Orthoptic Changes following Photorefractive Keratectomy

Purpose: To report orthoptic changes after photorefractive keratectomy (PRK). Methods: This interventional case series included 297 eyes of 150 patients scheduled for PRK. Complete ophthalmologic evaluations focusing on orthoptic examinations were performed before and 3 months after PRK. Results: Before PRK, 2 (1.3%) patients had esotropia which remained unchanged; 3 (2%) patients had far exotropia which improved after the procedure. Of 12 cases (8%) with initial exotropia at near, 3 (2%) cases became orthophoric, however 6 patients (4%) developed new near exotropia. A significant reduction in convergence and divergence amplitudes (P < 0.001) and a significant increase in near point of convergence (NPC) (P < 0.006) were noticed after PRK. A reduction ≥ 10 PD in convergence amplitude and ≥ 5 PD in divergence amplitude occurred in 10 and 5 patients, respectively. Four patients had initial NPC > 10 cm which remained unchanged after surgery. Out of 9 (6%) patients with baseline stereopsis > 60 seconds of arc, 2 (1.33%) showed an improvement in stereopsis following PRK. No patient developed diplopia postoperatively. Conclusion: Preexisting strabismus may improve or remain unchanged after PRK, and new deviations can develop following the procedure. A decrease in fusional amplitudes, an increase in NPC, and an improvement in stereopsis may also occur after PRK. Preoperative evaluation of orthoptic status for detection of baseline abnormalities and identification of susceptible patients seem advisable

Patients Perception and Satisfaction of the Ambulance Service (115) at Shahrekord, Iran

The services provided to the patients of pre-hospital emergency center and their satisfactions indicate the quality of pre-hospital emergency services. The goal of this study is to investigate the satisfaction of patients with Ambulance Service services (115) in Shahrekord in the first half of (2012). In this descriptive and analytic study, 450 patients transferred to the hospital by pre-hospital emergency center were chosen using simple random sampling method and data was collected by using satisfaction evaluation questionnaire. The information obtained under SPSS software version 16 was analyzed by statistical descriptive test, independent t test, variance analysis test and Pierson Correlation test. The findings showed that satisfaction level with pre-hospital emergency services in men, low-educated people, married people, those with the record of using emergency services and those with emergency problems was significantly higher than others. Satisfaction level in all fields was above 50% and was totally 71.12. The highest level of satisfaction was for the efficiency of emergency center (58, 78) and the lowest level of satisfaction in the questions was for the performance of technicians (58, 73). Patients' satisfaction with emergency services and their quality is considered as one of the main concepts in pre-hospital emergency procedures, in the manner that the results of this study showed that patients' satisfaction in different fields were high and satisfactory and the technicians should allocate much more time for interaction with patients in order to improve their satisfaction. sharifi M, Baraz S, Mohammadi F, ramezani R, Esmaeili Vardanjani SA. Patients Perception and Satisfaction of the Ambulance Service (115) at Shahrekord, Iran. Life Sci J 2012; 9(4):2196-2201] (ISSN: 1097-8135). http://www.lifesciencesite.com. 32

Effect of Mothers' Educational Supportive Care Program on Pain Intensity and Crying Duration Caused by Colic Pain in Infants Aged 1-5 Months

Background: Baby colic is one of the most common digestive problems in infants. Due to its several and unknown causes, colic treatment depends on the parent's individual and social education and support. Aim: This study aimed to determine the effect of mothers' educational supportive care program on the pain intensity and crying caused by colic in infants aged 1-5 months. Method: This study was conducted based on a randomized controlled clinical trial. This study included 88 infants with colic who were referred to a specialized pediatric clinic at a public hospital in eastern Iran. The patients were randomly divided into the intervention and control groups. The educational supportive care program was implemented for eight days and the infant crying duration and frequency were recorded each day. On the other hand, the control group received the clinic routine care. Subsequently, the data were analyzed in SPSS software (Version 21). Results: The two groups were homogeneous in terms of demographic variables (

Health-Promoting Lifestyle among the Survivors of Colorectal Cancer: An Integrative Review

Introduction: Health-promoting lifestyle (HPL) among the survivors of colorectal cancer (CRC) is essential to reduce CRC complications, prevent its recurrence, and improve survival. Nonetheless, there is no comprehensive definition for the concept of HPL in CRC survivors. This study aimed to define the concept of HPL among CRC survivors based on the existing literature. Methods: This integrative review was conducted in 2021 using Whittemore and Knafl’s method. The national and international databases of SID, Magiran, ProQuest, Medline, ScienceDirect, Web of Science, and Scopus were searched. Quality appraisal was performed using the Mixed Methods Appraisal Tool (MMAT) and the data were analyzed using the four-step approach proposed by Whittemore and Knafl. Results: After data evaluation, 167 documents were included in final analysis. In total, 1863 codes were generated and categorized into eighteen main categories and the three main themes of antecedents, attributes, and consequences. Accordingly, HPL among CRC survivors was defined as "a set of behaviors in the areas of health responsibility, physical activity, nutrition, spiritual growth, psychological management, and interpersonal relations which are affected by socio-demographic characteristics, clinical characteristics, psychological status, physical conditions, time and place limitations, and patient education, and lead to better disease prognosis, better general health status, better bio-psycho-social status, and better quality of life". Conclusion: The definition of HPL among CRC survivors provided in the present study can be used in counseling, educational, supportive, and care programs for CRC survivors in order to improve their quality of life and survival

Investigation the Suitability of Patient Education Pamphlets and Patient Satisfaction among Teaching Hospitals in 2015

Background: To make the best use of written information in education pamphlets, suitability criteria developed for instructional materials. Moreover, client satisfaction with the quality of written materials provided in hospitals for patients needs to be taken into account. Aim: Therefore, the present study aimed to assess the suitability of patient education pamphlets and patient satisfaction among teaching hospitals in Mashhad, Iran. Method: A total number of 542 patient education pamphlets developed in 11 teaching hospitals in Mashhad was collected via a census method and their suitability was investigated using Suitability Assessment of Materials (SAM) instrument. Subsequently, satisfaction with education pamphlets among 2820 hospitalized patients was evaluated using a questionnaire designed based on SAM instrument. The association between the suitability of the given pamphlets and patient satisfaction was also determined. Descriptive statistics and the Chi-square test were used to analyze the findings. Results: The results revealed that 33.3% and 66.7% of the given pamphlets fell into the superior and adequate categories in terms of suitability, respectively. With regard to the satisfaction level, 0.7%, 26.4%, and 72.9 % of the patients were poorly, fairly, and completely satisfied with the pamphlets, respectively. Moreover, the pamphlets rated the higher suitability by patients obtained the higher satisfaction scores. Implications for Practice: The results of this study indicated a need for reconsiderations in some suitability factors for the pamphlets. In this respect, the factors of cultural appropriateness as well as layout and typography rated as acceptable

A survey of the quality of clinical education in nursing

Introduction:Lack of coordination in clinical education of nursing, the method of health care after graduation, and the existence of many problems in fulfilling the aims of clinical teaching encouraged the researchers to conduct this research, aiming at investigating the quality and obstacles of clinical teaching in nursing.Method:This is a cross-sectional descriptive study on 90 individuals (clinical teachers, senior M.S. students of nursing and 30 nurses). 3 self-made questionnaires were used to collect the data.Results:The results showed that the quality of clinical teaching in viewpoint of the majority of students (73.3%) is weak and for the majority of clinical teachers (86.7%) it is moderate .The X2 statistical test revealed a significant difference between the viewpoints of these two groups. As to the problems and obstacles in achieving the aims of clinical teaching, 100% of the students stated the inadequacies concerning the clinical teachers. 96.6% of the clinical teachers indicated that the existing insufficiencies in the curriculum and environmental factors are the obstacles in this regard. 100% of the nursing staff emphasized lack of familiarization of the personnel with the aim of clinical teaching of nursing students which is the main problem.Conclusion:To improve the quality of clinical teaching in nursing, it is recommended that there should be a cooperation among clinical teachers, nurses, head nurses, educational supervisors, and nursing managers in preparing curriculum plans in nursing

Spirituality in Contemporary Paradigms: An Integrative Review

Background: As two of the most prominent cultural components, spirituality and religion give sense to our human values, conducts, and experiences. The spiritual dimension is one of the four significant aspects of holistic care. However, the diversity of views has resulted in different interpretations of the reality of spirituality and its origins and consequences. Aim: This study aimed to examine the available approaches and paradigms in the realm of spirituality. Method: In the present integrative review, the initial search was performed in national and international databases, including Science Direct, PubMed, Google Scholar, Scopus, Sage, Medline, Wiley, SID, MagIran, IranMedex, and IranDoc, using the keyword, "spirituality", without considering any time limits. Articles relevant to the objectives of the study were then fully reviewed. Results: Since ancient times, spirituality has been sporadically discussed in human intellectual and artistic artifacts. This concept was expanded as an independent, systematic, and conscious movement since the second half of the 19th century in Europe, USA, and Canada. The three prominent approaches to spirituality include religious, secular, and holistic health perspectives. Implications for Practice: Despite the growing interest in research on spirituality, it is difficult to reach a unanimous decision about this concept. However, it should be noted that spiritual concerns cannot be disregarded, considering the holistic perspective to humanity as the building block of holistic nursing care. Overall, every patient is a unique human being whose spiritual needs are affected by his/her cultural beliefs and values

Designing and Evaluating Patient Education Pamphlets based on Readability Indexes and Comparison with Literacy Levels of Society

Background: Hundreds of patient education materials i.e. pamphlets are annually published in healthcare systems following their design, correction, and revision. Aim: to design and evaluate patient education pamphlets based on readability indexes and their comparison with literacy level in society. Method: The average literacy level among 500 patients admitted to two training hospitals in Bojnurd (northeastern Iran) was determined in 2014-2015. Afterwards, all patient education pamphlets in both hospitals (n=69) were collected and their readability level was determined. After that, all the pamphlets were re-designed according to the given standards and in line with literacy level in society. The SPSS software (Version 20) was also used to analyze the data. Results: The average level of literacy among 500 patients in both hospitals in the present study was 6.72±4.34 which was placed in grades six and seven in terms of the guide to readability indexes. In line with McLaughlin’s SMOG Readability Formula, the bulk of pamphlets (91.3%) were at college level before corrections and revisions based on the given standards, but 23.2% were at a level lower than grade seven following corrections and revisions. Implications for Practice: Evaluation of patient education pamphlets plays an important role in promoting self-care among patients. Due to the novelty of the present study in Iran, the results of this study can contribute to patient education researchers in order to identify the strengths and weaknesses of patient education materials i.e. pamphlets based on scientific indices as well as their revisions and re-developments

Mothers’ lived experience of caring for children with inborn errors of amino acid metabolism

Abstract Background Inborn errors of amino acid metabolism are chronic conditions that have many sequels. Mothers of these children are facing different challenges which are underdetermined. This study was done to explore lived experience of mothers caring for these children. Methods This is an interpretive phenomenology with van Manen’s approach which has 6 steps. Data were gathered by convenience and purposeful sampling. Nine mothers with different experiences were interviewed and the interviews were audiotaped. Results Six final themes were revealed from the exploring mothers’ experiences including the future tied to the past, psychosis in the shadow of a lost ideal child, rebellion and blaming, the ways of escaping difficulties, self-forgetting in the shadow of full-time care, passing difficulties in the duality of hope-hopelessness, caring in a continuum of isolation-socialization. Conclusion Mothers have multiple challenges in taking care of their children, especially psychologically and financially. So, nurses must plan programs for helping mothers of children with inborn errors of amino acid metabolism to reduce the effects of disease on mothers and consequently the children and the whole family