Barriers and Challenges to Self-Care among Older Adults with Knee Osteoarthritis: A Qualitative Study

Background: Knee osteoarthritis (KOA) is a chronic disease causing disability in older adults. Self-care is an effective strategy for KOA management  in older adults and clinicians have shown increased interest regarding the challenges of self-care activities in these patients.The present study aimed  to explore the perception of older adults' patients with KOA regarding barriers and challenges faced in their self-care management.    Methods: In this qualitative study, data were collected using purposeful sampling and in-depth semi-structured interviews with 22 older adults with  KOA, their first-degree caregivers, and medical team members in Mashhad, northeast Iran, from April to December 2020. All the interviews were  transcribed verbatim. Interviews continued until reaching data saturation. All interviews were recorded. Data analysis was done using conventional  content analysis according to the technique described by Graneheim and Lundman. The MAXQDA (Version 10) was used to organize, code, and  manage the data. Findings: Three main themes (confusion, confrontation with increasing stresses, and social rupture) were emerged as the barriers and challenges  to self-care among older adults with KOA. Conclusion: The results of this study provide a broad range of context-specific of barriers and challenges to selfcare among older adults with KOA,  which can be used for designing and implementing appropriate interventions to improve self-care in these patients

Spiritual Leadership Model as a Paradigm for Nursing Leadership: A Review Article

AbstractIntroduction: The aim of this study was to explain how the spiritual leadership modelcould be used as a paradigm for nursing leadership. Nursing leaders play a critical rolein the management of the health care system. Spiritual leadership is a new area that hasrecently been considered in nursing management.Methods: In this review article, electronic databases (PubMed, Scopus, GoogleScholar and Science Direct) were searched from September 2014 to July 2016 to findrelevant articles using keywords, such as spirituality, leadership, management, nursesand motivation. In this regard, the articles that fulfilled the goals of the study that werewritten in English or Persian, had their full texts accessible, and were published in theintended time interval were entered in the study. The articles without authors’ namesand dates and non-scientific papers were excluded from the study. On the whole, a totalof 120 articles were obtained, of which 48 were selected and analyzed.Results: A review of the literature focusing on spiritual leadership demonstrated thatthe spiritual leadership model has been examined in different countries, various fieldsof the industry, trade training, and the health system with positive individual andorganizational consequences. It seems that the characteristics of this style of leadershipfits the nursing profession as well. Of course, more large-scale future studies for testingthis model of leadership in the field of nursing will bring about more promising results.Conclusions: Spiritual leadership could improve the organizational productivity andemployees’ satisfaction. Nursing leaders should have paid greater attention to this typeof leadership to achieve positive organizational outcomes; therefore, they need moretraining in this issue.

Explanation of women’s and family health care personnel’s perception of the barriers of pre-pregnancy care coverage: a qualitative study

AbstractBackground and Aims: Pre-pregnancy care is a set of interventions through prevention and treatment to identify and modify biomedical, behavioral and social hazards. The current study aimed to explain ideas ofwomen about reproductive age and the personnel of family health centers about barriers of pre-pregnancycare coverage in the healthcare centers supervised by Iran University of Medical Sciences.Materials and Methods: In this qualitative study, 32 mothers and the personnel of family health unit (experts of midwifery and family heath) working in health centers affiliated to Iran University of Medical Sciences were interviewed both individually and in group. A purposeful sampling was exploited. Data were gathered through interviews and focused on group discussion with open questions until data saturation was reached and data were analyzed using conventional content analysis approach and based on the Graneheim and Landman’s model (2004). Before each interview, mothers were informed regarding the aim of research, interview style, freedom to leave the interview and the way interview content would be kept private.Results: After analyzing the data, the perceived obstacles of pre-pregnancy care coverage were achieved in three main formats including: Organizational obstacles, communicative obstacles and personal obstacles.Conclusions: Thorough explanation participants’ experiences, structural, communicative and personal factors were shown to be effective on pregnancy care coverage in healthcare centers supervised by IranUniversity of Medical Sciences. Better quality services could be obtained by prioritizing and implementing proper interventions.Keywords: Pre-pregnancy care, Barriers or obstacles, perceptions, Mothers’ health, women’s healthFor downloading the full text please click her

Perceptions of Mothers from Barriers of Nursing Care Satisfaction: A Qualitative Research

Introduction: Parents are legal guardian for children and they have right for assessment of quality of care given to their children. Parent satisfaction assessment can be identified deficiencies in nursing care and the use of qualitative methods in this area can be identified with the aspects that the quantitative methods alone were not able to detect them. Therefore, this study aimed to explore mother's perceptions of barriers of nursing care satisfaction. Method: This was a qualitative research with content analysis approach. Interviews were done with semistructured approach by 14 mothers with hospitalized children in pediatrics wards of Yazd hospitals. All the interviews were tape-recorded and then transcribed verbatim and finally analyzed through content analysis. Results: Thematic data analysis revealed one main theme that inefficient caring nurse and category include unrealistic meaning of caring, failing in skill and agility of the nurse, the mother needs neglect ineffective communication and reluctance to participate mother. Conclusion: This study revealed barriers effecting on mothers satisfaction of nursing care that often remains hidden from quantitative study view. It seems that with eliminating barriers it can be an effective step taken into improving the quality of care. Keywords: Carriers, Satisfaction, Nursing care, Perceptions, Content analysi

Comparative virulotyping and phylogenomics of Escherichia coli isolates from urine samples of men and women suffering urinary tract infections

Objective(s): Escherichia coli strains are common pathogens that can cause urinary tract infections (UTI). This study aimed to assess E. coli phylogroups and virulence types in male and female UTI patients.Materials and Methods: In the present study, 160 uropathogenic E. coli (UPEC) isolates (from both sexes) were assigned to phylogroups/types and some extraintestinal virulence factors were detected within them by multiplex-PCR.Results: The isolates from women and men were predominantly distributed within phylogroup B2 and D, respectively. The presence of D2 phylotype was higher in men isolates than women, significantly (P=0.045). In male isolates papEF and sfa/focDE are more prevalent in B2 group than D, significantly (P=0.048; P=0.035). The prevalence of hly in B2 group is significantly higher than D (P=0.034) in female isolates.Conclusion: This study highlighted different features of E. coli genotypes from phylogenetic and virulence point of view implicated in UTI’s in both human genders

Measuring self-rated social health of Iranians: a population based survey in three cities

Abstract:Background and objectives: Social health as third dimension of health, along with physical and mental health, has drawn more attention in recent years among policy makers and health system managers. No other study, to our knowledge, has documented measuring individual-level social health in Iran. In response to this need, our study tends to assess Iranians self-rated social health through conducting a survey in 3 cities of Iran. Methods: We conducted a survey using cross sectional method in three cities of Iran included people more than 18 years old. We use a random sample size of 800 people. The scale provides a total score of social health and three sub-scores. Total score was calculated by summing all 33 items, so the range was between 33 to 165, considering that higher score indicating better social health. Psychometric parameters of scale were acceptable. To interpret scores, respondents were categorized into five ordered groups as quintiles for amount of social health. To compare social health scores in different demographic groups multiple linear regression was employed to interpret association between demographic variables and social health score. Results: From a pool of 800 persons, 794 (99%) agreed to participate and filled out the questionnaire completely.  The mean of self-rated social health score was 105.0 (95% confidence interval, 103.8 to 106.2). 50% of participants had medium level of social health. social health score was higher for those who live in Urmia as a small city in comparison with big cities- Tehran and Isfahan (P V< 0.001) and was lower for unemployed people (PV= 0.029). There was no association between social health score and other factors such as sex, age and educational level (PV>0.05) Conclusion:This study may be considered as the first step in evidence-based policy-making in the field of social health in Iran. Certainly, it is necessary to conduct more studies to measure social health and its determinants in a nation-wide approach

Exploring the Experiences of Parents of Hospitalized Children Regarding Trust Barriers to Nursing Care

Introduction: Trust in nursing care has profound effects on parents of hospitalized children, their child, and subsequent hospital admissions. The creation and maintenance of trust is essential to increasing the benefits of the relationship between nurses and parents of hospitalized children. Therefore, this study was conducted to explore experiences of parents of hospitalized children regarding trust barriers to nursing care. Method: This qualitative study was conducted in 2012-2013 using content analysis. The Study population consisted of 18 parents of children admitted to pediatric hospitals in Yazd, Iran. The subjects were selected through purposive sampling. Data were collected through targeted in-depth semi-structured interviews. Data were analyzed using qualitative content analysis. Results: Data analysis led to the emergence of the main category of unsafe care the sub-classes of which included low caring sensitivity, lack of competence, stressful communication, and lack of interest in the profession and patients. Conclusion: Nursing managers can facilitate the evolution of trust in nursing care among parents by taking measures to improve the professional performance of nurses, educate nurses about issues such as how to communicate with parents and children, and updat professional knowledge. Keywords: Trust, Care, Nurse, Parents, Child, Patien

The Effect of Rhythmic Movements on Mild Anxiety in Children of 7 to 12 Years Old with Cancer

 Background and Aim: Cancer is a chronic childhood disease with many unpleasant psychological consequences such as anxiety. The study conducted to assess the effect of rhythmic movement on mild anxiety of children with cancer.Material and Methods: This study was a Quasi-experimental study. The study population included all children aged 7 to 12 years old diagnosed with cancer who were hospitalized in oncology ward of a pediatrics hospital affiliated with Shahidbeheshti University of Medical Sciences in Tehran, Iran. Sampling was through convenient sampling and based on the inclusion criteria. 31 children with mild anxiety chosen according to ʺSpielberger Anxiety Inventoryʺ were recruited. Rhythmic movements with hip-hop style along with playing music performed in the playing room for 45 minutes during 6 sessions. Questionnaires were recompleted on the final day of intervention (sixth day) and 3 weeks later through reading the items for children and filling by researcher. Data analyzed using SPSS V.18 by repeated analysis of variance (ANOVA).Results: The results showed significant differences between the mean values of anxiety (P<0.05) score before intervention and at the end of day 6 and weeks 3.Conclusion: Rhythmic movements as a non pharmacologic intervention reduce mild anxiety in children with cancer. It is recommended that nurses use non pharmacological approaches such as rhythmic movements to reduce the psychological effects of cancer instead of using drugs