Expectations of Multiple Sclerosis Patients and Their Families: A Qualitative Study in Iran

Background: Multiple Sclerosis (MS) is a neurological disease that is most commonly observed among young people. Drug and non-drug treatments are used to prevent the progression of the disease and to control illness-related disorders. Patients with MS often have multiple and complicated needs that require a broad spectrum of health services. Objectives: This study was conducted to identify the expectations of individuals with MS and their families for healthcare services. Patients and Methods: This article is part of a qualitative case study. The participants were selected by a purposive sampling method. In this study, semi-structured interviews of 20 individuals with MS and 8 family members were conducted to identify the expectations of MS patients and their families. In addition to the interviews, the documents related to the aim of the study, including weblogs, MS magazines, special websites of individuals with MS, and news agencies were gathered. Analysis of data was performed by a conventional content analysis method. Results: The age of the participants ranged from 22–63 years. The data obtained from this study was classified into 5 main categories as follows: being cured, need for comfort, promoting knowledge, economic welfare, and social security. Conclusions: Individuals with MS and their families had different expectations pertaining to all dimensions of life, such that not meeting the needs related to any dimension could have affect the other dimensions. Therefore, it is necessary for healthcare providers to have a holistic assessment as well as try to meet all needs and expectations

Social Support and Depression in Iranian Cancer Patients: the Role of Demographic Variables

Introduction: Depression is the most frequent mental disorder in cancer patients, which is, unfortunately, less noticeable. Despite extensive researches, we only have scant knowledge about the influence of social support on depression in cancer patients. The aim of this study is to examine the relationship between perceived social support and depression and demographic variables on cancer patients. Methods: This is a descriptive correlational study on two hundred cancer patients in Isfahan, Iran. The study subjects were selected through convenient sampling method and data were collected using questionnaires (demographic questionnaire, Multidimensional Scale of Perceived Social Support (MSPSS) and Beck Depression Scale (BDS). Data were analyzed by SPSS software (Frequency distribution, Chi-Square and Spearman correlation). Results: The findings showed that social support and depression in cancer patients are significantly correlated with each other (r = - 0.785, P <0.001). Furthermore, the findings indicated that there are statistically significant correlations between degrees of education with depression and also between the numbers of children with social support and depression in cancer patients. For all analyses, was considered significant. Conclusion: In conclusion, we suggest that interventions to alleviate depression in cancer patients may be designed with consideration of demographic characteristics especially the level of education and the number of supporters of the patient to increase the quality of life in cancer patients and minimize the negative consequences of cancer diagnosis

The Use of Qualitative Case Study in Nursing

Introduction: Case study as a qualitative research has been used in many disciplines including sociology, anthropology, history, psychology, medicine, education, political science, and economics. Now, case study is used by nursing researchers for exploring phenomena in health care practice. The article aimed to assess the principles of the case study and its’ using in nursing. Method: Computerized search was done in Medline and Elsevier databases with case study, qualitative research, and nursing keywords among the articles in English language between 2000 and 2015. The main themes, agreement, and disagreement were assessed among the articles. Results: Case study is a research approach for providing deeper understanding of the complex and multifaceted phenomenon in real life context and checks general and significant characteristics of events. So, using this method is useful to evaluate the performance of nursing practice. This method was used in some of nursing researches. Conclusion: Qualitative case study is a method that can play an important role in the production new knowledge in nursing and health system research by providing a holistic view about a phenomenon. Keywords: Case study, Qualitative research, Nursin

An Educational Intervention on Based Information, Motivation and Behavior Skills Model and Predicting Breast Self-examination

Introduction: Breast self-examination recommend as a breast screening method in developing countries where there are limited access to other screening methods. Therefore promoting breast self-examination required to identify effective interventions and relevant factors.Methods: This study was a quasi-experimental design which carried out on 314 women 20-69 years. Sampling was conducted from April to 10 August, 2016. A structured questionnaire was used for data collection in before and after the educational intervention. Then participants were followed by phone call after one month for breast self-examination performance.We used descriptive statistical analysis (mean, standard division, frequency distribution), and also other statistical methods (Paired t-test, Pearson’s correlation and logistic regression).The data were analyzed using SPSS version 18 with considering a significant level less than 0.05.Results: There was significant difference between mean scores of information, motivation and behavior skill before and after intervention (P&lt;0/001). After one month following 205 of women (72.2%) reported to perform breast self-examination. Pearson’s correlation showed that breast self-examination significantly correlated with information (r=.305, p=.000), motivation (r=.128, p=.031) and behavior skills (r=.161, p=.006). Also the logistic regression results demonstrated that information (p&lt;.001, OR=1.071), motivation (p=.045, OR=.978) and behavior skills (p=.001, OR=1.033) predicted breast self- examination.Conclusions: Considering the results of this study, it appears that the use of educational interventions based on three constructs of information, motivation and behavior skills can be used to promote breast self-examination. Moreover these results can apply to improve breast self-examination among women by health care providers

Research barriers from the viewpoint of faculty members and students of Ardabil University of Medical Sciences, Iran, 2014

Background: Due to its role in identifying educational, research, health problems and providing a solution to prevail upon the problems related to public health, the research in the Medical Sciences University has a special importance. The present research aims to determine the restraining factors of doing research from the viewpoint of professors and students of the Medical Sciences University of Ardabil; it was conducted in 2014.Methods: In this descriptive cross-sectional study, 250 individuals from between the professors (50 individuals) and students (200 individuals) of the various academic disciplines of medical sciences were selected by way of completely random sampling. The data collection tool was a researcher-made questionnaire containing 3 parts: demographic information, individual barriers (10 questions) and organizational and environmental barriers (25 questions) based on the binary scale (Yes or No). By using the descriptive statistics and student t-test, data were analyzed with the significance level of 0.05, in the software SPSS19.Results: In the area of organizational factors, the most important restraining factor of the research activities of students was the lack of access to information sources (73.2%) and in the area of individual factors the main obstacle was lack of domination in English (68.6%). Also, the administrative restrictive regulations (73.3%) as the most important organizational restraining factor and lack of time due to job preoccupation (68.9%) as the main individual barrier were recognized for doing research in view of professors. There is not any statistical significant difference between the view of students under study in all the influential individual barriers other than the being unimportant of research from my view and having the negative attitude towards the research works in the view of professors. Also, there is a significant difference between students’ view in all effective organizational barriers other than lack of research in the chapter heading of courses of most of fields and the professors’ view. In total the score of organizational barriers was more than that of the individual barriers.Conclusions: Organizational barriers and personal barriers have an important role in doing the research in the Medical Sciences University of Ardabil; these barriers can be passed through. The availability of consulting forces and sufficient and necessary counseling, teaching know-how and attitude correction, compensating the lack of facilities and equipment, creating the motivation by the authorities and educating and empowering as executive working procedures are recommended for overcoming the research barriers in the universities

Drug Utilization Evaluation of Vancomycin in Pediatric Department

Background: Increasing reports of Vancomycin resistance have raised concerns about effectiveness of this drug. One of the most important factors of resistance emergence is no adherence of physician to principles of antibiotic therapy. This study is a drug utilization evaluation (DUE) of Vancomycin in pediatric ward to assess appropriateness of drug regimens and to find possible problems in clinical practices that may necessitate reconciliation to improve Vancomycin use.Materials and Methods: This prospective study was done for 1year from October 2014 to September 2015 at Khalij Fars General Hospital in Bandar Abbas. Data including patients’ demographics, paraclinic, diagnosis, vancomycin dose, and treatment duration were collected. The concordance of practice with standard guidelines (CDC, ASHP, and IDSA) and principles of antibiotic therapy was assessed. Results were analyzed by SPSS 20.Results: 102 medical records were reviewed in this study. Pneumonia (60=59%) and sepsis (22=21.5%) were the most common diagnosis. Sampling was done in 6% of patients with 2% antibiogram. Vancomycin was administered appropriately in 56.9% percent of patients with no sex difference (PV= 0.55) but age with significant difference (PV= 0.017). Over use was in a great proportion of patients (36cases=35%) as unnecessary, improper combination and broad spectrum regimen.Conclusion: Vancomycin was overused irrationally in a great proportion of patients. There was no serum level monitoring. Microbial resistance, serum trough level monitoring programs and continuous medical education for physicians can be effective in rational use of antibiotic

Compassionate care challenges and barriers in clinical nurses: A qualitative study

Background: Compassion is the heart of nursing care. Barriers to compassion in nursing may be influenced by the prevailing culture and religion of a society. Determining the barriers to providing compassion-based care would help nurses to plan better and more appropriate interventions. This study aimed to explore the challenges and barriers to compassionate care in nurses. Materials and Methods: This ethnographic study was performed in 2014–2016. The study participants consisted of 40 nurses, 16 patients, and 8 family members in medical and surgical wards. Data collection was performed through observations and interviews. Data analysis was performed based on Strauss and Corbin's constant comparative method. Results: Data analysis defined three themes as the challenges and barriers to compassionate care; challenges and barriers related to the contextual environment of hospitals, sociocultural challenges and barriers, and challenges; and barriers related to staff. Conclusions: This study described the challenges and barriers to compassionate care. Therefore, to eliminate these barriers and challenges, corrective action should be taken by managers. Attention to teaching the concept of compassion and patient-centered care and increasing the number of nurses and positive attitude toward the nursing profession in clinical environment can be effective in providing compassionate care

Doctor of Nursing Practice (initiated or disorder)

After years of trying to make independent PhD course, Nursing could create two independent course including research-focused course (PhD) and clinical practice -focused (DNP). PhD focused more on research and DNP emphasis more on clinical activities and innovative clinical application of evidence-based research results. Presence or absence of DNP is still a debate as a challenge in nursing. In this paper, the authors compare these two doctoral nursing courses according to various sources

Contextual facilitators and maintaining of compassion-based care: An ethnographic study

Background: Compassion is an important part of nursing. It fosters better relationships between nurses and their patients. Moreover, it gives patients more confidence in the care they receive. Determining facilitators of compassion are essential to holistic care. The purpose of this study was to explore these facilitators. Materials and Methods: This ethnographic study was conducted in 2014–2015 with 20 nurses, 12 patients, and 4 family members in the medical and surgical wards. Data collection was done through observations and in-depth semi-structured interviews with purposive sampling. The study was carried out in 15 months. Data analysis was performed using constant comparison based on Strauss and Corbin. Results: Data analysis defined three main themes and eight subthemes as the fundamentals of compassion-based care. Nurses' personal factors with subcategories of personality, attitudes, and values and holistic view; and socio-cultural factors with subcategories of kindness role model, religious, and cultural values are needed to elicit compassionate behaviors. Initiator factors, with subcategories of patient suffering, patient communication demands, and patient emotional and psychological necessity are also needed to start compassionate behaviors. Conclusions: The findings of this study showed that nurses' communication with patients is nurse's duty in order to understand and respect the needs of patients. Attention should be paid to issues relating to compassion in nursing and practice educational programs. Indeed, creating a care environment with compassion, regardless of any shortcomings in the work condition, would help in the development of effective nursing

Empathy, burnout, demographic variables and their relationships in oncology nurses

Introduction: Development of nurse–patient empathic communication in the oncology ward is of great importance for the patients to relieve their psychological stress, however, nursing care of cancer patients is accompanied with high stress and burnout. The present study aimed to define the level of empathy and its association with burnout and some demographic characteristics of oncology nurses. Materials and Methods: This descriptive/correlation study was conducted in a professional cancer treatment center in Isfahan. Through census sampling, 67 oncology nurses were selected. The data collection tools were Jefferson Scale of Nursing Empathy, Maslach Burnout Inventory, and demographic characteristics questionnaire. Results: Mean nurses' empathy and overall burnout scores were 62.28 out of 100 and 38.8 out of 100, respectively. Score of empathy showed an inverse correlation with overall burnout score (r = −0.189, P = 0.04), depersonalization (r = −0.218, P = 0.02), and personal accomplishment (r = −0.265, P = 0.01). Multiple regression test was used to detect which dimension of burnout was a better predictor for the reduction of empathy score. Results showed that the best predictors were lack of personal accomplishment (P = 0.02), depersonalization (P = 0.04), and emotional exhaustion (P = 0.14), respectively. The most influential demographic factor on empathy was work experience (r = 0.304, P = 0.004). One-way analysis of variance showed that official staff had a higher empathy score (f = 2.39, P = 0.045) and their burnout was lower (f = 2.56, P = 0.04). Conclusions: Results showed a negative relationship between empathy and burnout in oncology nurses. Therefore, nursing support from managers to reduce burnout increases empathic behavior of nurses