Evolutionary concept analysis of health seeking behavior in nursing: A systematic review

Background: Although the research in health seeking behavior has been evolving, its concept remains ambiguous. Concept clarification, as a central basis of developing knowledge, plays an undeniable role in the formation of nursing sciences. As the initial step toward the development of theories and theoretical models, concept analysis is broadly used through which the goals can be used and tested. The aim of this study was to report an analysis of the concept of "health seeking behavior". Method: Employing a rigorous evolutionary concept analysis approach, the concept of health seeking behavior was examined for its implications, use, and significance in the discipline of nursing between 2000 and 2012. After applying inclusion and exclusion criteria, a total of 40 articles and 3 books were selected for the final analysis. Results: The definition of attributes, antecedents, and consequences of health seeking behavior was performed through concept analysis. Core attributes (interactional, processing, intellectual, active, decision making based and measurable) were studied. The antecedents of concept were categorized as social, cultural, economic, disease pattern and issues related to health services. Health-seeking behavior resulted in health promotion and disease risk reduction. In addition, it led to predicting the future probable burden of the diseases, facilitation of the health status, early diagnosis, complete and effective treatment, and complication control. Conclusion: Health-seeking behavior, as a multi-dimensional concept, relies on time and context. An awareness of health-seeking behavior attributes antecedents and consequences results in promoting the status, importance and application of this concept in the nursing profession. �© 2015 Poortaghi et al

The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery

Background: Cardiopulmonary bypass is associated with increased fluid accumulation around the heart which influences pulmonary and cardiac diastolic function. The aim of this study was to compare the effects of modified ultrafiltration (MUF) versus conventional ultrafiltration (CUF) on duration of mechanical ventilation and hemodynamic status in children undergoing congenital heart surgery. Materials and Methods: A randomized clinical trial was conducted on 46 pediatric patients undergoing cardiopulmonary bypass throughout their congenital heart surgery. Arteriovenous MUF plus CUF was performed in 23 patients (intervention group) and sole CUF was performed for other 23 patients (control group). In MUF group, arterial cannula was linked to the filter inlet through the arterial line, and for 10 min, 10 ml/kg/min of blood was filtered and returned via cardioplegia line to the right atrium. Different parameters including hemodynamic variables, length of mechanical ventilation, Intensive Care Unit (ICU) stay, and inotrope requirement were compared between the two groups. Results: At immediate post�MUF phase, there was a statistically significant increase in the mean arterial pressure, systolic blood pressure, and diastolic blood pressure (P < 0.05) only in the study group. Furthermore, there was a significant difference in time of mechanical ventilation (P = 0.004) and ICU stay (P = 0.007) between the two groups. Inotropes including milrinone (P = 0.04), epinephrine (P = 0.001), and dobutamine (P = 0.002) were used significantly less frequently for patients in the intervention than the control group. Conclusion: Administration of MUF following surgery improves hemodynamic status of patients and also significantly decreases the duration of mechanical ventilation and inotrope requirement within 48 h after surgery. � 2016 Journal of Research in Medical Sciences

Adherence to hemovigilance protocols on storage, preparation, and administration among nurses in the open-heart intensive care unit

Background: Adherence to blood storage, preparation, and administration standards has an important role in preventing blood-transfusion errors. In addition, the blood-transfusion rate following open-heart surgery is quite high. The aim of this study was to assess the adherence to hemovigilance standards on blood storage, preparation, and administration among nurses in the intensive care unit (ICU). Methods: One hundred nurses of the Open-Heart ICU of Rajaie Cardiovascular, Medical, and Research Center, Tehran, Iran, participated in this descriptive study. The nurses� practice was supervised from the time of the entrance of the blood unit to the ICU until the end of the transfusion process. The ICU nurses� hemovigilance practice was compared with the Iranian Ministry of Health and Medical Education�s standards. The nurses' demographic and occupational characteristics were evaluated regarding the scores of the hemovigilance standards in their practice. Results: Concerning the standards of blood transfusion, 93 of the study nurses adhered to the protocols on blood-unit preservation, 84 on preparation, and 92 on transfusion. There were no statistically significant differences between the nurses� age, sex, work experience, education, last transfusion workshop participation and practice assessment, number of blood-transfusion procedures performed per month, and achieved standard scores on blood storage, preparation, and administration (all P>0.05). Conclusions: The study nurses achieved 85 of the standard scores on the preservation, preparation, and transfusion of blood units. The demographic and occupational characteristics of the ICU nurses had no effect on their hemovigilance practice. © 2015, Iranian Heart Association. All rights reserved