Facilitators and threats to the patient dignity in hospitalized patients with heart diseases: a qualitative study

Background: Patient's dignity is an important issue which is highlighted in nursing It is an issue that is highly dependent on context and culture. Heart disease is the most common disease in Iran and the world. Identification of facilitator and threatening patient dignity in heart patients is vital. This study aimed to explore facilitator and threatening patient dignity in hospitalized patients with heart disease

Methods: This qualitative content analysis study was performed in 2014 in Kerman, Iran. 20 patients admitted to coronary care units and 5 personnel were selected using purposeful sampling in semi structured and in depth interviews. Researchers also used documentation and field notes until data saturation. Qualitative data analysis was done constantly and simultaneously with data collection

Results: Three central themes emerged: a] Care context which includes human environment and physical environment, b] Holistic safe care including meeting the needs of patients both in the hospital and after discharge, c] Creating a sense of security and an effective relationship between patient and nurse, including a respectful relationship and account the family in health team

Conclusion: The results of this study showed that care context is important for patient dignity as well as physical environment and safe holistic care

Effect of activating early warning system on Motahari Hospital preparedness

Background: One of the important aspects of hospital preparedness in disasters is implementing early warning system. In this study, the performance of this function was evaluated under the monitoring of disasters workgroup of the Ministry of Health [MOH] based on the national program of "hospitals preparedness in disasters" in Shahid Motahari Hospital

Materials and Methods: This is an interventional study, with a quasi-experimental pre-test and post-test design. This hospital was chosen by MOH as a benchmark for implementing the national disaster programs. The data collecting instrument was the hospital disaster preparedness checklist which evaluates 9 indexes of "command and control," "communications," "safety and security," "triage," "increasing capacity," "continuity of critical services," "human resources," "logistics and supply management," and "recovery after disasters." Data of pretest and posttest were analyzed through nonparametric Wilcoxon test, using SPSS software, version 16

Results: The preparedness score before the intervention was 134, which represents the moderate level of hospital preparedness. The evaluation before and after the intervention indicated that "recovery after disaster" and "triage" had the least change with an increase of one score and the index of "logistics and supply management" had the maximum increase by 5 scores. The overall score of preparedness significantly increased from 134 to 159 [P<0.05] after the intervention, which represents a change from moderate to high hospital preparedness

Conclusion: The preparedness of Shahid Motahari Hospital, which is the only specialized hospital of Tehran in burns, has significantly increased and reached a level of high preparedness to deal with disasters. This study indicates the importance of developing the activation of early warning system in hospitals for rapid and appropriate response to the disasters

[ Comparision of Iranian Physician and nurses attitudes towards do- not- resusciate Ordersdian]

Background and Aim: Decision making process about Do- Not-Resusciate [DNR] order is unique, since, it is the only treatment decision that should be taken in advance. Most physicians and nurses are not sure whether and when to make a decision about DNR order and its moral aspects. The current study is performed to compare and investigate nurses and physicians attitude about DNR order for patients in their final phases of life

Materials and Methods: In this descriptive-comparative study, 152 physicians and 152 nurses have been studied. The sampling method was stratified sampling. The data gathering tools were a demographical questionnaire and a attitude questionnaire about DNR order

Results: The nurses and physicians in this research with averages of 3.25 for nurses and 3.22 for physicians, had a positive attitude about DNR order. But there was no significant difference between the attitude average score of the physicians and nurses about DNR order [p>0.5]. Nurses and physicians with experience of participating in implementation of cardiopulmonary resuscitation and DNR order, had more positive attitude toward DNR order

Conclusions: The findings suggest that there is no difference between the physician's and nurse's view about DNR order. Although there is a significant relationship between former experience of participating in implementation of cardiopulmonary resuscitation and DNR order with positive attitude about DNR order

[Personality Compatibility of Sabzevar University of Medical Sciences Nurses with Nursing Profession]

Background: Personality compatibility of individuals with profession that provides services to others is one of important issues that have received less attention while there is a great impact on the quality of services provided and to professional success. This study aimed to assessment of personality compatibility of nurses with nursing profession in Sabzevar University of Medical Sciences in 2013.

Materials and Methods: 62 nurses were worked in Sabzevar University of Medical Sciences in 2013 were selected by simple random sampling participated in this cross-sectional study. This survey Instrument was standardized questionnaire of Holland personality-job compatibility that by means of it compatibility of nurses' personality with the nursing profession is determined at three levels: non-compatible, relatively compatible and absolutely compatible. Data was analyzed by SPSS.

Results: 46% of nurses participating in this study had non-compatible personality and 33/4% of them had relatively compatible personality and only 20/6% had absolutely compatible personality whit nursing profession. Compatibility of personality whit nursing profession according to demographic characteristics had no meaningful differences.

Conclusion: this study showed large percentage of nurses working in Sabzevar University of Medical Sciences had non-compatible personality whit nursing profession, and this results shows attention to this important issue by health managers and correction of selection of more compatible nursing student are necessary.

[ effect of telenursing [cellphone software] on a1c hemoglobin in patients with type 2 diabetes mellitus]

Nowadays technology development has remarkable and undeniable effects on caring. The aim of this study was to evaluate the effect of telenursing [cellphone software] on metabolic control of patients with Type 2 Diabetes Mellitus. It was a clinical trial with IRCT201009114728N1 Registration Code. In the spring of 2011 from patients of Valiasr hospital department of endocrinology 60 patients were chosen and randomly allocated in two groups. The Demographic questionnaire was completed by them. Blood sample for A1c hemoglobin was taken from patients. In the intervention group cellphone software was installed on the personal mobile of participants. The data was analyzed by t-test and SPSS 21. The pre and post A1c hemoglobin was -0.58 +/- 0.77 and -0.19 +/- 0.51 respectively and this difference was significant [P<0.05]. The result indicated that telenursing by using cellphone software can have positive effect on metabolic control of patients with Type 2 Diabetes Mellitus. This technology can persuade patients and health team members to follow up caring of these patients more effectively.

Changing the Care Process: A New Concept in Iranian Rural Health Care

PURPOSE: Health care delivery systems in rural areas face numerous challenges in meeting the community's needs. There is a lack of adequate attention for this problem. This study aims to explore the challenges of the health care process in rural Iran according to health care providers' experiences. METHODS: This was a qualitative study that used the content analysis method. We selected a total of 21 health care providers based on purposive sampling. Data collection consisted of semi-structured individual interviews that were analyzed by qualitative content analysis. RESULTS: Data analysis led to the formation of one main category, the challenges of process of health care in rural society. Within this main category, we created the following subcategories: change in characteristics of the rural society, increase in complexity of the health care process, decrease in workforce efficiency, and decrease in propensity of people's care. CONCLUSION: The findings of this study indicate that the process of health care in Iranian rural society is changing rapidly with community health workers encountering new challenges. There is diminished efficiency in responding to the changing care process in Iran's rural society. Considering this change in process of care, therefore, the health care system should respond to these new challenges by establishing new health care models.

[ effect of distraction by bubble-making on the procedural anxiety of injection in Thalassemic school- age children in Kerman Thalasemia center]

Medical procedures, particularly injection, cause anxiety in children. Coping with invasive medical treatment is an important issue for all children, particularly chronically ill children such as thalassemic children who may have to endure many treatment procedures. This study examined the effect of breathing exersice on the anxiety resulted from the injection procedure in thalassemic school-age children in Kerman thalassemia center. In this clinical trial, 40 thalassemia children with 6-12 years old, in Kerman thalasemia center were selected through convenience sampling method. Then subjects were randomly allocated in two groups [experimental group and control group]. In experimental group, bubble making was used. Data collection tools were: Demographic Information Questionnaire, and the Scale of facial self reported anxiety. The analysis of the data was carried out through SPSS 16. Average score of anxiety in bubble making group was 2.9 +/- 1.5 before and 1.0 +/- 1.1 after injection. The average score in control group was 3.1 +/- 2.2 before and 2.4 +/- 2.1after injection. There was no significant difference between two groups of study regarding the average scores of anxiety before the injection [p>0.05] but there was a significant difference between two groups regarding the average scores of anxiety after the injection [p>0.05]. The results of this study showed that bubble making is an effective method to decrease anxiety resulted from the injection procedures.

[ effect of family-centered empowerment model on the knowledge and attitudes of mothers with thalassemia children]

Objective: Thalassemia disease is providing many problems for patients, families and health care system. In family-centered empowerment model, individuals feel threatened with knowing the disease and its complications. This study was aimed at determine the effectiveness of family-centered empowerment model on the mothers' knowledge and attitudes about thalassemia disorder

Methods: This semi-experimental study was performed on 86 thalassemic children that were randomly divided into case and control group. The research tool was researcher maker questionnaire of parents' knowledge and attitude about the disease and it was used after determination content validity and reliability [internal correlation]. The next was intervention stage

Results: Data analysis showed that before the intervention, the average of mother's awareness and attitude in testing group was 12/98 [+/-4.99], 13/58 [+/-13.9] and in control group was12/47 [+/-3.87], 11/02 [+/-11.26].There was no significant difference between average of knowledge and attitude in testing and control groups [p>0.05]. But after performing model in the test group, the average of mother's awareness and attitudes was 18/86 [+/-3.63],22/09 [+/-10.02] and in control group was13/16 [+/-3.65], 12/13 [+/-10.83], that shows significant differences between two groups [p<0.05]

Conclusion: The results of this study indicates that implementation of the family-centered empowerment model is effective on knowledge and attitudes of mothers of children with thalassemia. Using of this model was suggested in care of thalassemia patients for improvement mothers' knowledge and attitude about disease

[Comparison of health belief model-based methods of video and face to face training about risk factors on knowledge and attitude of patients with myocardial infarction during discharge]

Objective [s]: To comparison of Health Belief Model- based methods of video and face to face training about risk factors on knowledge and attitude of Myocardial Infarction patients during discharge

Methods: This was a Clinical trial study. Eighty patients randomly assigned to either video or face to face group. Data was collected by a researcher-made questionnaire. Educational contents were designed in health belief model frame based on the collected data and educational needs; then it was turned into a movie. The movie was shown to each patient in the video group individually and face to face group received face to face training. Finally, data were analyzed using SPSS [version 16]

Results: Analysis of baseline data showed that there were no significant differences between the two groups regarding any of dimensions of model [P> 0.05]. Study results showed that the mean score of knowledge and attitudes in the video group was 32[+/-0.98], 112/62[+/-3.12] and in face to face group was 31/02[+/-1.4], 105/9 [+/-5.96], Comparing these means using t-test showed a significant difference between the means of two groups [P<0.05] in any of dimensions of model exception knowledge of diet

Conclusion: Using videos for educating myocardial infarction patients about risk factors of the disease is a useful method for preventing recurrence of the disease

[Nursing students perception of barriers of acquiring professional ethics: a qualitative research]

Background and Objective: Ethical competency in nursing means performing nursing cares based on bioethics. This type of competency is an important factor in improving the quality of nursing cares. Realizing the obstacles of acquiring ethical qualification by nursing students is one of the basic necessities towards nursing education development. The development of ethical competency is one of the most important strategies which can help in improving nursing students' capabilities and professional development. This study aimed to identify the barriers to acquiring ethical qualification by nursing students through content analysis of their experiences

Methods: A qualitative study was conducted using a content analysis approach. Convenience sampling was employed to select 25 nursing students studying in nursing schools of Tehran public universities, Tehran, Iran. Data were collected through semi-structured interviews, which were tape recorded and transcribed verbatim. Data were analyzed using descriptive content analysis approach according to Graneheim and Lundman method. Results: Eight themes emerged from data analyses including lack of motivation and interest of the students in their profession, insufficient self-awareness, the shortage of expert nursing instructors in ethics science, inadequacy of curriculum, inappropriate ethical teaching methods, problems in evaluation of ethical characteristics, poor interpersonal relationships and constraints in clinical setting

Conclusion: It seems that in developing nursing student's ethical competency, both contexts and individuals have a role. Therefore, barriers of ethical competency should be sought in various aspects. The present study provides special classification of obstacles that because of growing from a unique study context can be helpful in planning for the development of professional nursing ethics in education and clinical services. Also the findings of this study can provide a base for further researches on this subject?

[ relationship between self-efficacy and health beliefs among type 2 diabetic patients]

To determine relationships between self-efficacy and health beliefs among type 2 diabetic patients. A Health Belief Model [HBM]. Diabetic patient's self-efficacy and health beliefs level are about average. There is significant relation between these tow variables. Among demographic variables it seems that education level has maximal effect on almost of models elements also with self-efficacy. Most elements are interrelated and this relation is significant. But cues to action have not significant regression with perceived benefits and perceived barriers. Significant relations between self-efficacy and health beliefs point out this fact that in order to patient self-care enhancement we need self-efficacy improvement via establishment of positive health beliefs. Health care professional due to continue communication with patients have specific position in positive health beliefs and self-efficacy. Results show that cues to action that indirectly related to health care personnel and medias, have not adequate effects on enforcement of patients positive health beliefs. It is recommended more studies and measures in this field