Barriers of pre-hospital services in road traffic injuries in Tehran: the viewpoint of service providers

Iran is one of the countries with considerable road traffic injuries. Pre-hospital interventions have an important role in preventing mortalities and disabilities caused by traffic accidents. The present study aimed to explore the barriers of pre-hospital care in traffic injuries in Tehran, Iran. A qualitative content analysis approach was conducted based on 21 semi-structured interviews with 18 participants. A purposeful sampling method was applied until reaching data saturation. Interviews were transcribed verbatim, and then data condensing, labeling, coding and defining categories were performed by qualitative content analysis. Four main barriers including 4 main categories and 13 subcategories emerged; they included Barriers related to people, Barriers related to metropolitan infrastructure, Barriers related to the profession and Barriers related to managerial issues. Based on the findings of this study, pre-hospital service barriers in traffic accidents have many dimensions including cultural, structural and managerial domains. Policy makers in health system can use these findings to promote the quality of pre-hospital services, especially in the field of traffic injuries

relationship between perceived life changes and mental health in family caregivers of patients with heart failure who referred to Rajaei cardiovascular medical and research center, Tehran

Caring for a patient with heart failure can be a challenging and stressful situation. However, researchers have paid less attention to caregiving outcomes in heart failure caregivers. This study was conducted to investigate the relationship between perceived life changes and mental health of family caregivers of heart failure patients. Through a correlational design, a convenience sample of 90 Iranian family caregivers of patients with heart failure was selected. Data were collected using demographic-clinical characteristics form, Bakas Caregiving Outcomes Scale and General Health Questionnaire-28. Data were analyzed in SPSS using independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression analysis. Half of the caregivers reported that their lives had changed for the worse and nearly three fourths were suspected cases of mental disorders. There was a strong negative correlation between perceived life changes and mental health [r=-0.607, P<0.001]. This finding remained consistent [B=-0.522, P<0.001] even when potential confounding factors including caregiver's age [B=-0.222, P=0.016], caregiver's marital status [B=-6.085, P=0.025], and patient's age [B=-0.153, P=0.030] were controlled. Being younger, unmarried caregiver and caring of younger patients were identified as other correlated factors of poor caregivers' mental health. The strong negative correlation between perceived life changes and mental health in caregivers of patients with heart failure suggests that the heart failure caregivers with poor mental health may benefit from nursing interventions that improve appropriate coping with life changes related to caregiving

Impact of Regular Nursing Rounds on Patient Satisfaction with Nursing Care

PURPOSE: The purpose of the study was to determine the impact of regular nursing rounds on patient satisfaction with nursing care. METHODS: This was a controlled clinical trial in which 100 hospitalized patients in a medical surgical ward were allocated to control and experimental groups through convenience sampling. The experimental group received regular nursing rounds every 1e2 hours. Routine care was performed for the control group. Patient satisfaction with the quality of nursing care was assessed on the second and fifth days of hospitalization in both groups using Patient Satisfaction with Nursing Care Quality Questionnaire. RESULTS: On the second day, patient satisfaction scores of the two groups had no significant difference (p = .499). However, the intervention was associated with statistically significant increased patient satisfaction in the experimental group compared to the control group (p < .001). CONCLUSION: Implementing regular nursing rounds had a positive impact on patient satisfaction. This method may hence improve patient-nurse interactions and promote the quality of nursing care and patient satisfaction.

Mental health in family caregivers of patients with heart failure

Family caregivers of patients with heart failure [HF] deal with a wide range of problems related to caregiving that influence their mental health. The aim of this study was to investigate the mental health status of the family caregivers of patients with HF. In this descriptive cross-sectional study, 90 family caregivers of patients with HF, who referred Shahid Rajaei Cardiovascular Center, were selected through convenience sampling method. The data were collected using General Health Questionnaire [GHQ-28] for measuring mental health and were also analyzed by SPSS 16, and then processed using descriptive statistics, independent t-test, one-way ANOVA and Pearson correlation test. The mean score of GHQ-28 was 33.06 +/- 14.34 [range: 9–72]. The majority of caregivers [74.4%] were suspected cases of mental health disorders. Regarding to instrument subscales, the prevalence of caregivers' problems were 65.6% in somatic symptoms, 82.2% in anxiety/insomnia, 83.3% in social dysfunction, and 25.6% in depression. The total GHQ-28 score of the caregivers gradually decreased with increasing patient's age as in the minimum age group of the patients [aged 40 years and lower], the highest mean score of GHQ-28 was observed [P < 0.05]. A considerable proportion of family caregivers of patients with HF were suspected cases of mental health disorders. A routine assessment of mental health in this group of caregivers should be considered to identify those at risk. Also, clinical team should design and implement effective programs aimed at improving the mental health, especially in caregiver who provide care for younger patients

Effect of clinically competent nurses services on safety and patients5 satisfaction in an emergency department

Access to quality care is important in delivering health services. Patients' safety and satisfaction are indicators of quality of care evaluation. Competent nurses may deliver quality care. This study aimed to investigate the impact of using competent nurses on patients' safety and satisfaction. In this interventional study with non-equivalent control group, we selected 120 patients admitted to the emergency department of Imam Khomeini hospital in 2012 using convenience sampling method. Nursing care for the experimental group [n=40] was provided by nurses who had high competency scores and. In the control group [n=80], nursing care was provided by usual emergency department nurses. Data were collected using the patient satisfaction with nursing care quality [PSNCQ], and patient safety inventory. Data were analyzed in the SPSS v.l 6 using descriptive and inferential statistics. The significance level for all statistical tests was considered at P0.05. Mean age of the intervention and control groups were 48.1 [ +/- 12.5] and 40.5 [ +/- 16.7], respectively [P0.018]. There was a significant difference between the two groups in terms of employment [P0.009]. The two groups were similar in terms of other variables such as gender, marital status, level of education, having health insurance, and the reasons for seeking admission. The results showed that there were significant differences between the two groups in patients' safety and satisfaction with nursing care [P0.001]. Regression test was used to eliminate the effects of age and job satisfaction; the results showed effect of intervention on the patients' safety and satisfaction with nursing care. These findings indicated that using competent nurses in providing nursing care promotes patients' safety and satisfaction with nursing care. Training nurses focusing on the level of competency is required in scheduling, staffing, and implementing nursing care to enhance safety, patient satisfaction, and quality of care

[Exploring nurse-patient communication strategies]

Nurses are informed from patients needs using effective mutual communications. This study aimed to explore the communication strategies between nurses and patients. This study had a qualitative approach with the content analysis method. Participants included 23 nurses, patients and their families in medical and surgical wards of Imam Khomeini hospital of Tehran University of Medical Sciences. Data were collected using interviews and observations. The first and second interviews were conducted unstructured. The semi-structured interviews were then conducted according to the derived concepts from the first and second interviews. We used observation in order to gain a deeper understanding and verifying data from interviews. The observations focused on the interactions between nurses and patients during mutual communications. A final theme was emerged through the data analysis: adaptation of nurses' attitudes and performances. This theme derived from three main categories: caring according to acute needs of patients, creating a professional realm, and participation. The caring according to acute needs of patients included subcategories such as identifying patients' acute needs and nurses' communication behavior. Creating the professional realm implicated on the clarifying roles and maintaining of privacy communication. Participation was defined as the audience and content. The findings showed that nurses, in response to the underlying conditions of nursing care, assimilate their attitudes and performances to be able to meet their professional needs and their patients' needs. In fact, the main character of nurse-patient communication is nurses' active role and patients' passive role

[Scientific publication in nursing and midwifery in Iran]

Production of knowledge in nursing and midwifery is essential to develop body of knowledge and improve quality of health care. In recent years, growth rate of scientific publication in Iran was significant as it could be considered as a scientific jihad. Although everyone is proud of this accomplishment, an important question remaining in nursing and midwifery is that how the pace of scientific publication in these fields is consistent with the pace of scientific publication in other scientific fields. This editorial tries to answer this question. Through searching the Scopus for Iranian papers during 2008-2012 articles, I found 1063 articles in nursing and midwifery indexed in the Scopus. The number of articles was almost doubled per year within the last five years, excluding 2012. It implies coordination of scientific publication in nursing and midwifery with rapid growth of total scientific activities in other scientific fields in the country. On the other hand, findings showed that only 29 articles [2.7%] published by Iranian nursing and midwifery researchers were review articles. While, in the UK, 13.5% of articles in nursing and midwifery was review articles. This finding along with the importance of review articles as credible scientific evidence for clinical decision-making and improving management procedures shows the necessity of writing review articles by senior researchers in Iran. Comparing nationality of authors between Iranian articles with the UK articles showed that only 154 Iranian articles [about 10%] had a non-native author; while, in the UK articles, about half of the articles had non-English collaborating authors. This finding reveals the necessity for further efforts to international studies. Through searching the Pubmed and Web of Science for Iranian articles during 2008-2012, we found 390 and 174 Iranian articles, respectively. The lower rate of articles indexed in these two databases, comparing to the Scopus, indicates the necessity of designing and conducting high quality studies and submitting articles in journals indexed in these two databases. Writing articles which observe principles of scientific writing in proper English language can increase the probability of acceptance of articles in more valid journals. Indexing Iranian nursing and midwifery journals in authoritative indexes can increase the rate of scientific publication. It requires more attention of administrators and editors of Iranian scientific journals to this critical issue

Iranian undergraduate nursing student perceptions of informal learning: a qualitative research

Nursing education is both formal and informal. Formal education represents only a small part of all the learning involved; and many students learn more effectively through informal processes. There is little information about nursing student informal education and how it affects their character and practice. This qualitative study explores undergraduate nursing student perceptions of informal learning during nursing studies. Data were gathered through semi-structured interviews with a sample of undergraduate nursing students [n = 14]. Strauss and Corbin's constant comparison analysis approach was used for data analysis. The categories that emerged included personal maturity and emotional development, social development, closeness to God, alterations in value systems, and ethical and professional commitment. Findings reveal that nursing education could take advantage of informal learning opportunities to develop students' nontechnical skills and produce more competent students. Implications for nursing education are discussed.

[Relationship between quality of senior nursing students' caring behaviors and patients' satisfaction]

Quality of nursing care is a major issue in nursing management. In the last year of nursing studies [internships] in Iran, nursing students are going to independently carry out responsibilities of graduated nurses. Patients' satisfaction is a main indicator for nursing care quality. This study was to determine the correlation between the quality of caring behaviors among internship students with the patients' satisfaction with nursing care quality. In this cross-sectional study, 200 patients were selected using convenience sampling method from the hospitals affiliated to the Tehran University of Medical Sciences. Data were gathered using two questionnaires including: 1] quality of the caring behaviors; and 2] patient satisfaction with nursing care quality questionnaire [PSNCQQ]. Data were analyzed using statistical tests in the SPSS-13. Regarding quality of caring behaviors, the subscale scores of the knowledge and skills were good; and patient education was low. The relationship between the nurses and patients, and nursing morality were in average level. Regarding the patient satisfaction, the highest level of satisfaction was related to nursing knowledge and skills; and the lowest level was related to the patient education. Significant correlation was found between the total quality of the caring behaviors with the patients' satisfaction and their subscales [P<0.001]. Based on the findings, patients are more satisfied with the caring behaviors of the students who focus on the communication with patients, nursing ethics, and especially patient education during the care

[General self-efficacy among family's female caregiver of elderly with Alzheimer's disease]

Caregivers of elderly with Alzheimer's disease, particularly females, encounter challenges. Their different roles in giving care to the patients could result in physical and mental disorders. The self-efficacy seems to be an essential factor in empowering individuals coping with stressful situations and challenging tasks. The aim of this study was to investigate general self-efficacy among women as family caregivers of elderly with Alzheimer's disease. In this cross-sectional descriptive study, 112 women reffered to the Iran Alzheimer Association, Tehran were selected through convenience sampling method. The General Self-Efficacy Scale [GSE-10] was used to collect data. Data were entered into the SPSS-16 and then processed using descriptive statistics and independent t-test, ANOVA and Scheffe. The mean score of the general self-efficacy was 28.24 +/- 6.34 indicating that considerable percentage of the participants had unsatisfactory level of self-efficacy [65.2%]. In addition, there were significant relationships between the women's general self-efficacy with educational and economic statuses [P<0.05]. There were no significant relationships between general self-efficacy with age, marital status, occupational status and duration of caring. According to the findings, a considerable percentage of the participants had unsatisfactory level of self-efficacy. Therefore, it is essential to promote the caregivers self-efficacy in order to give them the ability of better adaptation with the life's challenges. In particular, the self-efficacy promotive programs should be implemented among caregivers with lower educational and economic status

[Exploring contextual factors of the nurse-patient relationship: a qualitative study]

Communication is an important aspect of nursing care and much of nurses' duties such as providing physical care, emotional support, and exchanging of information with patients can not be performed without communication. The quality of care is improved through nurse-patient relationship. Nurse and patient relationship in clinical settings is influenced by multiple contextual factors which recognize them can improve the important role of nursing. This study aimed to explore the contextual factors influencing nurse and patient relationship. The study was performed by qualitative research approach. Participants were 17[8 nurses and 9 patients] in medical and surgical wards of Imam Khomeini hospital of Tehran university of medical sciences that selected by purposive sampling method. Data were gathered by interview [unstructured and semi-structured] and observation. Data analyzed by content analysis approach. Three theme emerged form data analysis which influenced the nurse-patient relationship. Those were formative factors, continuative factors and deterrent factors. These themes were explained in detail in the main text of article. Findings showed that in spite of nurses' positive attitude to communicate with patients and caring their needs, there were problems in nurse-patient communication that prevent from a patient centered communication between nurses and patients