The Effect of Peplau’s Model Application on Sleep Quality of Women Waiting for Breast Biopsy Results

Background & aim: During the waiting period for breast biopsy results, women experience sleep disorders. This study conducted to determine the effect of implementing Peplau’s model on sleep quality of women waiting for the results of breast biopsy.Methods: This randomized clinical trial was conducted in 2019 at two educational hospitals in Mashhad, Iran. Women who were eligible to enter the study were randomly assigned to the intervention (n=34) and control groups (n=34) by lottery method. The intervention group received a program based on the Peplau's model, included a face-to-face communication and three telephone follow-ups. The control group received conventional care. Data were collected using Pittsburgh Sleep Quality Index, in three stages of before sampling, before and two weeks after receiving the results. Data were analyzed using Chi-square, t-test and the analysis of variance with repeated measures.Results: The mean score of sleep quality of women was 9.1 ± 3.2 in the intervention and 8.4 ± 2.6 in the control group before sampling. It was 8.2 ± 0.3 in the intervention and 8.3 ± 2.4 in the control group before receiving the result. However, two weeks after receiving result. It was 7.4 ± 2.7 in the intervention and 7.6 ± 2.8 in the control group. The analysis showed statistically significant difference between two groups in terms of sleep quality in different time periods (P=0.01).Conclusion: Considering the positive effect of the Peplau’s model application on improving the sleep quality, it is recommended to use this model especially in outpatient care settings

The Effect of Biofeedback on the Motor– Muscular Situation in Rehabilitation of Stroke Patients

Introduction: Stroke is the most common debilitating neurological disease in adults. Therefore, rehabilitation is a major consideration to reduce costs and relief disabilities. Biofeedback, a newly recommended method is claimed to be able to improve the consequences following stroke by enhancing the understanding of the psychological functions of the body. The purpose of this study was to investigate the effects of biofeedback on the motor– muscular situation in balance and ability to walk, muscle stiffness (spasticity), hand muscles strength of stroke patients. Methods: The present study was a randomized clinical trial done in 2016. The participants were randomly divided into 2 groups (case and control group). In the intervention group, biofeedback was performed. The check list of main variables, including balance and ability to walk, muscle stiffness (spasticity) and hand muscles strength was completed by a physician before the intervention and at the end of the intervention (16th session). The statistical analysis was conducted, using SPSS version 13. Results: The mean score of balance in intervention group versus control group showed significant differences. The results showed that by eliminating the effects of muscular strength before the intervention, this variable had made improvements and significant differences in both intervention and control groups after the intervention. Comparison of the average spasticity showed that spasticity evaluation score before and after the intervention revealed no significant difference between the two groups. Conclusion: Biofeedback therapy is a promising treatment modality for improving the motor–muscular situation of patients after stroke

Basic Needs of Mothers with Children Undergoing Hemodialysis: A Meta-synthesis of Qualitative Studies

Background: Mothers of children undergoing hemodialysis encounter severe changes in their daily lives. It is of utmost importance to raise the awareness of treatment teams about the needs of these specific groups of mothers and different problems they may experience. The reason is that it can help health care professionals to support the mothers to fulfill their roles as the primary caregivers of such children. Aim: This study aimed to identify basic needs in mothers of children undergoing hemodialysis. Method: This meta-synthesis review of qualitative studies investigating the needs and experience of mothers whose children had kidney disease and published from January 1997 to October 2017. The articles were searched in four databases, including Web of Science, EMBASE, PubMed, and ProQuest. The search process was accomplished using the keywords “chronic kidney disease,” “hemodialysis,” “children,” “mothers,” “parents,” “caregivers,” “needs,” “experiences,” “perspectives,” and “perceptions”. Finally, 7 articles were chosen out of 567 papers and theses. The MAXQDA software was used to facilitate data management. Results: The systematic review of the qualitative studies revealed three main themes, including the need for child care management skills, the need to maintain family cohesion, and the need for emotional–psychological support. Implications for Practice: Mothers of children under hemodialysis should be considered as nursing clients. Accordingly, a multidisciplinary team can empower mothers to take care of the children under hemodialysis and preserve family coherence, as well as supporting them emotionally and psychologically

Improving Nursing Care Documentation in Emergency Department: A Participatory Action Research Study in Iran

BACKGROUND: Standardization of documentation has enabled the use of medical records as a primary tool for evaluating health care functions and obtaining appropriate credit points for medical centres. However, previous studies have shown that the quality of medical records in emergency departments is unsatisfactory.AIM: The aim of this study was improving the nursing care documentation in an emergency department, in Iran.MATERIAL AND METHODS: This collaborative action research study was carried out in two phases to improve nursing care documentation in cooperation with individuals involved in the process, from February 2015 to December 2017 in an affiliated academic hospital in Iran. The first phase featured virtual training, an educational workshop, and improvements to the hospital information system. The second phase involved the recruitment of human resources, the implementation of continuous codified training, the establishment of an appropriate reward and penalty system, and the review of patient education forms.RESULTS: The interventions improved nursing documentation quality score of 73.20%, which was the highest accreditation ranking provided by Iran’s Ministry of Health and Medical Education in 2017. In other words, this study caused a 32% improvement in the quality of nursing care documentation in the hospital.CONCLUSION: The appropriate practices for improving nursing care documentation are employee participation, managerial accountability, nurses’ adherence to documentation standards, improved leadership style, and continuous monitoring and control

Level of Knowledge and Attitude of ICU Nurses toward Organ Donation and the Related Factors: A Systematic Review

Introduction: Nurses play a key role in the process of organ donation and transplantation, and previous studies have widely addressed the level of knowledge and attitude of intensive care unit (ICU) nurses in this regard. Considering the direct correlation between the positive attitude of the healthcare team, especially nurses, and the level of consent on organ donation, knowledge and attitude of nurses are important factors that have been assessed in several studies. However, no definite conclusions have been drawn in this regard. The present study aimed to evaluate the knowledge and attitude of ICU nurses toward organ donation and the related factors.Methods: A systematic review was conducted via searching in databases such as ProQuest, Medscape, MedlinePlus, MagIran, PubMed, and ScienceDirect to identify the articles published during 1990-2015 using keywords such as knowledge, attitude, organ donation, and nurses.Result: Awareness and knowledge are the main determinants of attitude in nurses, which should be applied in order to foster positive attitudes in the process of organ donation. Furthermore, extensive clinical knowledge should be acquired on organ donation and communication skills by ICU nurses through proper training programs.Conclusion: According to the results, using standard guidelines or scheduled training programs in nursing schools could improve the level of knowledge in nurses, which in turn enhances nursing performance. In addition, our findings indicated that positive attitude and knowledge of nurses could largely infleunce the viewpoint of families toward organ donation

The Evaluation of Nurse,s Clinical Decision Making in Intensive Care Unit at the Teaching Hospitals of Mashhad

Background & Objectives: Unstable condition of clinical situation of patients in Intensive Care Unit requires made nurses be competent in decision making. Despite the importance of clinical decision making in nursing, yet this is not the appropriate place in the profession. This study was conducted to evaluate the clinical decision making of nurses in Intensive Care Units of educational hospitals in Mashhad.  Materials & method: This descriptive study was conducted through stratified random on 233 nurses employed in educational hospitals of Mashhad University of Medical Sciences. PDAQ questionnaire was used to collect data. Data analysis was done using descriptive and inferential statistics (t -test, correlation and ANOVA) in SPSS V.16.  Results: The results showed that nurses participation was in the average level at all phases of clinical decision making consist of identifying the problem (33.1±10.7), present of the solutions (34.1±10.3) and implement the solution (32.1±9.7). Nurses were acquired the highest score in the phase of present and evaluation of alternative solutions and lowest score in the phase of implement the solution.  Conclusion: According to results of this study, nurses� participation was in the average level at all phases of clinical decision making. It seems that nursing education programs are not effective to enhance clinical decision making skills; therefore, the results of this study can be used to improve clinical decision making in nursing education and continuing education programs

Enclosed in the synergistic rings of suffering: The experience of conscious patients under mechanical ventilation in the intensive care unit of the causes of suffering

Background: Patients undergoing mechanical ventilation in intensive care units are in a special position of suffering, and discovering their experiences in the painful situations of the intensive care unit can contribute greatly to improve the quality of nursing care for them. Objective: The present study was performed aiming to explain the experience of conscious patients receiving mechanical ventilation in the intensive care units of the causes of suffering. Methods: This is a qualitative content analysis study conducted in Iran in 2017. Participants of this study included 15 conscious mechanically ventilated patients in the intensive care unit. Semi-structured interviews and observations were used to collect data. For sampling, first, the purposeful and then theoretical methods (guided by the created categories) were used and the procedure continued until saturation of the data. The text of the handwritten notes of recorded interviews were analyzed using conventional qualitative content analysis. Results: Four subclasses of "unpleasant consequences of disease", "bitter elixir of therapy", "an inconvenient environment" and "understanding the threat to family safety and comfort" all under the general category "enclosed in the synergistic rings of suffering" were extracted from the profound descriptions of contributors. Conclusion: Mechanically ventilated patients in the intensive care unit are enclosed in the rings of suffering, so that each of these rings imposes a great deal of pain and suffering on the patient and have a synergic and intensifying effect on each other. Therefore, design and application of strategies and nursing care is essential to reduce the severity of the suffering and discomfort of these patients

Psychosocial Interventions by Nurses for Patients with HIV/ AIDS: A Systematic Review

Introduction: Providing psychological support is one of the traditional roles of nurses for patients with HIV/AIDS. Searching the literature showed that various psychological interventions have been performed by nurses to support HIV/AIDS patients; however, no summary of these interventions is available. We aimed to systematically review the interventional studies which investigated the effectiveness of psychosocial interventions delivered by nurses to HIV/AIDS patients. Methods: This systematic review was performed based on Cochrane’s handbook of systematic reviews of interventional studies. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement were used in this study. The databases of PubMed, Web of Science, Cochrane, Scopus and World Health Organization were searched from January 2009 to December 2022. Based on inclusion criteria, nine studies included in this systematic review. Cochrane data extraction form was used for the systematic review and the article’s information was summarized using the modified Jadad scale. Results: The interventions provided by the nurses included: virtual and face-to-face educational programs, written information resources, palliative care, motivational interview, case management, home visit, and care services, along with face-to-face and telephone follow-up. These interventions have a significant positive effect on the quality of life and management of high-risk behaviors, disease management, symptoms and complications, adherence to treatment, immune function, and mental health in patients with HIV/AIDS. Conclusion: The results of the present study show that despite the fact that the interventions have a purely psychological content and can be done with various methods, they are able to have positive consequences in physical, psychological, behavioral, and laboratory health in HIV/AIDS patients

Nursing intervention for quality of life in patients with ostomy: A systematic review

Background: Ostomy-related challenges in everyday life may negatively affect patients' Quality of Life (QL), even long after ostomy surgery. Nurses provide care interventions that may have a significant effect on the patients' QL. Therefore, the purpose of the present study was to determine evidence of effective nursing interventions on the QL of patients with an ostomy. Materials and Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. English articles published from 2000 to 2021 were identified and retrieved from PubMed, Medscape, MedlinePlus, ScienceDirect, Web of Science, Scopus, Wiley Online Library, ProQuest, ClinicalKey, SAGE, IRCT, and Cochrane. We assessed all included studies (18 articles) using the JBI Critical Appraisal Checklist. Results: Interventions reviewed in the study were categorized based on intervention, content of nursing intervention, training method, and target group of the nursing intervention. The nursing interventions involved natural treatments, self-care, and psychological support for patients. The training methods used in the studies included demonstration and lecture, mixed media presentation including PowerPoints, and Internet tools such as WeChat Applications. Some interventions were only presented to patients, caregivers, caregivers and patients together, or peer patients. Conclusions: According to the results of the present study, it is suggested that a regular care plan be used with the participation of families and patients from pre-operational to discharge along with nurses' follow-ups and home care to promote the QL. A combination of self-care and psychological education can promote these patients' QL

The Elixir of Visiting: A Qualitative Study on the Experiences of Conscious Mechanically Ventilated Patients in Intensive Care Units Regarding Visiting Family Members

Background: Visiting family members is one of the basic human needs; however, there is contradictory evidence about the advantages and disadvantages of the existing visiting systems.  Therefore, the investigation of patients’ preferences for the visiting strategies, and achievement of their authentic experiences can significantly contribute to decision-making about the type of acceptable and approved policies in this domain. Aim: The aim of this study was to explain the experiences of conscious patients undergoing mechanical ventilation in Intensive Care Units regarding their visits with their family members. Method: This qualitative study was conducted on 15 conscious mechanically ventilated patients admitted to the Intensive Care Unit in Iran in 2017. The data were collected using semi-structured interviews and observations. The sampling was performed through purposive sampling technique, which was continued until data saturation to select the individuals with rich experiences about the subject under investigation. The data were analyzed through the conventional type of qualitative content analysis. Results: Out of the initial 385 codes, 11 subthemes and 5 main themes were extracted during the analysis process, all of which were placed under the general concept of “the elixir of visiting”. The five main themes included visiting as a healing agent, visiting as an agent for the enhancement of perceived support, visiting as an agent for gaining hope, visiting as the patient’s urgent need, and preference for planed visiting. Implications for Practice: The results of the present study showed that visiting was like an elixir for the conscious patients undergoing mechanical ventilation in the Intensive Care Units. This practice could allay lots of their pains and lead to numerous valuable effects, such as elimination of loneliness and sadness, increased hope for survival and recovery, and enhancement of a sense of support. Therefore, nursing authorities and managers are required to take steps in terms of redefining visiting rules and regulations in line with patients’ preferences, and thereby move towards the promotion of patient care