[Nurses perceived worries from error disclosure: a qualitative study]

Declaration of error is an important aspect of ethic and a necessity for care. It has some benefits for client, care givers and health institution. But always, many concerns prevent health care provider to perform this important and necessary intervention. This study was conducted to clarify these concerns from the perspective of the nurses. This was a qualitative study. The study question was what is the experiences and perceptions of nurses about their worries regard to error declaration or what factors affect this concerns? Purposeful sampling was used. The data was gathered by semi-structured focus groups with 115 nurses of two major university of Iran. The data was explored and analyzed according to inductive content analysis. The data was classified in four groups, patient reaction related concerns, immediate manager reaction related concerns, job position related concerns and negative experiences from past error declaration incidences. According to the undeniable effects of [declaration of error to the patient and/or the family] on increase of safe care and reduction of error incidents, health providing system must reduce the concerns of health care providers in this area and provide appropriate context [situation] for this important caring intervention. Along with that, the reasons and benefits of error declaration should be increase by purposeful education of care givers especially health care managers and it is necessary that rules and regulations [Terms] of error declaration impose [pass] and all health care agencies should be informed to run them. [They should be communicate to run]

What do patients expect from their physicians?

To identify the most important expectations that patients have from their physicians. We collected data from 199 hospitalized and 201 ambulatory patients [response rates 88% and 93% respectively]. We used random sampling for selection of hospitalized patients and systematic sampling for the ambulatory ones. The questionnaire consisted of 18 different expectation items categorized in 5 domains. The participants scored each item from 1 ' to 9 using a VAS scale and ranked domains based on their importance. We analyzed the data using univariate and regression analyses. Among the ambulatory patients, the mean +/- standard error of the most important expectations was as follows: competency [8.9 +/- 0.01], courteousness [8.8 +/- 0.04], consultation in case of need [8.8 +/- 0.4], clear explanation of the disease [8.8 +/- 0.05] and attentiveness [8.8 +/- 0.04]. In hospitalized patients, the following items were the most important: competency [8.4 +/- 0.08], courteousness [8.4 +/- 0.09], availability of physician [8.4 +/- 0.09], consultation in case of need [8.2 +/- 0.11], setting following appointments [8.2 +/- 0.1], and disease follow-up [8.2 +/- 0.09]. In both groups, the most important domain of expectations was [competency and quality of care] followed by [availability] in hospitalized and [giving information and patient autonomy] among ambulatory patients. Our findings are similar to what reported in the literature from other countries and cultures. In addition to physician expertise and knowledge, patients value giving information and efficient doctor-patient relationship

[Relationship between cervicovaginal ferritin levels in 22-26 weeks of pregnant women with spontaneous preterm delivery]

Low serum ferritin levels correlate with low iron stores, whereas high levels are associated with an acute-phase reaction. Our objective was to determine whether elevated levels of ferritin in the genital tract can be a potential marker to identify patients at risk for spontaneous preterm delivery. We performed a nested case-control study involving 28 women who had spontaneous preterm delivery. 28 term control subjects mathched for parity, age, education, previous history of PTL and vaginal bleeding selected from 275 women enrolled in the preterm prediction study of the prenatal care unit at Imam Hospital. Cervical ferritin was measured using radoimmunoassay. Cervical ferritin levels were significantly higher in women who subsequently had spontaneous early preterm delivery [mean +/- SD: 54.5 +/- 5 ng/ml VS 36.39 +/- 1.59 in control, P=0.001]. Elevated cervical ferritin levels in 22=24 weeks of gestation in asymptomatic women are associated with subsequent spontaneous preterm birth. Cervical ferritin, alone or in combination with other potential markers, maybe a useful tool to help identify high risk women who would potentially benefit from such prospective intervention. Until the identification of such clinical interventions in a clinical trial, the use of cervical ferritin for the prediction of preterm delivery remains experimental