Patient’s Perception of Safety in the Hospital Settings: A Qualitative Systematic Review

Introduction: Patient safety is a key indicator and element in securing quality healthcare and this goal is multi-step, systemic, and multidisciplinary. The aim of the study was to investigate the meanings and definitions of “feeling of safety” in patient’s view and experiences during their hospital stay and to identify the antecedents and consequences of the concept.Methods: This qualitative systematic review was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009. Six databases (PubMed, Web of Science, Scopus, ProQuest, Embase, Cochrane) were searched up to 2019 with no time and language limit. Two authors individually evaluated the study quality using Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data from studies meeting the inclusion criteria were analyzed with concept analysis using of Walker and Avant approach (2011).Results: Twenty-five papers were included in this study. Data analysis resulted finally in eleven main categories: “receiving safe care”, “appropriate physical environment”, “resorting to spirituality”, “having previous negative experiences”, and “presence of family and friends”, “Feeling of Protection in a Safe Place”, “Emotional Enrichment and Confidence”, “Comfort and Tranquility”, “Feeling of Control on the Situation”, “Optimism towards Life” and “Coping”.Conclusions: Safe care is one of the fundamental needs in creating feeling of safety in patients. Focusing on this type of patient-centered care may promote quality care and improve the treatments provided in the hospital setting

Effect of Angiography Room Orientation Tour on Anxiety of Patients Awaiting Cerebrovascular Angiography

Abstract Introduction: Cerebrovascular angiography is a method of diagnosing cerebrovascular disorders. Invasive procedures induce anxiety in patients. Poor management of anxiety may be life-threatening for patients. It is the duty of nurses to reduce anxiety. Given the prevalence of anxiety in patients awaiting cerebrovascular angiography and its detrimental complications and also the critical role of nurses in the psychosomatic support of patients and their struggle to reduce anxiety, the use of different methods of patient education such as familiarizing them with diagnostic and therapeutic processes is of utmost significance. This study investigated the effect of orientation tour on anxiety in candidates of cerebrovascular angiography. Methods: In this experimental study, 114 patients awaiting cerebrovascular angiography presenting to Imam Hussein Hospital and Shohadaye Tajrish Hospital in Tehran, capital of Iran, were selected with a convenient sampling method and assigned randomly to either case or control groups. The control group just received routine education in the ward. In contrast, the case group received routine education in the ward and instructions on performing angiography and its pre-, peri-, and post-operative care. Demographics questionnaire and the Depression Anxiety Stress Scale (DASS-21) were used to collect data. Patients' anxiety was measured twice with this instrument at hospitalization and after the intervention. The gleaned data were analyzed with SPSS21 using independent t-test, Chi-square test, and ANOVA. Results: Distribution of age was the same in both groups (P < 0.11). Independent t-test showed a significant difference in the mean score of anxiety before intervention in the control group (9.2) and case group (7.2) (P = 0.02). This test also indicated a significant difference in the mean score of patients' anxiety after intervention in both the control group (9.7) and case group (6.7) (P = 0.001). However, using data collected before the orientation tour as the covariate, repeated measures ANOVA showed a significantly more significant reduction of anxiety in the case group. Conclusions: According to our findings, participation in the angiography room orientation tour leads to reduced anxiety in patients awaiting cerebrovascular angiography. The use of this method is advisable for patients before diagnostic and therapeutic processes

Factors Related to Functional Independence in Daily Activities of Older People with Osteoarthritis in Mashhad, Iran in 2016

AbstractIntroduction: Osteoarthritis is one of the leading causes of disability and reduction of functional independence in older people. The present study was conducted to investigate the factors related to functional independence in daily activities of older people with osteoarthritis in Mashhad, Iran.Methods: In this descriptive-correlational study, 300 older people with osteoarthritis who had referred to rheumatology clinics of Mashhad University of Medical Sciences Hospitals in Mashhad in 2016 were selected and entered in the study by available sampling method. Data collection tools in this study included demographic information questionnaire and scale of activities of daily living, the validity and reliability of which were measured. SPSS-21 software was used for data analysis.Results: The age average of the study subjects was 70.75 (± 7.27). The older people with higher education levels, male gender, married and who lived with a spouse or spouse and children, lower in age, economically independent (higher income and working), lower body mass index, the ones with less duration of osteoarthritis, ones who did not need to use assistive devices, did not suffer from the lack of joint mobility, and did not have hip osteoarthritis, had more independence in activities of daily living (P value < 0.05).Conclusions: According to the obtained results and related factors from this study, it is necessary that more accurate planning be considered to prevent, control and manage factors leading to the dependence of older people

The effect of continuous-educational program in interferon therapy on quality of life in patients suffering from Hepatitis B and C.

چکیده: زمینه و هدف: مؤثرترین روش در درمان بیماران مبتلا به هپاتیت های مزمن B و C درمان ترکیبی با اینتروفرون می باشد. این درمان ها به هر حال درجات مختلفی از عوارض جانبی ایجاد می کنند که ممکن است تأثیر منفی بر روی حیات بیمار، تعاملات اجتماعی و توانایی انجام کار و دیگر فعالیت های آنها داشته باشد. هدف از این مطالعه بررسی تأثیر آموزش نحوه مصرف صحیح اینترفرون، کنترل عوارض جانبی و پی گیری بیماران به مدت 28 هفته بر روی کیفیت زندگی بیماران مبتلا به هپاتیت B و C بود. روش بررسی: این پژوهش یک پژوهش نیمه تجربی است که به صورت پیش آزمون- پس آزمون بر روی بیماران مبتلا به هپاتیت مزمن B و C کاندید اینترفرون تراپی در مرکز هپاتیت تهران صورت گرفت. تعداد 60 بیمار به روش نمونه گیری در دسترس با توجه به مشخصات نمونه انتخاب و به طور تصادفی در گروه شاهد و آزمون (30 نفر شاهد، 30 نفر آزمون) قرار گرفتند. ابزار گردآوری داده ها پرسشنامه اطلاعات دموگرافیک و پرسشنامه کیفیت زندگی ویژه بیماران کبدی ( CLDQ=Chronic Liver Disease Questionnaire) بود. برای گروه آزمون و همراهان برنامه آموزشی به صورت 4 جلسه 45 دقیقه ای اجرا شد و بیماران به مدت 28 هفته پیگیری شدند. کیفیت زندگی بیماران هپاتیتی در دو مرحله قبل و 28 هفته پس از شروع اینترفرون تراپی و اجرای برنامه آموزشی سنجیده شد و در پایان کیفیت زندگی در دو گروه با استفاده از آزمون های همبستگی و کای دو، من ویتنی و ویلکاکسون مقایسه گردید. یافته ها: قبل از اجرای مداخله متغیرهای دموگرافیک و امتیاز کلی کیفیت زندگی در دو گروه اختلاف معنی داری مشاهده نشد. میانگین امتیاز کلی کیفیت زندگی در گروه آزمون از 4/21±6/158 به 17±4/183 افزایش یافت (001/0p) امتیاز کلی کیفیت زندگی پس از مداخله بین دو گروه دارای تفاوت معنی دار بود (001/0

Effects of a self-care program on quality of life of cirrhotic patients referring to Tehran Hepatitis Center

BACKGROUND: Chronic liver disease especially liver cirrhosis is one of the medical problems that substantially reduces the quality of life of its victims. Because of the chronic and irreversible nature of the disease, it needs self-care programs to be developed according to client's needs and to maintain their independence and sense of well-being. The purpose of this study was to determine the effects of a self-care educational program on Quality of Life (QoL) of a sample of Iranian cirrhotic patients. METHODS: A quasi-experimental study was conducted on 44 cirrhotic patients in Tehran Hepatitis Center. Longitudinal case registry and random allocation technique were used to divide the sample into experimental (n = 21) and control (n = 23) groups. Chronic liver disease questionnaire (CLDQ) was used for measuring the quality of life. The experimental group was given a questionnaire to assess their educational needs. A self-care educational program was conducted and the patients were followed for 3 months. Then the quality of life of both groups was compared using descriptive and analytical statistics. RESULTS: The experimental and control groups were the same concerning the effective factors on the quality of life, such as age, sex, etc (P > 0.05). There was no significant difference between QOL mean score of both groups before the intervention, however the QoL significantly improved in the experimental group after the intervention (P= 0.001), while the QoL decreased in control group. CONCLUSION: The result of the present study confirmed the positive effects of the educational and self care programs on the QoL of cirrhotic patients. Extensive educational and self-care programs along with long-term follow up such as the program conducted in this study are suggested

The Effect of Education on Quality of Life in Patients under Interferon Therapy

Background and Aims: The main purpose of treating and caring for patients with chronic viral hepatitis is to promote life satisfaction and a feeling of well-being in patients suffering from this disease. The aim of this study was to evaluate the effect of education on quality of life in patients with chronic hepatitis who were treated with Interferon alpha. Methods: This quasi-experimental study was conducted on 60 patients with viral hepatitis. The intervention included teaching them the method of self injection of Interferon alpha 2 b, giving them educational pamphlets and then following their continuing treatment with interferon. Patients were randomly assigned to two 30-patient groups. The data- gathering tool was a demographic characteristics questionnaire and the Quality of Life Questionnaire for Patients with Chronic Liver Disease (CLDQ). The educational program was done in four 45- minute sessions for the case group and their relatives. The follow-up period was 12 weeks. Quality of life in patients with chronic hepatitis was measured before initiating interferon therapy, and after the educational period. Quality of life in the two groups was compared. Results: The total quality of life score in the two groups before therapy did not show any significant difference (P = 0.351); while 12 weeks after education there was a significant difference between the two groups (P < 0.001) in three items including abdominal symptoms (P = 0.01), worry (P < 0.001) and emotional factors (P < 0.001). The other three items did not show a significant difference between the two groups. The total quality of life score in the case group was significantly different before and after education (P < 0.001), and improved after education. The total quality of life score in the control group did not differ significantly after 12 weeks (P = 0.143). Conclusions: Planning short and simple educational programs has a significant effect on the patient's control of his/her disease and its side effects; and can improve quality of life, life satisfaction, and mechanisms of coping with treatment in patients with viral hepatitis

The Lack of Systematic Training for Health Care Providers, A Challenge for Providing Pediatric Palliative Home Care: A Comparative Study

Background: The growing prevalence of chronic diseases in children has increased their need for palliative care. We aimed to compare pediatric palliative care and home care training in Iran and in the selected countries. Materials and Methods: This comparative study was conducted based on the classifications of palliative care for children and using databases such as Scopus, Science Direct, Ovid, ProQuest and Medline, websites affiliated with communities and associated with palliative care and home care services and according to the framework of World Health Organization’s Public Health Road Map. The selected countries consist of England, Canada, Australia and South Africa, where home care services are provided for children in addition to palliative care. Results There is a pediatric palliative care training program for doctors in the selected countries. Home care is part of these programs in these countries. Despite the lack of an independent nursing course in postgraduate education in England, Canada, and Australia, community health nurses are responsible for providing care responsible to provide care for children with life-threatening diseases in the community and at home. In South Africa, a home-based palliative care training and support package for children was designed for community care workers. In Iran, pediatric palliative care is in the early stages and home care is evolving as a need. Conclusion Education is the most important factor for integrating home care and pediatric palliative care into the health system. In countries with advanced pediatric palliative care, the knowledge and skills of care providers have been considered. In Iran, revising medical and nursing curriculums and the integration of palliative care and home care programs into the curriculum are essential

A Comparative Analysis of Clinical Characteristics and Laboratory Findings of COVID-19 between Intensive Care Unit and Non-Intensive Care Unit Pediatric Patients: A Multicenter, Retrospective, Observational Study from Iranian Network for Research in Viral

Introduction: To date, little is known about the clinical features of pediatric COVID-19 patients admitted to intensive care units (ICUs).&nbsp;Objective: Herein, we aimed to describe the differences in demographic characteristics, laboratory findings, clinical presentations, and outcomes of Iranian pediatric COVID-19 patients admitted to ICU versus those in non-ICU settings.&nbsp;Methods: This multicenter investigation involved 15 general and pediatrics hospitals and included cases with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive real-time reverse transcription polymerase chain reaction (RT-PCR) admitted to these centers between March and May 2020, during the initial peak of the COVID-19 pandemic in Iran.&nbsp;Results: Overall, 166 patients were included, 61 (36.7%) of whom required ICU admission. The highest number of admitted cases to ICU were in the age group of 1–5 years old. Malignancy and heart diseases were the most frequent underlying conditions. Dyspnea was the major symptom for ICU-admitted patients. There were significant decreases in PH, HCO3 and base excess, as well as increases in creatinine, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and potassium levels between ICU-admitted and non-ICU patients. Acute respiratory distress syndrome (ARDS), shock, and acute cardiac injury were the most common features among ICU-admitted patients. The mortality rate in the ICU-admitted patients was substantially higher than non-ICU cases (45.9% vs. 1.9%, respectively; p&lt;0.001).&nbsp;Conclusions: Underlying diseases were the major risk factors for the increased ICU admissions and mortality rates in pediatric COVID-19 patients. There were few paraclinical parameters that could differentiate between pediatrics in terms of prognosis and serious outcomes of COVID-19. Healthcare providers should consider children as a high-risk group, especially those with underlying medical conditions

Nurses’ experiences of the role of organizational and environmental factors in the development of love of the profession: a qualitative study

Abstract Background Love of the profession has significant relationship with nurses’ job motivation and care quality. However, there is limited information about organizational and environmental factors affecting love of the profession among nurses. Aim This study aimed at exploring nurses’ experiences of the role of organizational and environmental factors in the development of love of the profession. Methods This qualitative study was conducted in 2020–2021 using the conventional content analysis approach. Participants were Fifteen Iranian nurses with deep love of the profession, nursing instructors, and nursing managers purposefully selected from different healthcare and academic settings in seven large cities of Iran. Data were gathered via semi-structured interviews and were analyzed via the conventional content analysis method proposed by Graneheim and Lundman. Results Organizational and environmental factors affecting the development of love of the profession were grouped into three main categories: The social context of the profession (with two subcategories), family support (with two subcategories), and organizational health (with four subcategories). Subcategories were respectively historical context of the profession, the evolving context, emotional family support, instrumental family support, quality of interpersonal relationships in the organization, level of organizational justice, level of authority delegation to nurses, and level of organizational support. Conclusion Different organizational and environmental factors can affect nurses’ love of the profession development. Improving public image of nursing, providing nurses with stronger support, improving organizational climate, and strengthening interpersonal relationships in healthcare settings are recommended to develop nurses’ Love of the profession