Novice Nurses’ Perception of Working Night Shifts: A Qualitative Study

Introduction: Nursing is always accompanied by shift working and nurses in Iran have to work night shifts in some stages of their professional life. Therefore, the present study aimed to describe the novice nurses’ perception of working night shifts. Methods: The present qualitative study was conducted on 20 novice nurses working in two university hospitals of Jahrom, Iran. The study data were collected through focus group interviews. All the interviews were recorded, transcribed, and analyzed using constant comparative analysis and qualitative content analysis. Results: The study findings revealed five major themes of value system, physical and psychological problems, social relationships, organizational problems, and appropriate opportunity. Conclusion: The study presented a deep understanding of the novice nurses’ perception of working night shifts, which can be used by the managers as a basis for organizing health and treatment systems

Spiritual Experience of Heart Attack Patients: A Qualitative Study

Introduction: There are few studies on the spiritual experiences of myocardial infarction patients in the light of cultural context. Therefore, the aim of this study was to explain the spiritual experiences of patients during heart attack. Method: This was a qualitative study. Nine (4 women, 5 men) myocardial infarction patients were interviewed (in-depth interview) in the CCUs of three hospitals in Shiraz. In addition, seven nurses participated in a focus group. Data gathering and analysis were performed simultaneously and continued until data saturation. All the interviews were tape-recorded and transcribed verbatim. Thematic analysis method was used for data analysis. Results: The participants’ spiritual experiences were categorized into four themes and 11 subthemes. The main themes were trust in God, struggling with the heart, family (soothing and stress-inducing), and help-seeking. Conclusion: According to the results heart attack can bring spirituality in greater focus. Therefore, in order to deliver holistic care, health care providers must be concerned with their patients’ spiritual experiences and needs, especially in life-threatening events Keywords: Spiritual experience, Spirituality, Heart attack, Holistic care, Qualitative stud

Effects of the Problem Solving Technique in Type 2 Diabetic Patients with Cognitive Impairment: A Randomized Clinical Trial

Background: Diabetes mellitus is a common metabolic disorder, one of the lesser known of whose consequences is cognitive disorder. This study aimed to evaluate the effects of problem-solving technique in type 2 diabetic patients with cognitive impairment. Methods: This randomized clinical trial was conducted in the south of Iran between December 2014 and April 2015. 96 type 2 diabetic patients with cognitive impairment were randomly divided into two groups. The patients in the intervention group attended classes on problem-solving skills, while the patients in the control group attended the usual classes in the clinic. The quality of life, self-management profile, metabolic indexes of the patients in both groups were measured before and three months after the experiment. Data were analyzed using SPSS version 16.0. Paired t-test, independent t-test, Wilcoxon, Mann-Whitney and Chi-Square tests were used. Results: The differences between the groups’ levels of HbA1c (P=0.02) and HDL (P=0.02) were significant, but the differences between their FBS, cholesterol, triglycerides and LDL were not significant (P>0.05). The mean difference of the changes in the quality of life (P<0.001) between the intervention and control groups was significant. The differences between the two groups in the area of self-management were as follows: patient’s anxiety management (P<0.001), patient’s capability in using medicine (P<0.001), healthy eating (P<0.001), weight management (P=0.02), and confidence in one’s ability to manage his/her diabetes (P<0.001). Conclusion: Applying problem-solving technique significantly enhanced self-management, quality of life and metabolic indexes in type 2 diabetic patients with cognitive impairment. Trial Registration Number: IRCT2014041517283N

Effect of the BASNEF Model on Maternal-Fetal Attachment in the Pregnant Women Referring to the Prenatal Clinics Affiliated to Shiraz University of Medical Sciences

Background: Prenatal attachment and positive adaptation with the concept of motherhood play a pivotal role in maternal and fetal health. The present study aimed to evaluate the effect of the beliefs, attitudes, subjective norms, and enabling factors (BASNEF) model on maternal fetal attachment in the pregnant women referring to prenatal clinics. Methods: This quasi-experimental study was conducted on 100 nulliparous women in their third pregnancy trimester (36-41 weeks), who referred to the selected prenatal clinics in Shiraz, Iran during 2011-2012. Intervention was performed based on the BASNEF model in six training sessions for 90 minutes. Data collection tools were the Cranley’s maternal-fetal attachment scale and BASNEF model. Data analysis was performed in SPSS version 18 using Pearson’s correlation-coefficient, independent t-test, and Chi-square at the significance level of 0.05.Results: After the intervention, a significant difference was observed in the mean score of maternal-fetal attachment in the intervention group compared to the control group (

Nursing Students\' Perspective toward Clinical Learning Environment

Introduction: The prosperity of nursing educational programs depends on the efficiency and sufficiency of clinical experiences. One of the most important factors recognized in this field is learning environment. In this study, different aspects of clinical environment have been evaluated from students' viewpoints. Methods: All interns attaining clinical experiences in the wards of pediatrics, neurosurgical ICU, recovery, surgical ICU, surgical emergencies, men medical emergencies, and obstetrics and gynecology took part in this descriptive cross-sectional study. Data gathering tool was a 50 item questionnaire developed through combining two questionnaires of clinical learning environment scale and clinical learning environment and supervision. Students assessed their clinical environment by completing this questionnaire during the second semester of 2006-2007 academic year. Data was analyzed by SPSS software using ANOVA and Post-hoc tests in order to compare the means of the ranks. Results: The mean of given ranks to the learning environment of different wards varied from 1.4 to 4.1 out of five. Four wards of surgical emergencies, male medical emergencies, pediatrics and recovery received a score of 3 or less while, other 3 wards had a score between 3 and 4. The evaluated wards were different in 6 of the variables including management pattern of ward administrator, learning in the ward, the commitment of nursing supervisor, the manner of communication with patient, the relationship between personnel and students, and students' satisfaction. But, no significant difference was observed in nursing students' percep-tion of the ward's atmosphere, the status of nursing care, and interpersonal and supervision relationships in different wards. Conclusion: From the students' viewpoints, learning environment and its related variables vary in different wards. More attention has to be paid to the quality improvement of different wards

Senior Medical Students\' Self Evaluation of their Capability in General Competencies in Shiraz University of Medical Sciences

Introduction: Evaluating graduates' proficiencies can provide a helpful reflection of medical education performance and lead to its improvement. The aim of this study was to assess general competencies of final year medical students from their own viewpoints. Methods: In this descriptive–evaluative study, 71 graduating students of Shiraz University of Medical Sciences evaluated themselves based on a 101 item evaluation form with Likert scale, in 17 general medical competencies. Calculating the mean scores given to the items related to each competency, their score in each competency was determined. Results: Medical graduates of this university had the mean scores of more than 3.5 for each competency. The highest scores belonged to the competencies including case presentation (4.94±0.75), basic procedures (4.83±0.47), tests interpretation (4.69±0.53), and diagnostic decision-making (4.69±0.66). The lowest scores belonged to geriatrics (3.56±0.75), nutrition (3.56±0.84), practice management (3.73±0.80), and advanced procedures (4.02±0.75), respectively. Conclusion: The medical education program in Shiraz University of Medical Sciences is more patient-centered rather than community oriented. Therefore, improving the competencies needed by the society such as geriatrics, nutrition, practice management, and advanced procedures requires more attention in the educational programs as well as continuing medical education. Improving these competencies can result in a better care delivery by general practitioners in the community

Nursing Students\' Experiences in Reflective Thinking: A Qualitative Study

Introduction: Reflective thinking has been emphasized as an effective educational strategy by many researchers but there are few qualitative researches regarding the results of its application. This research was conducted to find out the mechanisms by which reflection on practice affects clinical experiences. Methods: This qualitative study was performed as grounded theory. The participants were twenty 4th year nursing students having 10 weeks experience of reflective thinking program. A guide on reflective thinking was given to students who were asked to write their thoughts about experiences obtained in clinical environment in their personal journals and give them to the researcher on a weekly base. Then, they received an appropriate feedback based on the scales of reflective thinking levels and thinking strategies in nursing. At the end of the mentioned time, students participated in focus group interviews in two groups of ten. Transcripts were analyzed through qualitative method and were coded in three stages during which the data were categorized and named. The names of categories are the themes of this study. Results: Findings demonstrated that the process of reflective thinking influencing clinical experience emerges in 5 domains of caring, thinking, theory and practice integration, self-regulatory mechanisms and motivation. Conclusion: Students’ experiences in reflective thinking show that reflective thinking leads to having holistic approach toward patients, affecting thinking, integrating theory and practice, and improving self-regulatory mechanisms and motivation. Motivation variable as a central variable influences 4 other themes and is also affected by them. The element of motivation could be added to this cycle as a central variable. Integrating reflective thinking in nursing programs is recommended

The effects of training based on BASNEF model and acupressure at GB21 point on the infants’ physical growth indicators

objective: Educational models are used to study the behavior and plan for changing and determining the factors that affect the individuals’ decision making for conducting a behavior. This study aimed to compare the effects of the educational program based on BASNEF model and acupressure at GB21 point on the infants’ physical growth indicators.Methods: This clinical trial was conducted on 150 (50 per group) pregnant women in 2011-2012. The interventions included educational program based on the BASNEF model and application of acupressure at GB21 point. The infants’ physical indicators were compared to the control group one and three months after birth. The study data were analyzed using repeated measurement test, paired sample T-Test, one-way ANOVA, and Tukey’s test.finding: The results showed a significant difference between the intervention and the control group regarding the infants’ weight and height one and three months after birth (p0.05). Also, no significant difference was observed among the three groups concerning the infants’ head and arm circumference (P>0.05).Conclusion: BASNEF model improved the infants’ height and weight. Application of acupressure also improved the infants’ height, weight, and head and arm circumference compared to the control group. Hence, learning and application of techniques and models by the medical team are highly essential

The effect of empowerment on the self-efficacy, quality of life and clinical and laboratory indicators of patients treated with hemodialysis: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Hemodialysis patients face numerous physical and psychological stresses that result in reduced health. The aim of this study is to determine the impact of an empowerment program on self-efficacy, quality of life, clinical indicators of blood pressure and interdialytic weight gain, and laboratory results in these patients.</p> <p>Methods</p> <p>This randomized, controlled trial was conducted at Boo Ali Sina Dialysis Center, Shiraz, Iran. A total of 48 hemodialysis patients participated in this study. After acquisition of informed consent, eligible patients were randomly divided into two groups, control and experimental. Pre-test data were obtained by using a demographic data form and two questionnaires for self-efficacy and quality of life. Blood pressure and interdialytic weight gain were measured. We extracted laboratory data from patients’ charts. A six-week empowerment intervention that included four individual and two group counselling sessions was performed for the experimental group. Six weeks after intervention, post-test data were obtained from both groups in the same manner as the pre-test. Data were analyzed by ANCOVA using SPSS v11.5.</p> <p>Results</p> <p>There were no statistically significant differences in demographic variables between the groups. Pre-test mean scores for self-efficacy, quality of life, blood pressure, interdialytic weight gain and laboratory results did not differ between the groups. There was a significant difference between the experimental and control groups in terms of pre-to post-intervention changes in overall self-efficacy scores, stress reduction, and decision making, in addition to overall quality of life and all dimensions included within quality of life based on this questionnaire. Additionally, the pre- to post-intervention changes in systolic/diastolic blood pressures, interdialytic weight gain, hemoglobin and hematocrit levels significantly differed between the groups.</p> <p>Conclusion</p> <p>Our study demonstrates that a combination of individual and group empowerment counselling sessions improves self-efficacy, quality of life, clinical signs, and hemoglobin and hematocrit levels in hemodialysis patients. Empowerment of hemodialysis patients should be considered in hemodialysis centers to assist patients with the management of their health-related problems.</p> <p>Trial registration</p> <p>Irct ID: IRCT138901172621N4</p

Comparing the Effect of Teaching Breast Self-Examination by Peers and Health Care Personnel on Students Knowledge and Attitude

Introduction: Training breast self-examination by peers provides an appropriate situation in order to form proper health behaviors during the adolescence age. The aim of this study was to compare the effect of training breast self-examination by peers and health care personnel on students' knowledge and attitude. Methods: In this quasi-experimental study, 112 students from two schools of dentistry and management of Shiraz University of Medical Sciences were selected randomly and were allocated in two groups. They were taken a pre-test and two post-tests. Data gathering tool was an assessment test evaluating their knowledge about breast cancer and self-examination and their attitude toward breast self-examination. Four or five students from each class were selected and trained as peer instructors. Students of the first group were trained by peers and the students in the second group were instructed by health care personnel separately using booklet. At the end of educational sessions, the first post-test, and after 6 weeks, the second post-test were taken. Statistical analysis was performed using paired t-test and independent t-test, repeated measure ANOVA, and factor analysis test. Results: There was a significant difference between knowledge and attitude scores of the two groups immediately after education, so that, the mean score of knowledge in the group trained by peers was higher than the one educated by health care personnel. But, no significant difference was observed between the attitude scores of the two groups, 6 weeks after education. Comparing the knowledge and attitude scores, before, immediately after and 6 weeks after education showed a significant difference in each group. Conclusion: The efficacy of training breast self-examination by peers is higher than by health care personnel. It is recommended to employ this educational method more, especially in training self-examination