Self-efficacy in foot-care and effect of training: a single-blinded randomized controlled clinical trial

Diabetes mellitus [DM] is one of the most common metabolic and non-communicable disorders worldwide and the mortality rates caused by the complications associated with the disease, such as diabetic foot ulcer, is increasing dramatically. Patient education is considered as an essential part of controlling DM. Therefore, we aimed to compare the effects of individual and group training methods on self-efficacy in foot care among the patients with DM. In this single-blinded, randomized controlled clinical trial, we enrolled 150 patients with type 1 and 2 DM. The final participants were randomly assigned into two intervention groups [collective and individual training group] and a control group. Data were collected using foot-care self-efficacy questionnaire [Corrbet, 2003]. A research assistant collected the data by interviewing the participants using the questionnaire once before and once one month after the intervention. The participants of the intervention groups attended a training program consisting of three sessions per week for one week. Statistical descriptive tests such as mean and standard deviation [SD] percentage were used to describe the features of the data inferential statistics test such as Chi-square, independent t-test and repeated measures analysis of variance and analysis co-variance [ANOVA, ANCOVA] tests were also used as appropriate. The significance level was set at <0.05. The results indicated that there was no significant difference between the three groups regarding the mean of self-efficacy scores before foot-care training intervention [P=0.39]. But, comparison of the scores before and after the intervention showed that both group and individual training interventions increased the patients' self-efficacy [P

Coping strategies to hinder intention to leave in Iranian nurses: a qualitative content analysis

Due to the high clinical challenges, differences in coping strategies, and high workload in nurses, there is a need to develop strategies to keep them in the profession. The aim of the present study was to explore the Iranian nurses' coping strategies to deal with intention to leave. A qualitative content analysis was used to obtain rich data. We performed 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to Tabriz and Urmia Universities of Medical Sciences in Iran, selected through purposive sampling. Constant comparative method was used for data analysis. Three categories and eleven subcategories emerged during data analysis. The extracted categories and sub-categories consisted of [I] Self-empowerment [practical knowledge increase, responsibility, finding identification of the nurse, balancing work and life, seek support and humanitarian interests], [II] Self-controlling [tolerance, avoidance, the routine-based performance], and [III] Pursuing opportunities for advancement and promotion [community development, planning for higher education]. Nurses make attempts to individually manage problems and stressors perceived from bedside that have led them to leave the bedside; these efforts have been effective in some cases but sometimes they are ineffective due to discontinuous training and relative competence in terms of how to manage and deal with problems. It is suggested that nurses should learn strategies scientifically to meet the challenges of bedside. Through enabling and supporting behaviors and creating opportunities for growth and professional development, nursery managers can help nurses to stay and achieve improvement of the quality of cares

[Effect of open and closed endothracheal suctioning on physiologic parameters and stability in premature infants undergoing mechanical ventilation]

Premature infants are the most admitted group to NICUs. Stabilization of cardio pulmonary parameters is a main goal in NICUs. Mechanical ventilation and endothracheal suctioning are the most common and effective procedures to stabilize cardio pulmonary parameters. The aim of present study was to compare the effects of two endothracheal suctioning methods [open and closed] on physiological stability in premature infants under mechanical ventilation. In this clinical trial, 90 preterm infants [GA: 27-34 weeks] hospitalized in the NICUs of Alzahra and Taleghani hospitals were selected and randomly assigned to two groups. In one group, infants were suctioned using open suctioning method and in the other group, infants were suctioned using closed suctioning method. The physiologic parameters [O2 sat, HR, mean BP variation] and stability [recovery time of HR, BP] were compared between the groups. Data were analyzed using descriptive and inferential statistical methods such as x[2], independent t-test and mixed model in the SPSS-21. There was significant statistical difference between the two groups on mean BP [P=0.016]. Recovery time of the BP and HR was shorter in the closed suctioning group. Physiologic stability was better in the closed suctioning group [P<0.05]. Variation of the mean BP and recovery time was more in the open suctioning group compared with the closed suctioning group. Considering better physiologic effects of closed suctioning, it is recommended to assess the combined effect of closed suctioning with weight on physiologic parameters of premature infants

Emotional Labour of Caring for Hematopoietic Stem Cell Transplantation Patients: Iranian Nurses' Experiences

PURPOSE: The purpose of this study was to describe the emotional labour experienced by nurses who care for hematopoietic stem cell transplantation (HSCT) patients in Iran. METHODS: Eighteen nurses participated in semi-structured interviews. The interviews were analyzed using qualitative content analysis methods. RESULTS: Three main categories described the emotional labour involved, namely, emotional intimacy, feeling overwhelmed with the sadness and suffering, and changing self. Nurses had compassion for their patients, contributing to a close nurse-patient relationship. The nurses' emotional labour resulted in their feeling overwhelmed with sadness and suffering. Five subcategories described this emotional toll: (a) witnessing suffering, (b) struggling mentally, (c) hurting emotionally, (d) feeling drained of energy, and (e) escaping grief. Dealing with death and dying on an ongoing basis promoted the nurses' changing self. CONCLUSION: Iranian nurses who care for HSCT patients experience a range of positive and negative emotions. Establishing appropriate support systems for nurses might help mediate the negative aspects of emotional labour. thereby improving nursing work life and ultimately the quality of patient care.

Importance and availability of nursing support for mothers in NICU: a comparison of opinions of Iranian mothers and nurses

The current study was conducted to compare the opinions of mothers and nurses on the importance and availability of nursing support for parents with premature infants hospitalized in NICU. There is no overall picture of the nursing support for parents with hospitalized premature infants in Iran. Nurses, providing care in NICU, must view parent as an essential partner in care. But what is the situation? Assessing the viewpoints of both parents and nurses regarding the importance and availability of nursing support can elucidate this situation. A comparative descriptive design was used. The population consisted of all mothers with hospitalized premature newborns in NICU [n=300] and all NICU nurses [n=32] in three teaching hospitals in Tabriz [Iran], in 2007. Data was collected through the NPST questionnaire. Data analysis was done wit SPSS. Mann-Whitney test showed that there were significant differences between nurses and mothers on four subscales of nursing support. Generally, mothers scored every subscale lower than nurses who cared for them and their children. On the other hand, it could be said that NICU nurses claimed more importance for the subscales and rated the provided support higher in comparison with mothers who did not think so. The opinions of the nurses and mothers toward the availability and importance of the nursing supports in NICU were different. This study provides nurses with concrete information in order to better understand parents' need for support and try to meet their expectations, resulting in improved nursing care in neonatal intensive care units

[Supports provided by nurses for mothers of premature newborns hospitalized in NICU]

During recent 25 years, development in technology and investigation has been led to survive majority of newborns with low gestational age, even among very premature newborns. Hospitalization of premature newborns immediately after birth is inevitable in most situations. It seems that supports delivered by nurses for families of these newborns are very important. Therefore, the purpose of this study was to determine the importance/amount of supports provided by nurses for mothers of premature newborns hospitalized in NICU. A descriptive cross-sectional design was used to conduct the study. The study population consisted of all mothers with hospitalized premature newborn in NICU [n=300] during the first 6 months, year 2007, in three teaching hospitals in Tabriz [Taleghani, Alzahra, Kodakan]. Sampling method was census and data were collected by NPST questionnaire. Validity of the scale was confirmed in terms of content and translation validity. Reliability of the scale was determined with Cronbach alpha [alpha=0.9]. The findings showed that the most important received by mothers were informational-communicational and quality of care. Also, the difference between perceived importance and received support were statistically significant for four dimensions. Results showed that the mothers wanted more supports than they received from nurses. For this case, planning for promotion of nursing professional supports for parents, especially mothers with hospitalized premature newborn in NICU is necessary