Hepatitis-related stigma in chronic patients: A qualitative study

Background: Hepatitis is one of health problems throughout the world. It has numerous consequences on patients' life. Stigma, depression, social marginalization and financial problems are some of the challenges in these patients. Aim: The purpose of this qualitative study was to examine hepatitis-related stigma and discrimination in patients living with chronic hepatitis in Iranian society. Methods: This present study was designed as a qualitative method, and this article shows up the results of a qualitative research study undertaken with patients living with hepatitis in Iran. The study uses a content analysis method. A purposive sample of 18 patients was chosen. Data were collected through a semi-structured interview and field note that the researchers will take during participants' observation. Data analysis process was performed on the texts which were generated from verbatim transcripts of the participants interviews. Results: Participants were between 18 and 61 years old. The main theme, Stigma, emerged from three themes during the process data analysis in this study. These themes were including fear to lose of family and social support, fear to present in public and fear of transmission. Conclusions: This research indicates that stigma presents major challenges not only for patients living with chronic hepatitis but also for nurses, other healthcare practitioners, family and social networks, institutions and society. The researcher suggests that interventions to reduce or eliminate stigma should require individual, structural, cultural thought, society and systemic changes. © 2015 Elsevier Inc

Effect of Retrograde Autologous Priming on Clinical Outcome of Cardiopulmonary Bypassing on Patients Undergoing Coronary Artery bypass Grafting

Introduction: Cardiopulmonary bypass is a standard and low mortality-associated method used across the world. This method allows cardiac surgery to be performed in a bloodless environment. The study aimed to compare Conventional priming and Retrograde autologous prime (RAP) on patients undergoing coronary artery bypass grafting (CABG).Methods: The study population was patients undergoing CABG using cardiopulmonary bypass in Rajaei Hospital, of whom 80 patients were selected by simple random sampling convenience sampling and then were randomly assigned to two groups: Conventional priming and RAP. Demographic information, blood components transfused in the operating room and the intensive care unit, ejection fraction (EF) of left ventricle and changes in blood gases were collect.Results: The mean requirement for red blood cell transfusion bags to the patient during surgery was lower in the RAP group than the conventional priming group (P = 0.002). But the difference after surgery in both groups was not significant statistically (P = 0.2). The difference amount of platelet transfusion during operation the difference was not statistically significant (P = 0.4). The difference postoperative platelet transfusion was not statistically significant (P = 0.7). The fresh frozen plasma transfusion during surgery in the RAP group lower than the usual prime group, but the difference was not statistically significant (P = 0.406). The Fresh frozen plasma (FFP) transfusion after surgery in the two groups was not statistically significant (P = 0.217).Conclusion: RAP is compared with conventional priming a safe and low-cost technique in reducing the priming volume of the CPB system, causes less hemodilution, and reduces the need for intra- and postoperative blood transfusion. Therefore, it is recommended to consider RAP as an effective and low-cost technique of priming Cardiopulmonary bypass circuits

Comparison of current practices of cardiopulmonary perfusion technology in Iran with American Society of Extracorporeal Technology’s standards

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons. org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.INTRODUCTION: Standards have a significant role in showing the minimum level of optimal optimum and the expected performance. Since the perfusion technology staffs play an the leading role in providing the quality services to the patients undergoing open heart surgery with cardiopulmonary bypass machine, this study aimed to assess the standards on how Iranian perfusion technology staffs evaluate and manage the patients during the cardiopulmonary bypass process and compare their practice with the recommended standards by American Society of Extracorporeal Technology. METHODS: In this descriptive study, data was collected from 48 Iranian public hospitals and educational health centers through a researcher-created questionnaire. The data collection questionnaire assessed the standards which are recommended by American Society of Extracorporeal Technology. RESULTS: Findings showed that appropriate measurements were carried out by the perfusion technology staffs to prevent the hemodilution and avoid the blood transfusion and unnecessary blood products, determine the initial dose of heparin based on one of the proposed methods, monitor the anticoagulants based on ACT measurement, and determine the additional doses of heparin during the cardiopulmonary bypass based on ACT or protamine titration. It was done only in 4.2% of hospitals and health centers. CONCLUSION: Current practices of cardiopulmonary perfusion technology in Iran are inappropriate based on the standards of American Society of Cardiovascular Perfusion. This represents the necessity of authorities' attention to the validation programs and development of the caring standards on one hand and continuous assessment of using these standards on the other hand

To Restore the Stability: Family Experiences of Patients in Intensive Care Unit

Introduction: Experience of hospitalization in the intensive care unit is stressful for patients and families. When a family member is hospitalized in intensive care unit, patient's condition causes instability and imbalance in quality of family life. Accordingly, this study aimed to explore experiences of families of hospitalized patients in intensive care unit related to resture the stability. Method: In this qualitative study, 19 family members of patients in intensive care unit were enrolled via purposive sampling method. Data were collected through semi-structured interviews, observation, and field notes. All interviews were recorded and transcript verbatim, and were analyzed using qualitative content analysis method. Results: The extracted three main themes wereas “search for supporter resources”, “organizing of situation”, and “contextual-tructural factors”. Subcategories of “searching for supporter resources” were “sources of hope” and “sources of support”. “Organizing of situation” had two subcategories of “interaction with the health care team” and “efforts of stress relief”. Moreover, “contextua-structural factors” included two subcategories of “factors related to family” and “factors related to care-medical system”. Conclusion: According to the results of this study, it seems essential that health care team understand experiences of family members of patients in intensive care unit related to restore family stability, and balance in their life for providing family-centered interventions. Keywords: Family members, Intensive care unit, Qualitative research, Data analysi

Determinants of Early Marriage from Married Girls' Perspectives in Iranian Setting: A Qualitative Study

Early marriage is a worldwide problem associated with a range of health and social consequences for teenage girls. Designing effective health interventions for managing early marriage needs to apply the community-based approaches. However, it has received less attention from policymakers and health researchers in Iran. Therefore, the current study aimed to explore determinants of early marriage from married girls' perspectives. The study was conducted from May 2013 to January 2015 in Ahvaz, Iran. A purposeful sampling method was used to select fifteen eligible participants. Data were collected through face-to-face, semistructured interviews and were analyzed using the conventional content analysis approach. Three categories emerged from the qualitative data including "family structure," "Low autonomy in decision-making," and "response to needs." According to the results, although the participants were not ready to get married and intended to postpone their marriage, multiple factors such as individual and contextual factors propelled them to early marriage. Given that early marriage is a multifactorial problem, health care providers should consider a multidimensional approach to support and empower these vulnerable girls

Determinants of Early Marriage from Married Girls’ Perspectives in Iranian Setting: A Qualitative Study

Early marriage is a worldwide problem associated with a range of health and social consequences for teenage girls. Designing effective health interventions for managing early marriage needs to apply the community-based approaches. However, it has received less attention from policymakers and health researchers in Iran. Therefore, the current study aimed to explore determinants of early marriage from married girls’ perspectives. The study was conducted from May 2013 to January 2015 in Ahvaz, Iran. A purposeful sampling method was used to select fifteen eligible participants. Data were collected through face-to-face, semistructured interviews and were analyzed using the conventional content analysis approach. Three categories emerged from the qualitative data including “family structure,” “Low autonomy in decision-making,” and “response to needs.” According to the results, although the participants were not ready to get married and intended to postpone their marriage, multiple factors such as individual and contextual factors propelled them to early marriage. Given that early marriage is a multifactorial problem, health care providers should consider a multidimensional approach to support and empower these vulnerable girls

Living in the Blurry World: The Story of HIV-infected Iranian Nurses

Background: Despite progress in reducing HIV-related mortality over the past decade, the prevalence and incidence of HIV infection slightly decreased. Nursing profession as a part of the health care system is most affected by HIV/AIDS. HIV-positive nurses need more support from governments and officials. Little is known about how Iranian HIV-positive nurses experience their life situations.  Aim: This study evaluated the experiences of HIV-positive nurses and their attempts to manage HIV/AIDS in personal and occupational livings. Method: The hermeneutic phenomenological approach developed by van Manen's methodology (1990) was adopted to explore the experience of daily life for HIV-positive nurses. A purposive sampling of eight HIV-positive nurses was recruited. Face-to-face in-depth interviews were conducted with two female and six male nurses who had infected with HIV via occupational exposure. Data were analyzed using thematic analysis. Results: The experiences of HIV-infected nurses derived in one major theme and three subthemes. Major theme “living in the blurry world” extracted from three sub-themes: ‘being-in-the-risky world’, ‘being-in-the-shadow of illness’, and ‘ambiguous being-in-the-world’. Implications for Practice: HIV positive nurses perceive the world full of fear and ambiguities. They prefer to suffer in silence and reluctant to disclose their seropositive status. The results of this study can be used by professionals to better understand the HIV positive nurses' world and make more efforts to improve their workplace experiences and reduce stigma in the future

A hermeneutic phenomenological inquiry into the lived experience of Muslim patients in Australian hospitals.

In the past few years, many people with an Islamic background have settled in Australia. Within the health care context, this means that health care providers must modify the care provided to ensure it meets the needs of this culturally diverse population. Little nursing research has focused on understanding the perceptions and experiences of Muslim people within health care systems, particularly in Australia. This study provided an opportunity to explore, and document the experience of the hospitalisation for Islamic people and thereby advance the available information upon which important nursing care decisions that relate to this group can be more informatively made. This study aims to explore and interpret the lived experience of thirteen Muslim patients who had been hospitalised in an Australian hospital. The hermeneutic phenomenology of Heidegger (1967/1996), the philosophical hermeneutics of Gadamer (1989), and the ideas of van Manen (1990/1996) underpin this study. The meaning and understanding of the everyday experience of Muslim patient in a non-Islamic hospital is achieved through interpretation of the participants’ stories. Data were generated using unstructured audio-taped interviews from participants. The interviews were transcribed verbatim and analysed, then interpreted using phenomenological methods. The two themes to emerge from the participants’ experiences are: Being-thrown-into-an-un-everyday-world and living-Islam-in-the-un-everyday-world. The theme of Being-thrown-into-an-un-everyday-world arose from the sub-themes of the awareness of self and Being an outsider. The theme living-Islam-in-the-un-everyday-world was drawn from the three sub-themes of Being the same and different, hindrances to being Muslim, and adapting-to-the-un-everyday-world. The findings of this study provide an insight into the experience of Muslims being cared for in Australian hospitals. It is hoped that this interpretation will make a significant contribution to the care of Muslim patients by having health professionals consider how this group could be cared for in a culturally sensitive manner. It is not intended as a prescription for care but draws the reader to reflect on aspects of the Muslim faith and how this may impact on individuals experience when in hospital. The scope of this study and the dearth of available research in this area conclude that much more research needs to be undertaken.Thesis(Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 200

Hindrances to the implementation of family-centered care approach: a grounded theory study

Introduction: Family centered care is one of the caring approaches which support patient and family members and reduce their stress level caused by illness. This study aims to explain the challenges of family centered care approach implementations in Iranian health care settings. Methods: This article is a part of grounded theory study. Participants were selected through purposeful sampling method; the data was collected conducting an in-depth semi-structured interview with each participant. Participants were family members, nurses, clinical supervisors and physicians of educational hospitals affiliated to Khuzestan University of Medical Sciences. Data analysis was conducted using constant comparative analysis method. Results: Five challenges to implementation of family centered care were extracted in the process of data analysis including: healthcare resources limitations, health professional patient dependency, time constraints for providing care, nature of chronic diseases and medical paternalism. Conclusions: Implementing this approach is facing with some issues. It needs to develop a partnership between patients’ family members and healthcare providers. Health care system can achieve a range of potential benefits with the implementation of family centered care

Effect of Incentive Spirometry on Pulmonary Function Tests in Patients Undergoing Hemodialysis: A Randomized Clinical Trials

Objectives: This study was aimed to determine the Effect effect of incentive spirometry on pulmonary function tests in patients undergoing hemodialysis. Methods: This study was a randomized clinical trial conducted in on hemodialysis patients. The obtained Data were collected from 26 patients in the experimental and 26 patients in the control group. In The the control group, patients received their routine care and the experimental group intervention for the experimental group was demonstrate the incentive spirometry program. The patients were encouraged to use the device for 5&ndash;10 breaths per session, every hour while awake for two months. The Pulmonary pulmonary function tests including FVC, FEV1, FEV1/FVC evaluated was indicatedwere taken at the beginning, and then 2 months after the starting onset of the study in two both groups. Results: The findings showed no significant differences between the two groups in terms of demographic characteristics and FVC, FEV1, FEV1/FVC before the intervention. The FVC, FEV1 increased significantly in the intervention group compared to the control group (P<0.05) after two months, while no significant improvement was observed in the FEV1/FVC ratio. Discussion: This study showed significant differences in pulmonary function (FVC, FEV1) in the two groups. Therefore, incentive spirometry seems to be an effective choice for improvements in pulmonary function test in hemodialysis patients. But considering the limited studies available, further research is required in this area