[Life threatening: the most important concern of patients confronting cancer diagnosis]

Increase in cancer prevalence results in feeling fear of being diagnosed with cancer among individuals. Understanding concerns of patients diagnosed with cancer helps health care professionals to provide appropriate caring plans. This study aimed to understand main concerns of patients who confront cancer diagnosis. This was a qualitative study with content analysis approach. Fifteen patients with cancer were selected from a specialized hospital, an oncology clinic, and Emdad Center of Cancer patients in Sari using a purposeful sampling method during May 2011 to June 2012. The sample size was completed regarding data saturation. Data were collected using interviews, observations and recording field notes. All interviews were tape-recorded and transcribed verbatim. Data were analyzed using descriptive content analysis and the Granhim and Landmann method. Three categories including 485 primary codes were emerged. The derived codes were as follows: 1] sever personal and family disturbance; 2] imagination of despair; and 3] unclear imagination of future. The main code included in all derived codes was life threatening nature of cancer. The findings showed that life threatening nature of cancer is a source of fear that makes the disease frightening. Clinical staff and nurses should pay more attention to concerns of patients with cancer and design their care plan accordingly

effects of listening to preferred music on pain intensity after open heart surgery

Pain is a common phenomenon after surgery. Cardiac surgeries are no exception and patients generally experience acute pain after these surgeries. Inadequate pain management after cardiac surgery predisposes patients to many complications. Therefore, the aim of this study was to determine the effects of listening to preferred music on pain intensity after open heart surgery. This study was a randomized clinical trial [RCT] conducted in open heart intensive care unit [ICU] of a university hospital in Sari, Iran. A total of 60 patients who were scheduled to undergo open heart surgery were randomly allocated in two groups. Patients in the intervention group [n = 30] listened to their preferred music by headphones for 30 minutes, whereas those in the control group [n = 30] did not listen to music. Using a Numerical Rating Scale [NRS], pain intensity was measured among the patients before the intervention, and immediately, 30 minutes and one hour after the intervention. Data was analyzed by Chi-square test, student's t-test and repeated measures analysis of variance [ANOVA]. Mean pain intensity in the intervention group before, immediately after, 30 minutes and one hour after the intervention were 5.8, 3.1, 2.5 and 2.4, respectively. Corresponding numbers in the control group were 4.7, 4.7, 4.8 and 4.9, respectively. Repeated measures ANOVA showed music to significantly reduce pain intensity [p = 0.0001]. Music can be effective as a non-pharmacological, inexpensive, non-invasive and side effect free method for pain management after open heart surgery.

[ relation between BMI with exercise test in individuals with cardiac ischemic pains]

Prevalence of over weight and obesity is increasing in the world. Those over weight are more susceptible to cardiovascular diseases than other individual's. Studies indicate that body fat distribution has a determining role in the identification of risk factors. Also, the relation between BMI, cardiac ischemic pains and exercise test condition in such patients, is in need further investigation. The aim of this study was to determine the relation between BMI with exercise tolerance test in patients with cardiac ischemic pains, who were referred to the Cardiac Center of Mazandaran Province, in Sari Township. In this case control study considering the BMI in ischemic patients, 65 were selected as case and 65 persons as control using Tread mill and according to Bruce Protocol, results and tolerance test time was recorded. Independent T test was used for comparison of quantitative indexes mean, while x[2] test using SPSS software was used for comparison of the ratio of persons with the qualitative features. Data indicated mean weight of 57.1 kg and height of 1.64m in the case group. Also, 58.5% had history of hyperlipidemia [Cholesterol higher than 200mg/dl] and 78.8% with history of blood sugar [higher than 120mg/dl [P<0.001]. Even 63.6% had hypertension of 140/90 mm Hg. Our findings showed that BMI in the case and control groups were [26.95 +/- 3.94] and [25.95 +/- 3.49] respectively. Moreover, a significant relationship between high BMI with cardiac ischemic pains and exercise tolerance test [P<0.001] were demonstrated. Cardiac ischemic pains in individuals with high BMI is common. Exercise tolerance test as one of the non invasive and less expensive procedures, can be an indicator of cardiac ischemic disease

[Concept analysis of competency in nursing: qualitative research and delivery of a hybrid model]

Competency is a complicated and an ambiguous concept. It is also a challenging subject in the health care arena, which is significant in different aspects of nursing, such as education, clinic and management. There are ambiguities about it, thus, in this article, researchers conducted analysis of this concept. This research is a concept analysis by the hybrid method. This model has three steps. In literature review stage, 475 related articles exist in databases up to September 2007 were analyzed and evaluated. As to the importance of educational system in the training of nursing courses, 5 educators were interviewed in the field work stage. After listening to tapes, results were Tran scripted and content analysis was done. In the last stage, holistic analysis was carried out. Best definition and properties of competency was selected based on literature reviews. In the field work stage, categories and attributes, same as literature reviews stage, were emerged with interviewing of nursing educators, in addition to holistic view properties, in relation to attitude domain and creativity of management domain. In the last stage, a hybrid model was delivered. In the Iranian field of nursing, educational planning, implementing competency instrument, nurses and students evaluation can be performed according to this study criterion