Iranian family caregivers' challenges and issues in caring of multiple sclerosis patients: A descriptive explorative qualitative study.

BACKGROUND The broad spectrum of problems caused by multiple sclerosis (MS) imposes heavy responsibility to caregivers in caring of their patients. Therefore, they encounter many issues and challenges in this situation. The purpose of this study was to explore the experiences and challenges of MS family caregivers. MATERIALS AND METHODS A qualitative design, based on a thematic analysis approach, was used to reach the study aim. Data were collected and analyzed concurrently through in-depth unstructured interviews, field notes, and observations that were held with 23 participants (14 family caregivers and 9 MS patients) at two referral centers in Ahvaz, Iran. FINDINGS THREE MAJOR THEMES WERE EXTRACTED FROM THE ANALYSIS OF THE TRANSCRIPTS: "emotional exhaustion of caregivers," "uncertain atmosphere of caring," and "insularity care." The first theme consisted of three subthemes: "stressful atmosphere of caring," "conflict and animism," and "continuing distress affecting the caregiver." The second theme consisted of three subthemes: "unstable and complicacy of disease," "caring with trial and error," and "frequent hospitalization of patients," and the third theme consisted of two subthemes: "caring gap and disintegration" and "lack of sufficient support." CONCLUSIONS This study will be useful to healthcare system for managing the challenges of MS patients' family caregivers. Improving the conditions and performance of family caregivers is crucial in order to provide high-quality care to people with MS

Effects of midwivies’ emotional support on clinical delivery trend

حاملگی و به ویژه زایمان با توجه به اثرات طولانی مدت که در زندگی زنان دارد، واقعه ای مهم تلقی گردیده و از دیرباز مورد تعمق و بررسی بوده است. بر همین اساس لزوم بررسی هایی در شیوه های مراقبتی در این زمان مطرح گردیده است، تا با ایجاد شرایطی مطلوب تر، این امر تحقق یابد. پژوهش حاضر یک مطالعه نیمه تجربی بوده است که در طی انجام پژوهش 94 نفر از زنان باردار مراجعه کننده به زایشگاه مورد نظر با توجه به داشتن شرایط ورود به مطالعه انتخاب و سپس به صورت تصادفی در دو گروه مراقبت معمول (شاهد) و مراقبت تحت مداخله (مورد) تقسیم بندی گردیدند. اطلاعات با استفاده از چک لیست و از طریق مصاحبه، پرسشگری و مشاهده و اندازه گیری جمع آوری گردید. اطلاعات به دست آمده با استفاده از آزمونهای آماری توصیفی و استنباطی و با نرم افزار کامپیوتری اس.پی.اس.اس مورد تجزیه و تحلیل قرار گرفت. نتایج پژوهش نشان داد که با تامین نیازهای عاطفی مددجویان حداقل طول مدت فاز فعال زایمان در گروه تحت مراقبت مداخله ای 120 دقیقه و در گروه شاهد 200 دقیقه بوده است و حداکثر طول مدت مرحله دوم زایمان در گروه مورد 45 دقیقه و در گروه شاهد 90 دقیقه بوده است. و با توجه به بررسی انتظارات مددجویان از عامل زایمانی، رفتارهای حمایتی مهمترین مسئله مورد توجه اکثریت واحدهای مورد پژوهش در دو گروه بوده است که با توجه به انجام آزمونهای آماری نیز مورد تایید قرار گرفت. نتایج نشان می دهد که زنان در جریان زایمان نیاز به حمایتهای عاطفی دارند و با اعمـــــال رفتارهای حمایتی طول مدت زایمان کوتاهتر می گردد

Care experiences and challenges of inpatients' companions in Iran's health care context: A qualitative study

Among the clients of nursing services, family members, as patient companions, serve as both caregiver and care receiver, such that specialized care is delivered by nurses and primary care is delegated to the patient companion. Hence, care experiences of all patient companions are not the same. The aim of this study is to investigate the care experiences of inpatients' companions at hospital. This work is a qualitative study conducted according to epistemiological methodology. The participants were 13 patient companions who were selected according to purposive sampling. Data were gathered throughout in-depth, unstructured interviews and then analyzed according to Colaizzi method. Overall, six themes were generated in this study, consisting of caregiver's burnout, burden of care, resistance against tension, caregiver's care function, needs, and organizational barriers. The findings demonstrated that the patients' companions are faced with numerous stressful factors during their patients' hospital stay, and hospitals' negligence of the companions' information and support needs to deal with complexities of care has led to increased burden of care among the companions. Meanwhile, the companions' dissatisfaction with health care delivery may bring about adverse outcomes. Therefore, hospital authorities should pay special attention to the status of patient companions as informal the caregivers and support sources of patients

Quality of Life in heart failure patients referred to the Kerman outpatient centers, 2010

زمینه و هدف: نارسایی قلبی یک سندرم کلینیکی است که می تواند تاثیر منفی بر کیفیت زندگی داشته باشد. پژوهش حاضر با هدف مطالعه کیفیت زندگی بیماران مبتلا به نارسایی قلبی انجام شد. روش بررسی: در این مطالعه توصیفی – تحلیلی200 بیمار مبتلا به نارسایی قلبی مراجعه کننده به مرکز سرپایی شهر کرمان به روش نمونه گیری هدفمند انتخاب و ابعاد کیفیت زندگی آنان با استفاده از ابزار استاندارد بررسی کیفیت زندگی 36 سواله (SF36) مورد بررسی قرار گرفت. به منظور تجزیه و تحلیل اطلاعات از آزمون های آماری مجذور کای، t مستقل و ANOVA استفاده شد. یافته ها: میانگین سنی بیماران تحت مطالعه 64 سال بود و اکثر آنها در درجه 2 بیماری قلبی قرار داشتند. نمره کیفیت زندگی مردان 57/15±36/42 و زنان 37/15±65/40 بود (36/0=P). مقایسه ابعاد کیفیت زندگی زنان و مردان نشان داد که در دو بعد عملکرد جسمی (005/0=P) و سلامت روان (01/0=P) نمره کیفیت زندگی مردان بیشتر از زنان است. افزایش سن و سابقه مصرف سیگار باعث کاهش بعد عملکرد جسمی کیفیت زندگی شده بود (05/0

Caring experiences and challenges of families with patients in vegetative state

زمینه و هدف: داشتن یک بیمار نباتی در خانواده تجربه پیچیده و استرس زایی است و مراقبت از چنین بیمارانی با ناتوانی کامل در منزل بسیار چالش زا می باشد. مطالعه حاضر با هدف تبیین تجارب و چالش های مراقبتی خانواده های دارای بیمار در وضعیت نباتی صورت گرفته است. روش بررسی: در مطالعه کیفی حاضر که به صورت مقطعی از مرداد ماه سال 1392 تا شهریور ماه سال 1393 در برخی استان های ایران (خوزستان، تهران و لرستان) صورت گرفت، 17 مشارکت کننده شامل 14 مراقب خانگی و 3 مراقب حرفه ای به مطالعه وارد شدند. جهت جمع آوری داده ها از مصاحبه های بدون ساختار و مشاهده استفاده شد. جمع آوری داده ها تا رسیدن به اشباع داده ها و پدیدار شدن الگوهای اصلی ادامه یافت. تحلیل داده ها با استفاده از روش تحلیل محتوایی صورت گرفت. یافته ها: چالش های مراقبتی که خانواده های دارای بیمار نباتی با آن مواجه بودند در قالب پنج الگوی اصلی شامل ولع آموزش، عهده داری مراقبتی دشوار، هزینه های فرساینده، برزخ حرف و حدیث ها و پسرفت روحی پدیدار گردید. نتیجه گیری: یافته های مطالعه حاضر نشان داد که خانواده های دارای بیماران نباتی طی دوره مراقبت از بیمار خود با چالش های متعددی روبرو هستند که بخش عمده ی این چالش ها مرتبط با سیاست های سیستم سلامت و برخی نیز مرتبط با سطح آگاهی عموم جامعه می باشد، لذا توجه بیشتر به این چالش ها از سوی مسئولان مرتبط پیشنهاد می گردد

Caring in an atmosphere of uncertainty: perspectives and experiences of caregivers of peoples undergoing haemodialysis in Iran

Chronic renal failure is one of the major causes of mortality and disability worldwide. Although dialysis treatment is considered as a life-saving treatment for these patients, their caregivers face various problems making the atmosphere of caring uncertain. Aims: This study is aimed to explore and describe the experiences and perspectives of family caregivers of the patients undergoing haemodialysis. Methods: In this study, 20 haemodialysis family caregivers were selected by purposeful sampling. Data gathering techniques in this research were in-depth and unstructured interview and field observation. The researchers used an inductive thematic analysis approach to analysing the interviews' data. Findings: Three main themes emerged from the data indicating the patients' care are conducted in a state of uncertainty including constant struggle to learn, effort and adherence to the divine thread, and in disease's captivity. Conclusions: Caring in an uncertain atmosphere leads to decreased efficiency and quality of family caregivers' care. To promote and improve the efficiency of care, healthcare planners should pay attention to the challenges and perspectives of caregivers of the patients undergoing haemodialysis

COPING SKILLS OF IRANIAN FAMILY CAREGIVERS’ IN CARETAKING OF PATIENTS UNDERGOING HAEMODIALYSIS: A QUALITATIVE STUDY

Coping skills enable caregivers to establish and maintain supportive relationships with the haemodialysis patients they care for. These skills are very important in terms of social support, promotion of mental health and social and family relations. The aim of this study is to investigate the coping skills of Iranian family caregivers as they take care of patients undergoing haemodialysis. Methods: Twenty participants were selected for the study through purposive sampling. The data gathering techniques used for the research were in-depth and unstructured interviews. The researchers used an inductive thematic analysis approach to analyse the data generated from the interviews. Results: Four main themes emerged from the data: help-seeking skills, self-nurturing skills, time management skills and stress management skills. Conclusion: The focus of attention was on the stress management coping skills of the caregivers of haemodialysis patients together with their ability to cope with complex problems. Healthcare providers, by taking into account these skills and strategies of empowerment, can help other caregivers of haemodialysis patients cope with their heavy care conditions and better define their purposes in caretaking

The Perspectives of Iranian Patients With Multiple Sclerosis on Continuity of Care: A Qualitative Study

Background: Continuity in multiple sclerosis (MS) care has been cited as a critical feature of this care and necessary to improve medical outcomes. Purpose: This exploratory and descriptive research attempts to identify continuity of care from the experience and perspective of patients with MS at two teaching hospitals and the MS Society in Ahvaz, Iran. Methods: In this study, 23 patients with MS were selected through purposeful sampling. Data were collected through in-depth and unstructured interviews and were analyzed using an inductive thematic analysis approach. Results: Four main themes emerged from the analysis: human-oriented attention, the necessity of purposeful planning, importance of responsibility, and caring with empathetic sensing. Conclusions/Implications for Practice: Because of the importance of professional caring practice to continuity of care for patients with MS, we suggest that healthcare providers should include these aspects in care planning

Learning activities and clinical nursing services gap and the related factors: a comparative study.

Background. The gap between what is theoretically taught and what is practically experienced has always been a remarkable issue in nursing. The present study was an attempt to explore the amount of coordination between learning activities and clinical nursing services. A comparison was made between them through comparing the means of ratings by nursing students, teaching staff and nursing employees. Also, factors causing the gap as viewed by subjects were studied. Methods. This research was carried out using triangulation quantitative and qualitative methods. In the first phase of the study through phenomenological method, the relationship between learning activities and clinical nursing services, and the variables affecting them were assessed by interviewing 10 nursing students, teaching staff and nursing employees and a questionnaire was finally designed. Analytic-Descriptive method was used in the second phase of the study during which the means of the scores earned from nursing students, teaching staff and nursing employees’ viewpoints about theoretical learning and clinical nursing services were statistically calculated. The areas covered were principles and techniques in nursing, medical and surgical nursing, community health nursing, mother and child health, pediatrics nursing, psychiatric nursing, client teaching, management in nursing, and nursing process. Using Likert’s scale, the items were ranked as completely coordinate, coordinate, partially coordinate, incoordinate, and completely incoordinate. Also for related variables using Likert’s scale, the items were ranked as completely effective, effective, partially effective, ineffective, and completely ineffective. Descriptive statistics were used to calculate and compare the means. Results. The findings indicate that according to the nursing students, teaching staff and nursing employees, learning activities and clinical nursing services do not have necessary coordination. Of the three groups studied, the teachers believed in less amount of coordination between the learning activities and clinical nursing services. Besides the null hypothesis regarding the differences between the viewpoints expressed by students, teachers and the Nursing staff were confirmed. Discussion. Appreciation and recognition of the gap between the learning activities and clinical nursing services and the factors affecting it can result in bridging up the gap. A reappraisal of the nursing education curriculum with regard to the effective variables is recommended so that the theoretical and practical activities are better orchestrated

Investigation of daily living situation after retirement, Isfahan, 2000

بازنشستگی یک تحول و انتقال از نقشی به نقش دیگر است. برای اینگونه تحولات فرد نیاز به سازش و تطابق با تغییر نقش دارد. بازنشستگی یک وقفه عمیق را در زندگی فرد بوجود می آورد. او از گذشته خود بریده می شود و با وضعیت جدیدی مواجه می گردد. این پژوهش یک مطالعه توصیفی تحلیلی است که با استفاده از روش نمونه گیری آسان پرسشنامه ها توسط 364 نفر اعضای مراجعه کننده به کانون بازنشستگی کشوری تکمیل گردیده اند. نتایج این پژوهش نشان داد که 41.4 واحدهای مورد پژوهش که درصد قابل توجهی است از نظر وضعیت زندگی روزمره وضعیت مناسب داشته ولی اکثریت آنها یعنی 54.9 وضعیت نسبتا مناسب و 3.7 وضعیت نامطلوب داشتند. آزمون های آماری رابطه معنی داری بین وضعیت زندگی روزمره و جنس، وضعیت سلامتی و وجود برنامه های آمادگی جهت بازنشسته شدن را نشان داد. باتوجه به نتایج پژوهش، وضعیت زندگی روزمره بازنشستگان علیرغم سازماندهی نشدن برنامه های آماده سازی برای بازنشستگی، مناسب می باشد و می توان دلایل دیگر از جمله مهارت های سازمانی، خانوادگی، تاثیرات فرهنگی و اقلیمی را نام برد و این درحالی است که معدودی از بازنشستگان در شرایط نامطلوب زندگی روزمره بسر می برند. آنها در بعضی از جنبه های زندگی روزمره مشکلاتی دارند که اجرای برنامه های آمادگی می تواند در سازگاری آنان نسبت به تغییرات زندگی روزمره متعاقب بازنشستگی موثر باشد