Stressors of Parents of Hospitalized Preterm Infants: a study in Neonatal Intensive Care Unit of Afzalipour Hospital, Kerman, Iran

Background: Birth is a pleasant event, but premature birth and subsequently neonate hospitalization in the neonatal intensive care unit, is stressful for parents. Therefore, identifying sources of stress and applying strategies to reduce parental stress seems to be necessary. The present study was conducted to determine the sources of stress in parents of preterm infants hospitalized in the neonatal intensive care unit of Afzalipour Hospital in Kerman, Iran. Methods: In this descriptive analytic study, 154 parents of premature infants hospitalized in the neonatal intensive care unit completed the Parent Stressor Scale questionnaire. Data analysis was done using descriptive statistics and through SPSS19 software package. Results: According to the results, participants experienced a moderate level of stress during hospitalization of their preterm infant (2.61± 0.69). Among "environmental stressors", the sound of the monitor alarm, among "parental role alteration stressors", parents' despair in supporting their neonate against pain and painful procedures, and among stressors related to the "appearance and behavior of infants", observing neonate in pain brought the highest level of stress to parents. Parents experienced different levels of stress according to some personal characteristics such as relationship with baby, previous history of hospital admission and type of stay in the ward. Conclusion: Since preterm birth and neonate hospitalization causes parents' stress, it is necessary that medical staff, in addition to neonate care, support parents of the neonate in order to decrease their stress level and consequently prevent negative outcomes for their neonate and family

effectiveness of their teaching skills to reduce stress job psychological empowerment of nursing staff in intensive care units in the center of Shiraz Shahid Rajaee 1392 .

Background and aims: Nurses of critical care wards are faced with a number of stressors that could also threaten the ability of those affected various aspects of health and undermine the quality of their performance. The role of psychological empowerment skills training to reduce stress among working nurses in intensive care wards is unknown. This research was aimed to determine the efficacy of psychological empowerment skills training to reduce stress among working nurses in intensive care wards in medical center of Shahid Rajaee in Shiraz was conducted in 2013. Methods: In this quasi-experimental study, 120 working nurses in intensive care wards randomly divided into interventional and control groups. Then, the workshop of self-empowerment skills training was performed for experimental group and a month after their training psychological empowerment, data were collectd using Osipow questionnaire in both groups. Data was analyzed using SPSS software and t-test, ANOVA, paired t-test, Chi-square and Mann-Whitney tests. Results: The mean score of job stress before training in the control group was 256.68±14.81 in intense level and after training) without training was 265.8±5.16 in severe level. Mean stress scores before training in the intervention group was 269.26±6.18 in intense level and after training was 251.70±17.97 in moderate level. There were significant differences between stress score mean before and after intervention (P=0.002). Conclusion: According to existing stress in the nursing profession; psychological empowerment can be effective to reduce stress and increase the quality of their nurses

Silent Screams: Experiences of Caregiver Suffering by Parents of Children with Thalassemia: A Qualitative Study

Introduction: Thalassemia is associated with severe blood disorders and hemolysis. As is the case with other chronic diseases, parents who care for these children tolerate insufferable pain. Given the importance of suffering in nursing, understanding this concept seems necessary in order to provide appropriate care based on their experience. This study aims to understand caregiver suffering experience of parents of children with thalassemia. Method: This was a qualitative study conducted with a content analysis approach. A total of 21 participants were selected from parents referred to the thalassemia ward of a university hospital in Kerman, Iran, by the theoretical purposive sampling method. Data were collected through recorded semistructured interviews that were transcribed verbatim and analyzed by the Lundman and Granheim’s content analysis method. Results: Data analysis resulted in the emergence of the four categories of living with hardship, stigma and labeling, parental concerns, and the role of a support network, all of which were incorporated into the parental suffering theme. Conclusion: The results indicate that parents as caregivers for children with thalassemia suffer intensely, but silently. Perhaps the results of this study can attract the attention of authorities and cause them to provide assistance for these parents. Keywords: Caregiver suffering, Parents, Thalassemia, Qualitative stud

Effects of simulation-based education on Ghanaian parents’ knowledge, attitude and management of fever control

Background: Childhood fever is very discomforting and most parents are usually anxious when children exhibit fever, leading to unnecessary visits and admissions into pediatric emergency centers.Objectives: This study aimed to determine the effects of simulation-based education on parents’ knowledge, attitude, and management of fever in children.Methods: A non-randomized quasi-experimental study using convenient sampling was conducted to recruit parents of children aged 3 months to 8 years admitted to the Tamale Teaching Hospital in Tamale, Ghana. The study was conducted from July to September 2019. Eighty parents were equally assigned into an intervention group and a control group and respectively educated using simulation-based and routine education approaches on childhood fever. Data were collected using a four-part questionnaire and analyzed using descriptive statistics, Chi-square, independent samples t, and paired t tests as well as analysis of covariance.Results: Except for the mean baseline knowledge (P< 0.0001), there were no significant differences between the two groups in mean pretest scores. The mean scores of fever knowledge, attitude, and management of parents in the simulation-based education group were 21.63 ± 2.40, 28.48 ± 6.03, and 25.15 ± 4.23 at baseline and increased to 26.38 ± 4.36, 28.48 ± 6.03, and 32.33 ± 5.18, respectively (P< 0.0001). All mean scores on the posttest were better than on the pretest in both groups.  However, at the posttest, mean scores for knowledge, attitude, and management were significantly higher in the simulation-based education than in the routine education group (P < 0.05).Conclusion: Compared with routine education, simulation-based education was more effective in improving parents’ knowledge, attitude, and management of fever. We therefore, recommend the use of similar simulation-based methods in educating parents regarding caring for acute fever in their children

Mental Health of Adolescents with Thalassemia Major Visiting Kerman Specific Diseases Center

Background: Beta Thalassemia is defined as a genetic disorder of globulin synthesis in which life can only be sustained by regular blood transfusion and Desferal injections. Since there are few studies concerning psychological and social adjustment of Thalassemia patients, this study aimed to assess the mental health status of adolescents with major Thalassemia visiting Kerman Specific Diseases Center during March 2006 to March 2007. Methods: This cross-sectional study was performed on 250 thalassemic adolescents. The data collection instrument was the General Health Questionnaire (GHQ-28) including 28 questions in four aspects of physical symptoms, anxiety, social dysfunction and depression. Data were analyzed through SPSS13 and using Chi-square test. Results: All patients had general health impairment. Among the four aspects evaluated, the maximum and minimum means were respectively functional disorder (14.6±4.4) and anxiety (13.5±3.4). In all four aspects, the maximum and minimum scores were respectively 7 and 28; and the percent of healthy subjects was much lower than the percent of those with mental disorders. Age group showed no significant relationship with disorder in any of the four evaluated aspects. Conclusion: Duo to the high prevalence of mental disorders in thalassemic patients' more attention to the mental health of these patients and implementing measures for prevention of mental health disorders is recommended. Keywords: Thalassemia, Mental health, Adolescen

Effect of Clustered Nursing Care on Sleep Behaviors of the Preterm Neonates Admitted to the Neonatal Intensive Care Unit

Background: Premature neonates admitted to the neonatal intensive care unit (NICU) undergo sleep disorder due to various manipulations. The present study aimed to investigate the effect of clustered nursing care on sleep behaviors in premature neonates admitted to NICUs. Methods: This clinical trial study was conducted on 60 neonates selected through convenience sampling method out of the infants admitted to the NICU. First, in the control group, a constant nurse took care of the neonates in a complete shift. The nurse observed the neonates sleep behaviors every two min for 45 min and recorded them in the questionnaire. The intervention group was investigated one week after the control group. The neonates ‘sleep behaviors were observed and recorded every two min by Prechtl instrument. All the data were analyzed by the Mann-Whitney U test using SPSS software version 16. Results: The mean sleep times in the control group were as follow: quiet sleep 5 min and 86 millisecond, active sleep 21 min and 50 milliseconds, quiet wake 4 min and 6 milliseconds,alertness9 min and 6 milliseconds, and cry1 min and 76 millisecond .On the other hand, in the neonates who received clustered care in the intervention group, the mean timings were as follow: quiet sleep time 19 min and 33 millisecond, active sleep 24 min and 66 millisecond, quiet wake 1 min and 76 millisecond,alertness2 min and 76 millisecond, and cry0.13 min. According to the mentioned times, it could be concluded that the neonates in the test group had a quiet and active sleep (P Conclusion: Findings of this study demonstrate that cluster care can significantly increase the time of quiet and active sleep in the newborns. Based on the result, it is recommended that this kind of care be provided in the NICU program, as well as in the syllabus of students and nursing retraining

Self-care in Patient with Major Thalassemia: A Grounded Theory

Introduction: Self-care is the core concept of health care and may be considered as one’s stabilization, and restoration as well as the improvement of his/her health and well-being. Looking at the process of Self-care from patients’ perspective who suffer from thalassemia may assist the nurses and health care providers to facilitate the health process. Thus this study was conducted to discover the process of self-care in patients with major thalassemia. Methods: This qualitative study was conducted with grounded theory approach. 21 patients with major thalassemia from a Medical Research Center, supervised by Kerman Medical University, were selected through purposeful and theoretical sampling. Data were collected by unstructured interviews which lasted 30-60 minutes. These data were analyzed using the method of Corbin and Strauss. Results: The main theme of "struggling to improve life quality" that included the sub-themes of "focus on needs of illness, "activating resources" and "restoring a new identity with thalassemia" were extracted from the data. This theme implies that participants endeavor to strengthen their self- efficacy via thalassemia. "Looking for strengthening self-efficacy in light of thalassemia" was the core theme in this study. Conclusion: Facilitating the process of self-care in patients with major thalassemia requires that they be helped so that their self-efficacy, influenced by real life conditions, might be strengthened in light of thalassemia. Increasing public awareness and social support may affect the recognition of individual, family and society

Parents’ experiences of living with a child with cancer undergoing hematopoietic stem cell transplantation: a qualitative content analysis study

ObjectivesPediatric Hematopoietic Stem Cell Transplant (HSCT) profoundly impacts the physical, psychological, and social aspects of parents’ lives. Thus, this study aimed to explore the experiences of parents living with a child with cancer who undergoes HSCT.MethodsThis qualitative study involved 20 parents of children with cancer who were undergoing HSCT at a referral hospital in Iran. Purposive sampling was used to select the participants from February 2023 to November 2023. In-depth semi-structured interviews, featuring open-ended questions, were utilized for data collection. Data analysis was performed using conventional content analysis.ResultsData analysis revealed two main themes. “Surrounded by hardships” and “Self-actualization.” The first theme encompassed participants’ experiences of facing difficulties in life after being aware of their child’s need for HSCT. This theme consisted of four categories: “uncertainty about the child’s future,” “exhaustion from the child’s treatment process,” “worrying about the healthy child(ren),” and “helplessness.” The second theme “self-actualization” included with two categories: “transformation in life’s philosophy” and “acquisition of new capabilities.” These categories highlighted the positive outcomes experienced by the participants following their child’s HSCT.ConclusionOur findings underscore the importance of healthcare providers being attuned to parents’ experiences throughout their child’s HSCT trajectory. It is crucial for healthcare providers to encourage parents to articulate their concerns and feelings and seek support from healthcare providers, family, and friends. The development of psychological support services in healthcare settings can facilitate tailored interventions to alleviate parents’ difficulties