Educational needs on palliative care for cancer patients in iran: a swot analysis

Background: By acceptance of palliative care as a part of health system of each country and due to increasing prevalence of cancer, special focus on stakeholder's educational needs is of vital importance so that palliative care services are improved and the quality of life of patients is enhanced. This study was conducted to explore the educational needs of stakeholders of palliative care for cancer patients in Iran

Methods: This qualitative study with 20 semi-structured interviews was conducted from August 2016 to February 2017 in Shohadaye Tajrish and Emam Khomeini Hospitals of Tehran. Participants were selected through purposive sampling and included cancer patients and their family caregivers as well as healthcare providers, experts and policy-makers. The data were analyzed through Conventional Content Analysis of Landman and Graneheim using MAXQDA10 software. Statements of each main category of the study were summarized in SWOT categorizes

Result: A total of 546 codes were extracted from the analysis of the interviews and four main categories and four subcategories were identified. The four main identified categories included:"academic education planning", "workforce education", "public awareness", and "patient and caregiver empowerment" that contained our subcategories as follows: "strengths", "weaknesses", "opportunities" and "threats" [SWOT].

Conclusion: Meeting the educational needs of the stakeholders of palliative care requires policymakers to identify the factors leading to strategies that are based on the use of opportunities, the removal of weaknesses, and coping with the threats to which the organization is faced

Effect of beloved person's voice on chest tube removal pain in patients undergoing open heart surgery: fuzzy logistic regression model

Chest tube removal pain is one of the most important complications after open heart surgery. The removal of a chest tube is a painful and frightening experience and should be managed with as little pain and distress as possible. The aim of this study is to assess the effect of beloved person's voice on chest tube removal pain in patients undergoing open heart surgery. 128 patients were randomly assigned to two groups: one group listened to beloved person's voice during the procedure, and the other did not. Since pain was measured by linguistic terms, a fuzzy logistic regression was applied for modeling. After controlling for the potential confounders, based on fuzzy logistic regression, the beloved person's voice reduced the risk of pain. Therefore, using beloved person's voice could be effective, inexpensive and safe for distraction and reduction of pain

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

[ relationship between nurses' awareness and attitude about ethics codes and determining the effective factors]

Background: Nursing ethics is a part of the responsibility and commitment to the nursing profession. The nurses' performance must be according to the professional principles. It seems one of the best ways to ensure performing ethical practice is increasing the nurses' awareness and attitudes about nursing ethics codes. The aim of this study was to assess the relationship between nurses' awareness and attitude about nursing ethics codes and determine the effective factors

Materials and methods: In this descriptive cross - sectional study, 108 nurses were selected by cluster sampling. Information was collected by a three- part questionnaire, including demographic characteristics, nursing ethics codes awareness and attitudes. Relationships between variables were estimated by Pearson's correlation coefficient [r] and independent t-test

Results: The mean [ +/- standard deviation] score of awareness [19.52 +/- 0.64] and attitude [17.71 +/- 0.59] of participants were in the middle range and there was statistically significant correlation between mean score of awareness and attitude [r=0.69, p=0.01]. There found higher score of attitude for married nurses, and also higher score of awareness and attitude for those have more years of work experiences [P<0.05]

Conclusion: The results of this study indicated that the nurses need more and continuously education of nursing ethics codes. Therefore, it is recommended that the managers and planners pay more attention to teaching these codes, as one of the basic part in nursing education until development of the nurses' ethics codes awareness and attitudes leads to improve the quality of nursing care

Factors influencing school health in elementary schools in Isfahan, Iran: a qualitative study

Background: students' health and future health of the community are related to providing health care in schools and since in every society, different contextual factors affect this matter, the present study aims to recognize the factors influencing the health care elementary students are provided with

Methods: this qualitative content analysis was performed in 2014 in Isfahan. This study was conducted on school health instructors of elementary schools. Through targeted sampling, 15 health care providers, two mothers and 3 principals from 23 elementary schools were selected. Twenty-two semi-structured interviews were performed. Qualitative data analysis was done using qualitative content analysis

Results: in this study, 3 concepts were extracted: family umbrella over health [with two sub-categories of 'family's social status and its effect on health' and 'family and health'], functional resources [with two sub-categories of 'opportunity', 'availability of resources for diagnoses] and health components [with two sub-categories of 'culture', 'the value of school health']. These contextual factors must be considered in providing health care for schools

Conclusions: consideration of effective contextual factors on providing elementary students with health care can help improve health for this group

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

association between neck circumference and cardiovascular risk factors in patients with acute coronary syndrome

To investigate the relationship between neck circumferences and cardiovascular risk factors in patients with acute coronary syndrome. In a cross-sectional study, 100 patients with acute coronary syndrome in Kerman hospitals were assessed by measuring their neck circumference and risk factors of cardiovascular disease. The data were analyzed by student t -test, Man-Whitney U test, chi[2] and Pearson and Spearman correlation tests. The mean of neck circumference in men with body mass index [BMI] >/= 25 kg/m[2] was 39.63 +/- 3.02 cm and for women it was 36.47 +/- 2.00 cm. The mean of neck circumference in overweight group was 42.70 +/- 2.99 cm for men and 38.66 +/- 3.28 cm for women. Neck circumference >/= 41.5 cm for men and >/= 36.5 cm for women were the best cutoff levels for determining the patients with BMI >/= 25 kg/m[2]. There were some associations between some cardiovascular disease risk factors. These risk factors were usually related to increasing weight. Because of fat accumulation in neck during weight gaining, this index can be used as a simple and easy screening way to recognize people with high weights

Details of content validity and objectifying it in instrument development

Researchers in the nursing science study complex constructs for which valid and reliable instruments are needed. When an instrument is created, psychometric testing is required, and the first-step is to study the content validity of the instrument. This article focuses on the process used to assess the content validity. This article examines the definition, importance, conceptual basis, and functional nature of content validity in instrument development. The conditional and dynamic nature of content validity is discussed, and multiple elements of content validity along with quantitative and qualitative methods of content validation are reviewed. In content validity process, content representativeness or content relevance of the items of an instrument is determined by the application of a two- stage [development and judgment] process. In this review, we demonstrate how to conduct content validity process, to collect specific data for items generation and calculation of content validity ratio, content validity index, modified Kappa coefficient, and to guide for interpreting these indices. Face validity through suggestions of expert panel and item impact scores is also discussed in paper. Understanding content validity is important for nursing researchers because they should realize if the instruments they use for their studies are suitable for the construct, population under study, and sociocultural background in which the study is carried out, or there is a need for new or modified instruments

[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.

relationship between students' bonding to school and multiple health risk behaviors among high school students in South-East of Iran

Background: School is the first social institution which affects adolescents' lives, and it determines their opportunities, life quality and behavior. Thus, the aim of this study was to determine the relationship between students' bonds with their school and multiple health risk behaviors amongst high school students in Kerman City, Iran

Methods: In this cross-sectional study, high school students of all levels participated during November and December 2001 in Kerman. The research sample included 1024 students [588 females and 436 males] aged 15 to 19 years. A CTC [Communities That Care Youth Survey] questionnaire was designed based ona standard questionnaire in order to collect a profile of students' risk behaviors. A multi-stage cluster sampling method was used to collect the data

Results: In the final multivariate logistic regression, two variables including; age, [ORa=1.15, P=0.02] and male gender [ORa=2.14, P=0.001] had a significant positive association with multiple health risk behaviors [MHRB]. School commitment [ORa=0.38, P=0.001] and school rewards for involvement [ORa=0.80, P=0.21], had a significant negative association with MHRB

Conclusion: Our results quantified the pivotal role of schools in shaping the risky behavior of students. It seems that school may minimize the risky behaviors by creating a strong link, and improving the effective communications with students

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 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.

[Attempt to compromise: the live experience of Kermanian Fathers who have a child, suffering from cancer, at diagnostic stage. phenomenology study]

There is a very limited research about unique experience of fathers, who have a child, suffering from cancer at the diagnostic stage. So we seldom know anything about this experience. This study aimed to discover, live experience of kermanian fathers who have a child, suffering from cancer, at diagnostic stage. This is a qualitative and phenomenology study, using purposive sampling, Data were collected via observation and semi-structured depth interview, with 7 fathers having children under 15 years old. The children were suffering from cancer and they were in ward of infant oncology department in Afzalipour hospital. Scale for samples sufficiency was saturation of data. After, recording interviews, data were coded in three stages and were contemporaneously analyzed with Colaizzi phenomenological method.-Sustaining injuries with cancer diagnosis are as following: shock, denying, feeling of pain [sadness and feeling of guilt], anxiety [uncertainty].-Confrontation with cancer diagnosis includes two groups of mechanism as: optimistic mechanisms like relationship with God, cognitive redefinition] and escape mechanisms like [use of opium, increase of job commitments as multi jobs and multi shifts]-Discovery of support sources as: Rooty family and spouse Findings of this study, show clear picture of fathers experience in diagnostic stage of their children cancer. In addition, provide oncology nurses, with new insight and knowledge about holistic and unique cares. Limitations of the study and recommendations for further research and nursing practice improvement, has been presented

[ 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.

Violence during pregnancy and postpartum depression

To estimate the prevalence of physical and emotional violence and postpartum depression in a pregnant Iranian population. This is a cross-sectional survey. A consecutive sample of women who were routinely referred to health care centers for immunization of their two month infants after delivery were enrolled in this study. They were interviewed by a designated research nurse using the-Edinburgh-Postpartum-Depression-Scale [EPOS] and Abused-Assess-Scale [AAS]. Nearly two-third of women reported some kind of violence; 59.7% had experienced one or more types of emotional abuse, and 37.0% reported physical violence during the pregnancy. The prevalence of postpartum depression was approximately 45.8%. The highest odds ratio of postpartum depression were associated with husband's drug abuse, domestic violence, woman's education. The high prevalence of different types of domestic violence during pregnancy and postpartum depression and their significant relationship should be regarded as a priority for local and possibly National Health Service policy

[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?

[Comparison of learning styles of nursing students in razi nursing school, kerman university of medical sciences - 2009]

Background and objectives: It is believed that any discrepancy between learning style of students and their field of study leads to their dissatisfaction and consequently dropping out of school. The aim of this study was to compare the learning styles of Nursing students in Kerman Razi Nursing School in 2009

Methods: In this cross-sectional study performed in 2009, all undergraduate and postgraduate Nursing students of Razi Nursing School [n=148] were asked to complete Kolb learning style inventory [KLSI] Version 3.1. Data were analyzed using descriptive and inferential statistics

Results: From all students, 87.8% were studying in undergraduate and 12.2% in master programs. Among undergraduate students assimilator learning style [48.5%] and among master students convergent learning styles [44.4%] had the highest frequencies. There was a statistically significant difference between learning styles of undergraduate and master students [P=0.028]

Conclusion: Since, nursing is an occupation requiring interaction and communication with people, attention of nursing teachers to the learning styles of their students is very essential for promotion of community health. It is suggested that nursing teachers use a variety of teaching methods based on students' educational level and preferred learning style

[Does a rehabilitation program improve quality of life in breast cancer patients?]

To evaluate the effect of a rehabilitation program on quality of life in breast cancer patients. Fifty-seven patients who underwent modified radical mastectomy, had finished chemotherapy and radiotherapy and received hormone therapy were selected and randomly assighned into case and control groups. Control group was under medical care and the case group in addition to medical care received a rehabilitation program [physiotherapy, education and individual counseling] for two months. Quality of life was measured by the EORTC QLQ C30 before one week and 3 months after rehabilitation in both groups. Before intervention there were statistically significant differences in physical [P< 0.001] and emotional functioning [P= 0.02] in cases compared to control group, while no other significant differences were observed in other scale. One week after the program, differences among two groups in 6 scales were significant indicating a better condition in intervention group. Three months after the intervention the cases showed a statistical meaningful improvments in 11 scales. Rehabilitation programs might improve the quality of life after mastectomy in breast cancer patients

[ 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

Effects of video information on anxiety, stress and depression of patients undergoing coronary angiography

Anxiety and stress are common in patients undergoing invasive procedures. Coronary angiography is a definitive diagnostic evaluation for coronary artery disease and valvular disease. It is necessary to give information to the patients in order to minimize levels of anxiety and stress to this invasive procedure. The aim of this study was to evaluate the effect of patients' education by video on levels of anxiety, stress and depression of patients undergoing coronary angiography. In a quasi-experimental, pretest-posttest design, 128 patients were randomly assigned to either control or experimental group. Control group received verbal routine education by nurses and experimental group received an informative video about coronary angiography procedure as well as pre and post angiography interventions. Using Depression, Anxiety, Stress Scale [DASS-21] levels of these variables were measured before and after education. Seventy eight [60.9%] males and fifty [39.1%] females participated in the study. There was a statistically significant reduction in the Anxiety, stress and depression levels of experimental group after video information [P= .000]. There was a statistically significant correlation between sex with anxiety [P= .000] and stress [P= .04]. The use of patients' education by informative video is a useful method for decreasing psychological parameters of patients undergoing coronary angiography procedure. Results of the study confirm the usefulness of video information prior to an Invasive angiography procedure