Effectiveness of Problem-Focused Coping Strategies on the Burden on Caregivers of Hemodialysis Patients

Background: Studies have shown that family caregivers of hemodialysis patients experience high levels of burden. However, these caregivers are often neglected, and no studies are available on the effectiveness of coping strategies on the burden of care among these caregivers. Objectives: This study aimed to examine the effectiveness of problem-focused coping strategies (communication skills, anger management, and deep breathing) on the burden on caregivers of hemodialysis patients. Patients and Methods: A randomized controlled clinical trial was conducted on 76 family caregivers of hemodialysis patients referred to Shahid Hasheminejad hemodialysis center in Tehran, Iran. The subjects were equally allocated into two groups of 38. Through a coin-tossing method, caregivers of patients who referred on even or odd days of the week were randomly assigned into the intervention group or the control group, respectively. The intervention group received four training sessions on problem-focused coping strategies, but the control group did not receive any intervention. Both groups answered the caregiver’s burnout inventory at the start and six weeks after the last educational session. Descriptive statistics, chi-square, Fisher’s exact test, independent-samples t-test, and Mann-Whitney U test were used to analyze the data. Results: The majority of caregivers (54%) were in the age range of 35 - 55 years, female (68.4%), and married (70%). No significant difference was found between the baseline mean caregivers’ burden scores of the intervention and control groups (88.56 ± 11.74 vs. 84.97 ± 15.13, P = 0.308). However, the mean caregivers’ burden in the intervention group decreased, and the two groups were significantly different at the end of the study (58.77 ± 6.64 vs. 87.84 ± 11.74, P < 0.001). Conclusions: The current study showed the effectiveness of problem-focused coping strategies on reducing the burden on caregivers of hemodialysis patients. Authorities and policymakers in the healthcare system are responsible for developing strategies to integrate educational programs, such as the program implemented in the current study, into the country’s healthcare system

Suffering Sources among the Newly-Graduated Nurses at the Beginning of Their Clinical Work: A Qualitative Study

Suffering is an inevitable reality at the beginning of work that may cause several damages to the amateur nurses and health care organizations. Although suffering has been investigated in some studies, its sources among the newly-graduated nurses have not been investigated so far. The goal of this study is to investigate suffering sources of the newly-graduated nurses at the beginning of work. The present research is a qualitative content analysis study. The participants included 17 amateur nurses of Tehran educational hospitals. The data was collected through a semi-systematic interview. Sampling was made by using a targeted method and was continued until data saturation. All interviews were recorded and were then written down and were analyzed by using the qualitative content analysis method. Findings of this study showed that suffering is a joint experience among the newly-graduated nurses at the first months of their beginning to work. The findings showed the suffering sources among the nurses. Four main themes emerged in this study, namely non-preparedness for working, workplace, patients, and colleagues as the suffering sources. Experiences of the participants showed that suffering of the newly-employed nurses has extensive sources that affect their personal and professional lives. Understanding suffering sources of the newly-employed nurses can be an important factor in helping this group of nurses. Sensitivity of nursing managers to the reduction of these suffering sources and supporting the newly-graduated nurses are very important. Rafii F, Sajadi hezaveh M, Seyedfatemi N, Esmaeili Vardanjani SA. Suffering Sources among the Newly-Graduated Nurses at the Beginning of Their Clinical Work: A Qualitative Study. Life Sci J 2012;9(4):5517-5524] (ISSN:1097-8135). http://www.lifesciencesite.com. 81

Effect of an educational support programme on caregiver burden among the family members of patients undergoing coronary artery bypass graft surgery

Objectives: The family caregivers of patients undergoing coronary artery bypass graft (CABG) surgery experience considerable physical and emotional distress. This study aimed to investigate the effect of an educational support programme on caregiver burden among the family caregivers of patients undergoing CABG surgery in Iran. Methods: This non-randomised controlled clinical trial was conducted from January to April 2017 at a cardiovascular centre in Tehran, Iran. A total of 80 family caregivers of patients undergoing CABG surgery were sequentially selected and non-randomly assigned to intervention and control groups. The control group received routine care, whereas the intervention group received additional education sessions at baseline, prior to surgery, the day after surgery and before discharge. Caregiver burden was compared at baseline and six weeks post-discharge using the Persian-language versions of the Caregiver Burden Inventory (CBI) and Katz Index of Independence in Activities of Daily Living (IADL). Results: A significant difference was observed between family caregivers in the control and intervention groups with regards to pre-post differences in mean CBI scores (+1.67 ± 19.23 versus +17.45 ± 9.83; P <0.001), with an effect size of �1.14. In addition, there was a significant increase in mean post-discharge IADL scores among CABG patients in the intervention group compared to the control group (4.42 ± 1.05 versus 3.07 ± 1.09; P <0.001). Conclusion: An educational support programme significantly reduced caregiver burden among the family members of patients undergoing CABG surgery in Iran. As such, in addition to routine care, healthcare providers should provide educational support to this population to help mitigate caregiver burden. © 2021, Sultan Qaboos University. All rights reserved

Identifying health seeking behaviors among middle-aged women: A qualitative study

Background and purpose: Middle age is a developmental stage. Women in this stage are capable of preserving and promoting their health. Nonetheless, there seems to be several issues affecting their health-oriented behaviors. Identifying such behaviors from the perspective of middle-aged women are of great importance in protecting and promoting their health. This study aimed at defining health seeking behaviors in middle-aged women. Materials and methods: The study was conducted by qualitative approach and conventional content analysis was adopted. The participants included 20 middle-aged women who were recruited by purposive sampling. Semi-structured face to face interviews were conducted to collect the data. Then verbatim transcription of interview data was done and categories were extracted. First, semantic similarities were identified and sub-categories were specified, then in reconsideration related subcategories were placed in a same category. Results: Four categories were identified including the status of health knowledge, understanding of health and diseases, controlling the health-oriented behaviors and "using self-soothing behaviors". Eight sub-categories were also determined: awareness of health risks, preventive/permissive behaviors, understanding of health, understanding of disease, health promoting behaviors, interactive behaviors, soothing and spiritual calming behaviors as health-seeking behaviors. Conclusion: The findings expressed behaviors that women showed in their quest for health. In fact, this quest for health is manifested in strategies that women adapted to maintain and promote their physical and mental health. In such a quest women constantly rely on their own knowledge of health, perception of health and diseases and tranquilizing and relaxing methods. © 2016, Mazandaran University of Medical Sciences. All rights reserved

Iranian clinical nurses' coping strategies for job stress

Iranian Clinical Nurses' Coping Strategies for Job Stress: Yadollah Jannati, et al. Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Iran-Objectives: Since the existence of work-related stressors is inevitable in nurses' workplace, nurses usually use a variety of coping strategies which can be called cognitive, affective, and behavioral techniques. In this study, we aimed to explore the coping strategies employed by the Iranian clinical nurses in depth. Methods: This work was a qualitative study using Straus and Corbin's grounded theory approach focusing on the process of coping with job stress used by Iranian clinical nurses. Results: The results of the present qualitative study indicate that the core category was "on the route to coping"which contained six categories comprising work management, self-control, emotional, spiritual, cognitive, and interactional strategies. Conclusions: We conclude that in nursing it is inevitable that different kinds of strategies are used to cope with the many stressors. The conceptual model emerging from the data indicate that nurses are engaged in a dynamic process of struggling to cope with job stressors. In fact, they are "on the route to coping"with the job stressors. Considering the high level of stress in the nursing profession, the findings of this study have implications for both hospital managers and Iranian clinical nurses

Palliative care as the driving force for providing psychological comfort to patients with cancer: A hermeneutic study

Background: Palliative care is an important part of effective cancer care Objectives: The purpose of our study was to explore the lived experiences of nurses providing psychological palliative care for cancer patients in Iran. Methods: A hermeneutic phenomenological study was performed. We interviewed 11 oncology nurses to understand their lived experiences in cancer wards about psychological palliative care. We employed a seven-stage process of data analysis. Results: One constitutive pattern �palliative care as the driving force for providing psychological comfort to patients with cancer� and three associated themes, namely �stress management�, �empathetic behavior�, and �all-embracing outlook�, were identified. Conclusions: The findings present better understanding of the lived experiences of oncology nurses in Iran regarding the phenomena under study. © 2016, Iranian Journal of Cancer Prevention

Body-image disturbance: A comparative study among Haemodialysis and kidney transplant patients

Introduction: As a chronic disease, End Stage Renal Disease (ESRD) changes the patients� body and affects their body image negatively. Although the changes in body image are expected in all types of renal replacement therapies, different renal replacement therapy methods could represent different levels of impact on body image. Aim: Present study was conducted to examine and compare the level of body-image disturbance between haemodialysis and kidney transplant patients. Materials and Methods: This descriptive study was conducted in two teaching hospitals in Tehran, Iran. Using convenient sampling, 84 patients (42 patients under haemodialysis and 42 patients with transplant) were invited to participate in the study. A self-designed questionnaire was developed to examine the level of body-image disturbance. Results: Out of 42 haemodialysis patients, 64.3, 19 and 16.7 of patients reported low, moderate and high level of body-image disturbance respectively. The mean score of body-image disturbance was 21.1±18.3(rang=1�71) in haemodialysis patients. Of 42 transplant patients, 69, 26.2 and 4.8 reported low, moderate and high level of body-image disturbance respectively. The mean score of body-image disturbance was 17.1±13.3 (rang=1�48). According to the results of independent t-test, difference between mean score of body-image disturbance in two groups was statistically significant (p < 0.05). Conclusion: The findings of the present study showed that both haemodialysis and renal transplant patients experienced some levels of body-image disturbance. This problem was more prevalent among haemodialysis patients in compared to kidney transplant ones. We recommend more studies may be conducted in this regard. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved

Relationship between the circadian types and nurses' caring behaviours

Introduction: Caring is the most important feature of the nursing profession and provides a crucial role in improving the patient�s health, process of recovery and their satisfaction. Circadian type is defined as the capability of individuals to adapt to shift works. Nurses� performance in caring the patients can be potentially under the influence of their circadian type. Based on that, the present study was performed to examine the relationship between circadian types and nurses� caring behaviours. Materials and Methods: In this descriptive correlative study, 573 nurses were participated from different hospital units associated with Tehran University of Medical Sciences and based on the clustering method. The data were collected from morning and evening types (MEQ) and caring behaviour questionnaires, and analysed by using standard methods. Results: The findings showed a significant relationship between circadian types and caring behaviour subscales with the exception of attentiveness to other�s experience subscale. Furthermore, the caring behaviours of fixed-morning shift nurses were more professional and effective than those of rotation and fixed-night shift nurses. Conclusion: A significant relationship between circadian types and caring behaviours showed that morning types have better caring behaviours than evening types. Because evening type nurses usually show lower emotional balance and self-esteem compared to those of morning types, therefore, providing them with more attention and training can increase their qualifications and skilfulness in caring patients. Furthermore, it is important to consider nurses� circadian type in determining their work shifts. © 2015, Semnan University of Medical Sciences. All rights reserved

Coping strategies of newly graduated nurses (NGNs) in the first year of clinical practice: A grounded theory study

Background: The first year of clinical work is one of the most important steps in the career life of nurses. Although some studies have been done regarding NGNs, a few studies have been conducted about coping strategies of newly graduated nurses in the first year of clinical work. The aim of this study was to explore and describe the coping strategies of NGNs in the first year of clinical work in Tehran, the capital of Iran. Methods: This study was conducted using the grounded theory methodology. In this study, 20 participants were selected using a purposive and theoretical sampling method. The data were collected by semi-structured in-depth interviews. For data analysis, the constant comparison method based on Strauss - Corbin approach was used. Results: Data analysis revealed that two strategies were used by NGNs, which included �positioning� at the beginning of work and then later, stabilizing the obtained �position (place)�. The core category of this study was �struggles to settle in the workplace.� Conclusions: This study showed that NGNs tried to create a perfect position in the ward and then consolidate the created position. The results of this study can serve as a good guide to develop training and supporting programs for NGNs and be used in helping them adapt better to the new position. However, it is recommended to do further studies in this regard. © 2018, Shiraz E-Medical Journal

Coping strategies of newly graduated nurses (NGNs) in the first year of clinical practice: A grounded theory study

Background: The first year of clinical work is one of the most important steps in the career life of nurses. Although some studies have been done regarding NGNs, a few studies have been conducted about coping strategies of newly graduated nurses in the first year of clinical work. The aim of this study was to explore and describe the coping strategies of NGNs in the first year of clinical work in Tehran, the capital of Iran. Methods: This study was conducted using the grounded theory methodology. In this study, 20 participants were selected using a purposive and theoretical sampling method. The data were collected by semi-structured in-depth interviews. For data analysis, the constant comparison method based on Strauss - Corbin approach was used. Results: Data analysis revealed that two strategies were used by NGNs, which included �positioning� at the beginning of work and then later, stabilizing the obtained �position (place)�. The core category of this study was �struggles to settle in the workplace.� Conclusions: This study showed that NGNs tried to create a perfect position in the ward and then consolidate the created position. The results of this study can serve as a good guide to develop training and supporting programs for NGNs and be used in helping them adapt better to the new position. However, it is recommended to do further studies in this regard. © 2018, Shiraz E-Medical Journal