, the present study can help the professional health staff to efficiently play their roles and provide patients with holistic care. It can also be effective in designing behavioral and cognitive interventional programs to change the patients’ attitude and promote their adaptation with their conditions

Experiences of the Iranian Neonatal Intensive Care Unit Nurses in Implementing Family-Centered Care: Walking on an Insecure Foundation

Background: Most of the nurses have accepted family-centered care (FCC) as a standard model of care; however, they meet difficulties using this model. The aim of this study was to explore the perception of Neonatal Intensive Care Unit (NICU) nurses about the implementation of FCC.Methods: This qualitative study was carried out on 11 in-service NICU nurses with at least three years of work experience using an interpretative phenomenological approach. The study setting was three separate NICUs of three teaching hospitals affiliated with Tabriz University of Medical Sciences, Tabriz, Iran. Data collection was performed through semi-structured interviews and field notes. The data were analyzed using the seven-stage Diekelmann, Allen, and Tanner approach.Results: One of the important themes emerging in this study was “Walking on an insecure foundation” that included three subthemes of “Inappropriate base”, “A pathway with no lines” and “Unequal encounter”. The nurses described a lack of facilities, inadequate space, and staff’s specific instruction in encouraging parents’ engagement, as well as high work pressure due to short staffing as factors that affected their ability to provide an ideal FCC.Conclusion: As the findings indicated, the lack of essential substructures and absence of a systematic program to engage parents in the care process of their infants have resulted in different operations by the nurses and discontinuous FCC implementation in NICUs. Officials and policy-makers should consider basic requirements, adequate workforce, and explicit guidelines to contextualize and guarantee the continuity of FCC