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@#BACKGROUND:Life-sustaining treatments (LSTs) may prolong life but greatly decrease the quality of death. One factor influencing decision-making about withholding and withdrawing these treatments is the attitude of nurses. This study aimed to evaluate the attitude of critical care nurses towards life-sustaining treatments in South East Iran. METHODS:In this cross-sectional study, "Ethnicity and Attitudes towards Advance Care Directives Questionnaire" was used to investigate the attitude of 104 critical care nurses towards life-sustaining treatments in three hospitals affiliated to Kerman University of Medical Sciences. RESULTS:The findings of this study indicated that although a majority of critical care nurses (77％) did not have personal desire for use of LSTs including CPR and mechanical ventilation, they had moderately negative to neutral attitude towards general use of LSTs (2.95 of 5). CONCLUSIONS:These findings suggest that nurses' attitude towards LSTs can be changed by inclusion of specific courses about death, palliative care and life-sustaining treatments in undergraduate and postgraduate nursing curricula. Educating Muslim nurses about religious aspects of LSTs may also improve their attitudes.
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Aims: End-of-life care is a significant part of nursing practice. The role of organizations at the end of life care cannot be ignored. Organization can act as a facilitator to improve the quality of care and provide a peaceful death at the end of life. The aim of this study was to illuminate oncology nurses’ organizational challenges of caring for dying patients in Iran. Study Design: Qualitative method with conventional content analysis approach, Data collected by interviewing nurses which worked in oncology units in hospitals supervised by Zahedan Medical University in Iran and were conducted during the late summer 2014 to spring 2015. Methodology: Was used to analyze the experiences of 18 oncology nurses in relation to caring for dying patients. The mean age of participants was 32 years old, and had a minimum of 9 months and up to 12 years (mean = 6 years) of working experience in the oncology sector. 75% of nurses were married; all of them had a bachelor's degree in nursing. Findings: Three themes emerged from the text including: 1) environment structural challenges, 2) cultural and structural challenges of the organization, and 3) educational challenges of end of life care. Conclusion: Considering the vital role of hospitals in providing holistic care for end of life patients, new technologies and methods of care can have a great impact on education, treatment and nursing practice, therefore, necessary organizational and cultural changes need to take place to improve nursing care which is fit to new condition.
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Introduction: Hypertension is a global public health concern. Among the factors that contribute to this crisis, the poor control of hypertensive patients is a major concern. Patients’ lack of adherence to the medication regimen is often considered to be the main reason for this failure. Several medication-adherence scales were designed to measure the extent to which patients adhere to their medication and treatment regimens. Since these scales must be very reliable and have strong validity if they are to be used in clinics and research, this study was performed to test the reliability and validity of the Hill-Bone’s scale of “Compliance to High Blood Pressure Therapy.” Methods: After using a modified forward/backward translation procedure to create a Persian version of the Hill-Bone’s scale, we conducted a cross-sectional study in which two hundred and eighty hypertensive patients participated to validate the Persian version. Exploratory and confirmatory factor analysis, criterion validity, Cronbach’s alpha, and test-retest reliability were used to determine the validity and reliability of the Persian scales’ psychometric properties. Results: The analysis of the data showed that the scale had excellent stability (Intraclass Correlation Coefficient = 0.97) and low acceptability of internal consistency (Cronbach’s Alpha = 0.44). The exploratory factor analysis did not clarify meaningful patterns among the subscales. The confirmatory factor analysis failed to fit the observed items with the latent subscales. The scale scores were not correlated with blood pressure (P > 0.05). Conclusion: Although some of the psychometric properties of the Persian version of the Hill- Bone’s scale and its modified version were acceptable, they were not sufficient to recommend the Persian version for general use. More studies are needed to revise and develop a more comprehensive scale that is appropriate for use in the context of the mentioned population.
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Background: Hypertension is a global public health crisis. Poorly controlled high blood pressure is one of the most important factors contributed to this crisis. Lack of medication adherence is often considered as the main reason for insufficient control of high blood pressure. Difficulty in measuring medication adherence is another problem in this field. To reduce this difficulty several medication adherence scales were developed. This study was performed to test reliability and validity of Morisky Medication Adherence Scale-8. Materials and Methods: A cross-sectional study was conducted to validate the Persian version of MMAS-8. The Persian version of MMAS-8 was generated by using a modified forward/backward translation procedure. Two hundred and fifty hypertensive patients were participated in the study. Construct and known-groups validity, Cronbach’s alpha and test-retest reliability were used to assess psychometric properties of Persian scale. Results: Data analysis showed that the scale did not have an acceptable internal consistency (Cronbach’s Alpha= 0.40) but had excellent stability (p= 0.89). The confirmatory factor analysis poorly fitted with one-dimensional model. Participants with controlled blood pressure had significantly higher MMAS-8 scores than uncontrolled blood pressure group. Conclusion: Totally some of the psychometric properties of the Persian version of the MMAS-8 did not meet the requirements of the standard level so it is not recommended to use in general. More studies are needed to establish a more appropriate scale in order to be used in the mentioned population.
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BACKGROUND: Paramedic and emergency personnel may encounter directly many events that threat their own wellbeing during their daily work. This study was conducted to examine the prevalence rate of post-traumatic stress disorder (PTSD) among two groups of paramedic and emergency personnel in south-east Iran.METHODS: The study employed a descriptive design and was conducted in four hospital emergency wards and a pre-hospital emergency base supervised by Kerman Medical University. Using Mississippi PTSD, we assessed the prevalence rate in paramedics (n=150) and emergency personnel (n=250).RESULTS: The two groups had different levels of education, marital status, experience of traumatic events, work hours per month, and gender. Most (94%) of paramedic and hospital emergency personnel reported moderate PTSD. The two groups had significant different levels of PTSD in all subscale.CONCLUSION: The study suggests that health care managers should organize systematic and dynamic policies and procedures in dealing with PTSD to assist both groups of personnel.