Exploring the criteria and factors affecting firefighters' resilience: A qualitative study / 中华创伤杂志(英文版)

PURPOSE@#Firefighters are exposed to high levels of occupational risk factors, such as safety risks, chemical, ergonomic, and physical hazards that may jeopardize their lives. To overcome these hazards, firefighters must be physically, mentally, and personally fit to work. This study aimed to explore the criteria and factors affecting firefighters' resilience based on stakeholders' experiences.@*METHODS@#This qualitative study was carried out using conventional content analysis. In total, 21 face-to-face interviews were conducted by firefighters who were experienced in the field. The interviews were carried out from July 2019 to January 2020. The data were collected using 3 unstructured interviews and then resumed by 18 semi-structured interviews. Data analysis was done using Graneheim method.@*RESULTS@#The participants had more than 5 years of experience in the field of search and rescue. The extracted codes through data analysis were classified into 3 main categories (individual, organizational, and social factors), 9 sub-categories (mental, physical, occupational, managerial, colleagues-related, equipment-related, environmental, community-related, and family-related factors), as well as 19 sub-sub-categories and 570 codes.@*CONCLUSION@#Firefighters' personality, physical condition, behavior and psychological characteristics can affect their resilience along with organizational and management factors that play significant role in people's safety. Developing a tool for assessing resilience can help decision makers to have a real depict of firefighters' job qualifications.

Construction and validation of a mentoring questionnaire based on Islamic culture / 한국의학교육

Education is considered to be a cultural and value-driven matter where any intervention in this field requires certain tools in order to describe the status quo. The current study, while taking into account the contextual texts related to Islamic mentoring, seeks to develop a tool to quantify this concept, as well as introduce the respective psychometric properties. A 113 items questionnaire was designed after reviewing the literature, the recommended guidelines concerning Islamic mentor and mentee, and reviewing available international tools. Content validity of the questionnaire was evaluated based on several criteria of clarity, fitness, and comprehensiveness by a survey of 10 experts and the necessary corrections were made. In the primary phase of this study, the psychometric properties of this questionnaire were evaluated by collecting the data from a random sample of 213 Iranian Ph.D. students in Tehran Universities of Medical Sciences. The factors analysis results show that 70 items, in the form of nine factors, construct the Islamic monitoring. Furthermore, The Cronbach's α coefficient was determined for each factor and the entire questionnaire. Total reliability of the scale was obtained at 0.97. Considering the confirmed validity and reliability of the questionnaire, this tool can be highly beneficial for the experts and education professionals, particularly in the field of medicine, for the assessment and establishment of mentoring.

Construction and validation of a mentoring questionnaire based on Islamic culture / 한국의학교육

Education is considered to be a cultural and value-driven matter where any intervention in this field requires certain tools in order to describe the status quo. The current study, while taking into account the contextual texts related to Islamic mentoring, seeks to develop a tool to quantify this concept, as well as introduce the respective psychometric properties. A 113 items questionnaire was designed after reviewing the literature, the recommended guidelines concerning Islamic mentor and mentee, and reviewing available international tools. Content validity of the questionnaire was evaluated based on several criteria of clarity, fitness, and comprehensiveness by a survey of 10 experts and the necessary corrections were made. In the primary phase of this study, the psychometric properties of this questionnaire were evaluated by collecting the data from a random sample of 213 Iranian Ph.D. students in Tehran Universities of Medical Sciences. The factors analysis results show that 70 items, in the form of nine factors, construct the Islamic monitoring. Furthermore, The Cronbach's α coefficient was determined for each factor and the entire questionnaire. Total reliability of the scale was obtained at 0.97. Considering the confirmed validity and reliability of the questionnaire, this tool can be highly beneficial for the experts and education professionals, particularly in the field of medicine, for the assessment and establishment of mentoring.

Quality of life among family caregivers of patients on hemodialysis and its relevant factors: a systematic review

Background: Family caregivers are considered as hidden patients experiencing physical and mental disorders. This affects the quality of not only their lives but also the health care provided to patients. This study aimed to investigate the quality of life [QOL] and its related factors among the caregivers of patients undergoing hemodialysis

Methods: This systematic review was conducted based on the eight-step guidelines presented by the York University. The databases relevant to the medical field including Nursing and Allied Health, Web of Science, Scopus, Pubmed, Embase, PsycINFO and Psychology Library were used. Finally, 12 articles observing the inclusion criteria and with regard to the research questions were found. The data obtained from these articles were summarized, classified, and analyzed

Results: QOL among Family Caregivers of Patients on Hemodialysis is low, compared to the general population; however, their QOL is higher than the patients under their care. Factors relevant to the QOL for caregivers including age, gender, perceived social support, perceived burden of care, affliction with other diseases [lupus, hypertension, hypothyroidism and depression], intellectual understanding of the limitations of the patient's disease in their daily life, employment of adaptation strategies, better marital relationships, accepting self and family relationship with the patient [mother and wife]. Furthermore, the factors associated with care takers affecting the quality of caregivers' lives were age, QOL and the type of treatment

Conclusions: Caregivers of patients undergoing hemodialysis enjoyed low QOL. Since there is a direct relationship between family caregivers' quality and patients' QOL, health care system and health policy makers should pay more attention to family caregivers

Antecedents of coping with the disease in patients with multiple sclerosis: a qualitative content analysis

Background: Due to many physical and mental disorders that occur in multiple sclerosis patients, identifying the factors affecting coping based on the experiences of patients using qualitative study is essential to improve their quality of life. This study was conducted to explore the antecedents of coping with the disease in patients with multiple sclerosis

Methods: This is a qualitative study conducted on 11 patients with multiple sclerosis in 2015 in Tehran, Iran. These patients were selected based on purposive sampling. Data were collected using semistructured and in-depth interviews and coded. These data were analyzed using the conventional content analysis. The rigor of qualitative data using the criteria proposed by Guba and Lincoln were assessed

Results: Five main categories were revealed: [1] social support, [2] lenience, [3] reliance on faith, [4] knowledge of multiple sclerosis and modeling, and [5] economic and environmental situation. Each category had several distinct sub-categories

Conclusions: The results of this study showed that coping with multiple sclerosis is a complex, multidimensional and contextual concept that is affected by various factors in relation to the context of Iran. The findings of the study can provide the healthcare professionals with deeper recognition and understanding of these antecedents to improve successful coping in Iranian patients suffering from multiple sclerosis

Empowering education: a new model for in-service training of nursing staff

Introduction: In-service training of nurses plays an indispensable role in improving the quality of inpatient care. Need to enhance the effectiveness of in-service training of nurses is an inevitable requirement. This study attempted to design a new optimal model for in-service training of nurses

Methods: This qualitative study was conducted in two stages during 2015-2016. In the first stage, the Grounded Theory was adopted to explore the process of training 35 participating nurses. The sampling was initially purposeful and then theoretically based on emerging concept. Data were collected through interview, observation and field notes. Moreover, the data were analyzed through Corbin-Strauss method and the data were coded through MAXQDA-10. In the second stage, the findings were employed through Walker and Avant's strategy for theory construction so as to design an optimal model for in-service training of nursing staff

Results: In the first stage, there were five major themes including unsuccessful mandatory education, empowering education, organizational challenges of education, poor educational management, and educational-occupational resiliency. Empowering education was the core variable derived from the research, based on which a grounded theory was proposed. The new empowering education model was composed of self-directed learning and practical learning. There are several strategies to achieve empowering education, including the fostering of searching skills, clinical performance monitoring, motivational factors, participation in the design and implementation, and problem-solving approach

Conclusion: Empowering education is a new model for in-service training of nurses, which matches the training programs with andragogical needs and desirability of learning among the staff. Owing to its practical nature, the empowering education can facilitate occupational tasks and achieving greater mastery of professional skills among the nurses

Death anxiety among nurses and health care professionals: a review article

Death anxiety, a negative affective state that is incited by mortality salience, may be experienced by nurses and other health care workers who are exposed to sickness, trauma, and violence. This paper examines death anxiety and management strategies among health providers in different health settings across cultures. A literature review of the research published since 2000 in the English language was conducted using PubMed, Science direct, CINAHL, and PsychInfo databases. Death anxiety is commonly experienced and is associated with more negative attitudes about caring for dying patients and their families. Performing educational and psychological interventions to help nurses build strong coping strategies for managing death anxiety are recommended to offset negative consequences such as leaving positions, poor communication, and decrements in personal health and quality of life

[Frequency of dyslipidemia and its accompanying factors in hemodialysis patients]

Dyslipidemia is a common disorder and one of the major causes of the atherosclerosis development and progression in hemodialysis patients. Timely diagnosis and treatment of dyslipidemia can reduce mortality and morbidity of cardiovascular disease and protect the remaining function of kidneys in patients with chronic renal failure. This study was performed with the objective of evaluating the frequency of dyslipidemia and its accompanying factors in hemodialysis patients. In a descriptive cross-sectional study, 182 patients with chronic renal failure referred to hemodialysis units of Baqiyatallah and Shahid Chamran hospitals, Tehran in 2012 were studied. For data collection, in addition to demographic questionnaire, serum levels of cholesterol, triglyceride, HDL and LDL were measured. Data analysis was done using Chi-square, independent t-test, and one-way ANOVA. The significance level was considered to be p<0.05. In this research, 8.2% of the patients had hypercholesterolemia, 26.4% hypertriglyceridemia, and 6.8% LDL level more than 130. In half of the patients, serum HDL was less than 35. A significant relationship was observed between dyslipidemia and variables of gender [p=0.001], duration of hemodialysis [p=0.004], education level [p=0.005], and weight [p=0.007]. Dyslipidemia has a high prevalence in hemodialysis patients, especially patients with low literacy and obesity. So that, at least one of the components of lipid profiles is abnormal in more than 80% of hemodialysis patients. Therefore, planning to improve life style and provide training on proper nutrition and physical activity is recommended as one of the principles of care in hemodialysis patients

[ effect of vitamin C supplementation on serum levels of hemoglobin, hematocrit and ferritin in hemodialysis patients: a randomized clinical trial]

Anemia is one of the common complications of chronic renal failure and vitamin C can improve anemia through releasing iron from ferritin and its transfer from the reticuloendothelial system to transferrin. This study was performed with the objective of evaluating the effect of vitamin C supplementation on serum levels of hemoglobin, hematocrit, and ferritin in hemodialysis patients. In a double-blind clinical trial, 178 patients with chronic renal failure were randomly divided into three groups of intervention, control, and witness. In the intervention group, 250 mg vitamin C, 250 mg of vitamin C was injected intravenously at the end of each hemodialysis session three times a week for 8 weeks. In the witness group, same amount of placebo saline was injected at the same time, and no intervention was performed in the control group. Laboratory parameters, including serum levels of hemoglobin, hematocrit, and ferritin were measured at the beginning and end of the intervention. Data analysis was performed by Chi-square and one-way ANOVA. The significance level was considered to be p < 0.05. There were significant differences in serum levels of hemoglobin and hematocrit in the intervention group, but, the changes of the serum level of ferritin were not significant in any of the groups. The results of this study showed that vitamin C supplementation in hemodialysis patients can significantly increase the mean serum levels of hemoglobin and hematocrit, however, it cannot significantly change the serum ferritin level

systematic review of the liaison nurse role on patient's outcomes after intensive care unit discharge

This review focuses on the impact of liaison nurse in nursing care of patient after ICU discharge on patient's outcomes, compared with patients that are not taken care of by liaison nurses. The role of the ICU liaison nurse has transpired to solve the gap between intensive care unit and wards. Therefore, we aimed to review the outcomes of all studies in this field. A systematic review of intervention studies between 2004 and 2013 was undertaken using standard and sensitive keywords such as liaison nurse, intensive care unit, and patient outcomes in the following databases: Science direct, PubMed, Scopus, Ovid, Oxford, Wiley, Scholar, and Mosby. Then, the articles which had the inclusion criteria after quality control were selected for a systematic review. From 662 retrieved articles, six articles were analyzed in a case study and four articles showed a statistically significant effect of the liaison nurse on the patient's outcomes such as reducing delays in patient discharge, effective discharge planning, improvement in survival for patients at the risk for readmission. Liaison nurses have a positive role on the outcomes of patients who are discharged from the ICU and more research should be done to examine the exact function of liaison nurses and other factors that influence outcomes in patients discharged from ICU

Studying the Environmental health status and consumption of Baking soda in military and urban Lavash bakeries of Tehran in 2012

Consumption of baking soda, as a primary material for preparation of bread dough, has been banned due to its health complications in Iran. So bread production in our country faced difficulties and one part of them is related to health issues which are bread production. Also, in some cases, baking soda is used in the bread production. This study was done to study the environmental health status and consumption of baking soda in the military and urban Lavash bakeries of Tehran in 2012. This is a descriptive comparative study done on Lavash bread production of 14 military bakeries and 14 corresponding urban bakeries near them. PH in the samples was tested based on Institute of Standards and Industrial Research of Iran No. 2628. To check the status of environmental health and personal hygiene of bakeries, the check list of Cereal Research Center was used. In terms of environmental health status,28.6% military bakeries and7.1% urban bakeries were at good level. In terms of personal hygiene, all bakeries were in the poor category. Also,42.9% of military Lavash bakeries and 14.3% of urban Lavash bakeries used baking soda in their bread production. Environment health and personal hygiene status in military bakeries are better than the urban bakeries; however, hygiene status was not desirable in military bakeries. Also, baking soda consumption in military bakeries was more common than the urban bakeries. According to the results of this study, control of health status and avoiding baking soda consumption in the bakeries are necessary. [Rostami H. farajzadeh D. Haratian P.Masoumbeigi H.Ebadi A. Delkhosh M. Studying the Environmental health status and consumption of Baking soda in military and urban Lavash bakeries of Tehran in 2012. IJHS 2013; 1[1]: 19-24] http:/jhs.mazums.ac.ir

Professional concerns of role-model nursing instructors: a qualitative research

The present study was conducted to perceive the role-model nursing instructors' experience in terms of professional challenges and identification of occupational concerns in the education of nursing students. Nursing instructors have a critical and decisive role in the training of skilled and specialized manpower and subsequent growth and development of the communities. So, the present study was conducted to address the role model nursing instructor's experience in terms of professional challenges of nursing students' education. The present qualitative study was carried out using the inductive thematic analysis method and the objective-based sampling. Data were collected until saturation, using three focus-group discussions [n=22] and two individual interviews with nursing instructors, as well as eight semi-structured face-to-face interview's with role-model instructors from five nursing faculties of the universities in Tehran. The three main themes were extracted, indicating the occupational challenges perceived by the instructors as follows: [Inefficient education-research system] [Inappropriate professional position] and [Ineffective interpersonal interactions]. Regarding the concerns of successful model instructors, professional development, prevention of job dissatisfaction, and implementation of role modeling strategies are recommended to be emphasized. Taken together, reducing the clinical training-associated problems in order to modify the education-research system was recognized as the main professional concern of the role-model nursing instructors

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

[Expectations of faculty of nursing schools in Tehran on administrative management of schools: a qualitative study]

Motivated faculty promotes nursing students' educational level which leads to community health promotion. Attempts should be made to recognize and analyze motivating factors including expectations. This qualitative study attempted to clarify expectations of faculty of Tehran nursing schools on management system. This was a qualitative study. The participants were 14 nursing faculty members of Tehran, Shahid Beheshti, Artesh, Shahed, and Baghiatallah Universities located in Tehran. Purposive sampling was used to recruit the participants. Data were collected using semi-structured interviews with the participants. Qualitative content analysis was used to analyze the data. Expectations of nursing faculty were explained in eight categories: empowerment of the faculty, organizational support, fairness, appropriate performance evaluation, providing appropriate working conditions, applying appropriate management strategies, attention to welfare and financial problems and promoting quality of education and research. Understanding the expectations of the nursing faculty and trying to meet them can improve performance of the faculty. Meeting these expectations can enhance motivation and job satisfaction among the faculty

Comparison of nursing students' and clinical nurses' attitude toward the nursing profession

To develop nursing education and promote nursing strategies, there is a need for a staff with positive attitude. The present study was conducted to compare the attitudes among clinical nurses and nursing students toward the nursing profession. In this descriptive- analytical study 313 clinical nurses and 81 nursing students [total n = 394] of Tehran, Iran, were selected through a systematic sampling method and their viewpoints were investigated using a nursing professional attitude questionnaire. The findings of this study showed that 72.6% of nurses and 65.4% of students had positive attitude toward their profession, and despite the high percentage of the clinical nurses' positive outlook, the difference was not statistically significant [P > 0.05]. The results showed that approximately one-third of the students and nursing practitioners had neutral or negative attitude toward their occupation. Due to the serious effect of one's professional attitude and commitment of service, it is necessary to have further studies about the current situation to eliminate such negative factors.

[Comparison of quality of life in military personnel with and without hypertension]

Quality of Life is people perception of their position in life regard to the cultural context and values which they live in. It is in relation with their goals, expectations, standards and concerns. In recent years increasing in quality of life of hypertensive patients became a goal in national health systems. The aim of this study was to compare health related- quality of life in male military personnel with and without hypertension. In this descriptive-comparative study, 200 male military [100 hypertensive patients and 100 healthy men] was selected with convenience sampling in Tehran. The quality of life was assessed by short form [SF36] quality of life questionnaire. The data was analyzed by independent t- test and chi-square. Mean age in hypertension group was 8.48 +/- 44.83 and in the compare group was 50 +/- 40.44. The quality of life was 82.20 +/- 10.72 and 72.77 +/- 17.60 in hypertensive and compare group. The quality of life was higher in the compare group [P<0.001]. Quality of life in chronic diseases such as hypertension is lower. Therefore there is need for more attention on early detection and better treatments based on the quality of life in people with hypertension

Experiences Living with Fatigue in Iranian Veterans Chemically Injured by Sulfur Mustard Gas: A Phenomenological Study

PURPOSE: Fatigue affects the quality of life. Evidence shows that the phenomenon of fatigue is experienced differently depending on the type of disease and its consequences. The aim of the study was to explicate the meanings of the experience of living with fatigue in chemically injured veterans. METHODS: The hermeneutic phenomenology approach was used in this study, with an emphasis on Van Mennen's viewpoint and approach. According to Van Mennen, six overlapping dynamic activities are recommended to conduct a phenomenological study. During unstructured interviews, the participants were asked to describe their daily living experiences with fatigue. The participants were individuals who were chemically injured due to exposure to mustard gas. After examining every statement in the interview text, extractions of the meaning units, clustering, and themes were performed. RESULTS: The data explication was based on the third to sixth stages of Van Mennen's approach. The experience living with fatigue was classified into four essential themes: fatigue as a chronic condition, as an unstable and affected situation, as a physical condition of the entire individual, and as a mental condition of the entire individual. CONCLUSION: Due to unique social interactions and pathogenicity, victims of mustard gas experience fatigue differently than patients with other chronic diseases.

Validity and reliability of neonatal infant pain scale in neonatal intensive care units in Iran [2010]

This study aimed to determine validity and reliability of the NIPS [Neonatal Infant Pain Scale] in the neonatal intensive care unit [NICU]. For this study, sixty eight infants were selected using available and purposive sampling method after translating the English version of NIPS to Persian using International Quality of Life Assessment [IQOLA] scale. These children have been filmed before, during and after two interventions of venipuncture and catheter insertion which was required and was ordered by physician. During painful interventions and until three minutes later, heart rate and arterial oxygen saturation of the infants were recorded. Thereafter, five observers [including three nurses, a neonatal specialist and the researcher nurse] scored the infants pain by watching the videos and using the translated version of NIPS. The Interclass correlation coefficient [ICC] was perfect [ICC > 0.9]. The minimum correlation coefficient between inter-rater was 0.868. Validity tests showed a high correlation between NIPS and visual analog scale [r = 0.949; p < 0.001]. According to the confirmed validity and reliability of this scale, use of NIPS in neonatal intensive care units in Iran is possible and can be recommended

[Relationship between sleep quality and quality of life in chemical warfare victims with bronchiolitis obliterans referred to Baqiyatallah hospital of Tehran, Iran]

Decrease of quality of life and undesirable sleep in individual with bronchiolitis due to chemical exposure reported in previous studies. This study was applied to assess relationship between sleep quality and quality of life in chemical warfare victims with bronchiolitis obliterans. In this descriptive correlative study, 93 chemical warfare victims with bronchiolitis obliterans referred to respiratory clinic of Baqyatallah hospital were selected by convenience sampling method. Quality of life and sleep quality was measuring the St George's Respiratory Questionnaire and Pittsburgh sleep Quality Index [PSQI]. Pearson correlation coefficient was showed a positive and significant correlation between sleep quality and quality of life. Also it was revealed significant relationship between psychological disorders and undesirable sleep quality [P<0.05]. The findings suggest there is need to improve sleep quality in this population in order to enhance their heathed-related quality of life

[ study of stress among head nurses in selected hospitals of Tehran]

Social changes, economic conditions, special class and living place situations have been understood as stressors for head nurses. Head nurses have an important role in quality of service delivery to clients. The purpose of this study was to examine stress among head nurses in selected hospitals in Tehran. This was descriptive cross-sectional study on 90 head nurses selected by census sampling. The participants filled out a questionnaire containing demographic characteristics and stressors variables. Data were analyzed by SPSS and descriptive and inferential statistical were reported. The finding showed that 74.4% of head nurses had normal stress and 25.6% of them had severe stress. There was statistically significant relationship between stress and experiencing general management course [P=0.03]. Role conflict and the absence of organizational support were respectively found to have the most and the least influential effect on stress. Also, job stress in heads nurses who had passed general management course was less than the others