frequency, contributing and preventive factors of harassment towards health professionals in Iran

There are high levels of sexual harassment in health care systems. Also, workplace violence occurs against ethnic and racial minorities. This study aimed to identify the frequency of and the factors contributing to and preventing sexual and racial harassment in the workplace towards health professionals in Iran. This cross-sectional study was conducted on 6500 out of 57000 health workers who were selected by multistage random sampling from some teaching hospitals in Iran. Data were collected using the questionnaire of [workplace violence in the health sector] developed by the International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. According to the findings, the frequencies of sexual harassment and racial harassment were, respectively, 4.7% and 12% for the 12 months prior to the study [2011]. Among healthcare workers, nurses reported the highest rate of violence. The most important contributing factors in sexual and racial harassment were lack of security facilities [45.8%] and people's ignorance of employees' tasks [55.7%]. The presence of security force, safety measures in the wards, and guards were noted as the most important preventive factor to harassment. Based on the results, the frequency of sexual and racial harassment is low, which can be attributed to underreporting due to cultural sensitivity or fear. So, identifying the reasons for refusal to report harassment, developing a clear mechanism for reporting and providing the necessary trainings to health workers are essential in order to deal with harassment

Family Adaptation to Stroke: A Metasynthesis of Qualitative Research based on Double ABCX Model

PURPOSE: There is growing interest in synthesizing qualitative research. Stroke is a very common cause of disability often leaving stroke survivors dependent on their family. This study reports an interpretive review of research into subjective experience of families with stroke survivors based on the components of the Double ABCX Model including stressors, resources, perception, coping strategies, and adaptation of these families. METHODS: Metasynthesis was applied to review qualitative research looking at stroke family members' experiences and responses to having a stroke survivor as a family member. Electronic database from 1990 to 2013 were searched and 18 separate studies were identified. Each study was evaluated using methodological criteria to provide a context for interpretation of substantive findings. Principal findings were extracted and synthesized under the Double ABCX Model elements. RESULTS: Loss of independence and uncertainty (as stressors), struggling with new phase of life (as perception), refocusing time and energy on elements of recovery process (as coping strategy), combined resources including personal, internal and external family support (as resources), and striking a balance (as adaptation) were identified as main categories. Family members of stroke survivor respond cognitively and practically and attempt to keep a balance between survivor's and their own everyday lives. CONCLUSIONS: The results of the study are in conformity with the tenets of the Double ABCX Model. Family adaptation is a dynamic process and the present study findings provide rich information on proper assessment and intervention to the practitioners working with families of stroke survivors.

Concept Analysis of Empowerment in Old People with Chronic Diseases Using a Hybrid Model

PURPOSE: The purpose of this study was to clarify the meaning and the nature of empowerment concept in some Iranian old people suffering from chronic diseases. METHODS: Concept analysis was undertaken according to the hybrid model, which consists of three phases: an initial theoretical phase, a fieldwork phase and a final analytical phase. After an extensive review of the literature in order to describe the characteristics and definition of the concept, a fieldwork phase followed in order to empirically elucidate the empowerment concept in the Iranian old people with chronic diseases. In the third phase, attributes of empowerment were extracted from the first and second phases. Purposive sampling was done for 13 participants consisted of 7 old people with chronic diseases, 3 family caregivers of elderly adult with chronic disease and 3 health care providers with experience of care with elderly patients with chronic disease. RESULTS: The review of literature in theoretical phase determined the attributes of the concept, including "active participation", "informed change", "knowledge to problem solve", "self-care responsibility", "presence of client competency", and "control of health or life". Fieldwork phase determined attributes such as "awareness promotion", "sense of control", "the development of personal abilities", "autonomy", and "coping". In the final analytical phase, the critical attributes of old people with chronic diseases were investigated. They included "social participation", "informed change", "awareness promotion to problem solve", "presence of client competency", and "control of health or life", "autonomy", "coping" and "the development of personal abilities". CONCLUSION: The concept analysis of empowerment showed some of the required conditions for the empowerment of older people with chronic diseases in nursing care, which have not been mentioned in the literature.

Psychiatric nurses' perceptions about physical restraint; a qualitative study

The use of physical restraint as an intervention in the care of psychiatric patients dates back to the beginning of psychiatry. Although it is a challenging question, it is still one of the common procedures in psychiatry. Considering that very little research has been done in Iran in relation to physical restraint, this qualitative study aimed to investigate the experiences of nurses working in psychiatric wards regarding physical restraint. This qualitative study was done on 14 nurses working in the psychiatric hospitals of Ahvaz city, southern Iran, during 2011-2012. The participants were selected by purposive sampling. Semistructured interviews were used for data collection, which were continued until data saturation and emergence of themes. Inductive content analysis was used to analyze the data. Four categories emerged: [1] Restraint as a multi-purpose procedure, [2] Processing of physical restraint, [3] Restraint as a challenging subject and [4] The effects of restraint on the spectrum. Each category has several different sub-categories. The participants described using physical restraint as one of the main strategies to control psychiatric patients, and despite having negative consequences, it is extensively used. Given the risks and challenges of using physical restraint, nursing education should find alternative methods.

[ effect of multi-dimentional model of psychiatric rehabilitation care on hemodialysis patients anxious]

Aims: Long-term use of hemodialysis affects all sides of hemodialysis patients and was caused disease and disturbances such as anxiety in them. This study aimed to determine the effect of multi-dimensional model of psychiatric rehabilitation care on anxiety in hemodialysis patients.

Methods: This study is a quasi-experimental study of two groups before and after hemodialysis on 35 patients of Razi hospital in Rasht [test group] and 35 hemodialysis patients from Bandar Anzali martyr Beheshti hospital [control group], in 1390 which were done on sampling method on purpose. Intervention was based psychiatric rehabilitation of multi-dimensional model in the form of a group and with the presence of a physician, nurse, psychologist and nutritionist and comprehensive client and family and with consideration of physical, mental, social and spiritual of patients, was carried out for three months. The tool includes a demographic questionnaire and Zung self-evaluation anxiety [SAS] which were measured three months before and after intervention. Then the data using SPSS 16 software and descriptive statistic, paired t-test, independent t-test, Chi-square and Fisher test were analyzed.

Results: Data analysis between the mean anxiety score of samples before [48/40 +/- 3/972] and after the intervention [42/57 +/- 6/331] showed significant difference [p<0/001].

Conclusion: The multi-dimensional model of psychiatric rehabilitation care caused a significant difference in anxiety scores in hemodialysis patients, so applying this model of care is associated with better living conditions in hemodialysis patients.

Corrigendum to Concept Analysis of Empowerment in Old People with Chronic Diseases Using a Hybrid Model Asian Nursing Research 8 (2014) 118-127

The authors regret that one of the coauthor's affiliation in this article was incorrectly printed.

Spiritual and religious interventions in health care: an integrative review

The aim of this review article is describing a research on spiritual and religious interventions in Iran. An integrative review was conducted to determine the state of the science in Iran. Iranmedex, Scientific Information Database, Irandoc, Noormags, Magiran and Google scholar were searched to find articles published in peer-reviewed journals from August 2002 to August 2012. A qualitative approach utilizing content analysis was used in the review. Overall, 21 articles on spiritual and religious interventions in Iran's health care system which met the search criteria were included from 800,000 records in 438 journals. The review shows that there are at least four overarching themes of spiritual and religious interventions: spiritual and religious behaviours, spiritual care as part of a holistic caring approach, spiritual/religious therapy as an effective healing technique, and patients' spiritual needs. These themes are linked and interrelated. The main concern for caregivers was "hanging on to spirituality" in spite of the eroding effects on spiritual beliefs caused by different factors in the health care system. Spirituality plays an important role in the way people live and die. The majority of the research on spiritual and religious interventions in Iran's health care system focuses on patients' need toward spiritual care and health professionals' spiritual approach, as well as factors that influence their spirituality. More research is needed on the factors that influence patients' spiritual needs, spirituality among health care providers, and interventions to engender spiritual and religious interventions in the health care system

investigation into occupational hazards faced by nurses in paediatrics hospitals of Tehran university of medical sciences, 2006-2009

Injuries resulting from sharp and cutting objects and exposure to patients' blood and other body fluids are considered as one of the most important occupational hazards facing health care personnel due to exposure to blood-borne viruses such as Hepatitis B and C and HIV. The aim of this study is to investigate occupational hazards that involve safe handling of sharp and penetrating objects by nursing staff working in paediatrics hospitals of Tehran University of Medical Sciences [2006-2009]. In this descriptive study, nursing personnel employed at the paediatrics hospitals of Tehran University of Medical Sciences were selected. Data were collected through a self-administered questionnaire containing two parts; part one was related to demographic information and part two focussed on details of injurious incidents. The collected data were analyzed using SPSS software, version 16. The study population reported 134 needle stick injuries[134HCWs exposure group, 380 HCW1s not exposure group]. The incidence rate of NSI was 26.07% [8.17% per year]. In most cases, needles [40.3%] and vein catheters [28.36%] were accounted for injuries. IV access [31.33%] and recapping of needles [20.9%] were most common action resulted to exposure. There was no statistically significant difference in demographic variables except in work experience between two groups. Based on the findings of this study, the incidence rate of NSI among HCWs working in paediatrics wards was less than those of other studies in different countries. This might be related to inadequate reporting, and also our results emphasize the importance of training and education of nursing personnel for reporting needle stick injuries.

Experiences of wives of veterans suffering from combat-related post-traumatic stress disorder: a qualitative content analysis

War as a cause of psychological trauma can lead to unfortunate events in human life. Trauma experienced by one of the family members can affect other members of that family as well. Family members, especially spouses, experience trauma due to permanent encounter with signs of Combat post-traumatic stress disorder [PTSD]. This study was conducted to investigate the experiences of the veterans' wives. The present qualitative study was conducted on 12 veterans' wives aging 37-50 years. The subjects were selected through purposeful sampling from Bonyad Consultancy Center from early April to late September, 2012. Data were collected using focused group discussion and analyzed through conventional content analysis approach. The participants' experiences were categorized into two main themes and 5 sub-themes. The extracted themes included [disease and family reaction] and [coping with the disease] and the sub-themes included [negative emotions], [iving together but not intimately], [reprehension and disease stigmatization], [support motivation], and [dual role-play]. The results of this study demonstrated that Combat PTSD had a negative effect on family members, especially wives. Thus, eliminating this problem requires health and educational interventions

[ effect of anger management training in groups on aggression of 12-15 years old male students]

More than one third of Iran's population is under 18 and prevalence of aggression in this group is high Because of the important role of adolescents as the architects of the future of countries, aggression should be considered as a very serious matter as it can adversely affects their physical and mental health. The aim of this study was to determine the effect of anger management training in groups on aggression of 12-15 years old male students. This study is a semi-experimental research and 60 male students, aged between 12 and 15 years old were selected based on multi-stage random sampling. Measurement tools of the research included: demographic data questionnaire and Eyscenk aggression questionnaire. The resulted data were analyzed by means of SPSS software. The comparison of mean aggression between both groups before and after intervention using independent T test showed that immediately after intervention a significant statistical difference appears between two groups [p= 0.000]. There were also correlations between aggression and many of demographics. The findings of this study indicates that anger management training in groups has an impact on the aggression of 12 - 15 years old male students and this intervention could by applied in other situations dealing with adolescents

Adaptation of Questionnaire Measuring Working Conditions and Health Problems Among Iranian Nursing Personnel

PURPOSE: To adapt a questionnaire in the Persian language measuring working conditions and health problems among nursing personnel. A further aim was to test the validity and reliability of the questionnaire. METHODS: The adapted questionnaire was based on three well-established questionnaires. Physical working conditions items were from Nurse Early Exit Study. Psychosocial working conditions scales were included from Copenhagen Psychosocial Questionnaire which contains two scales on general and mental health as well. The Nordic Musculoskeletal Questionnaire was the origin of the musculoskeletal disorders questions. During the culture adaptation process, an expert panel method was used. To achieve equivalence between the sources and target version, some changes were made by the expert panel. Then the questionnaire was examined in the field for face validity and construct validity (n = 92) among Iranian nursing personnel from two hospitals. Construct validity was assessed using a priori hypothesized correlations of the outcomes with exposures. Finally the adaptation process was completed by reliability assessment using Cronbach's alpha and Intra-class Correlation Coefficient (ICC). RESULTS: The construct validity result was the correlation of the health outcome with the work-related exposure (physical rs = .71 and psychosocial rs = .66). In the reliability assessment, Cronbach's alpha and ICC were .60 and .70 respectively. CONCLUSION: The findings show that the adapted questionnaire has an acceptable conceptual structure and provides reliable information from the nursing profession. Consequently, the questionnaire is applicable to work situation studies among nurses and other health care workers.

Nursing attitude to spirituality and spiritual care

To assess nurses' attitude toward spirituality and spiritual care in the care of psychiatric patients/clients. A cross sectional study was conducted to assess the attitude of nurses of Razi psychiatric center on spirituality and spiritual care and providing an educational plan. Samples consist of 107 nurses of Razi psychiatric center. Data were collected using the Spirituality and Spiritual Care Rating Scale [SSCRS]. Data were analyzed with statistical software [SPSS] with using descriptive methods and statistical tests. Results showed mean score of attitude on spirituality and spiritual care was 63.40 [SD +/- 4.57]. Majority of participants scored between 33-92 which was highest scores for the questionnaire. It shows that attitudes of nurses of Razi psychiatric center to spirituality and spiritual care were positively high. Nurses- attitude for spirituality and spiritual care is positive and they believe that nurses must give spiritual care for their patients