[Intensive care nurses' reaction to futile cares:a phenomenological study]

Introduction: Emotional stress due to futile care is very high and decreasing level of futile care can result in decrease of stress and increase nurses' job satisfaction

Objective: This study aimed to determine intensive care nurses' reaction to futile cares

Methods: In this qualitative study, a phenomenological approach was used. This study was conducted to understand ICU nurses' reaction to futile cares. Personal interview and observation was used for data collection.All interviews were recorded and coded and analyzed by Van Manen analytical method

Results: In this study 25 ICU nurses participated in personal interview. In primary coding 82 codes were extracted. In process of analysis and constant comparison of data, codes decreased to 78. Finally six categories, 17 subcategories and 2 themes emerged. These themes included robotic care and ethic-emotional conflict

Conclusion: Futile care causes the emotional exhaustion and moral distress for intensive care unit nurses. Lack of guidelines for nurses' practice futile care situation is among essential nursing care problems. Therefore in order to decrease futile care and its effects in nurses, health palnners should develop appropriate interventions to overcome existant barriers

[ qualitative study of managers' perspectives related to change management in schools of nursing and midwifery]

Introduction: The objective of this study was to explain the perspectives of managers regarding change management in nursing and midwifery faculties

Method: This study was conducted according to the qualitative approach; in fact, a descriptive exploratory method was applied with triangulation. Snow ball sampling method was used. Subjects composed of managers in nursing schools in Tehran and the inclusion criterion was at least 1-year experience. In qualitative phase, no variable was measured. Data were gathered by semi-structured interviews in which a guide and field notes were used. Data were saturated after observing the repetition of codes. Content analysis was used for data analysis. The trustworthiness was achieved by a prolonged field experience, member check, peer check and sharing the content with two experts in qualitative research

Results: Ten participants [7 females and 3 males] between 38 and 54 were interviewed. 2 of them had Master degree and 8 with PhD of nursing; only 3 of them were in high-level management of their faculties. After interviews, 124 conceptual codes, 15 sub concepts and 3 core concepts were extracted

Conclusion: Accordingly, the concept of change management was postulated as the purpose of this study. Furthermore, its influencing factors were identified. The implication of the study is in the faculties of nursing and midwifery to use the model according to organizational culture

[Developing and psychometric properties check list of clinical competency in mental health nursing students]

Introduction: One of the challenges in the medicine education system is evaluation of clinical competency of students. Evaluation of students in clinical education courses sometimes is not following a certain principles and also it is not clear that how much they reach to educational objectives at the end of courses. Aim of this study was developing and psychometric properties assessing psychometric properties of check list of clinical competency in mental health nursing students

Methods: This study was methodological approach. Participants were faculty members, head nurses and nurses who work in psychiatric wards and students [undergraduate and master sciences] of Medical Sciences universities of Iran. Based on entry criteria, sampling approach was depending on objective. Domains of tool developed with use of results of first step of research[qualitative part] in addition to study of valid references this filed .After developing primary check list, stages of psychometric properties including determination of validity[content and facial] and reliability[internal consistency and inter-observer correlation] developed. In order to analyze the data descriptive and analytic statistics with SPSS [20th version] were used

Results: Check list of "Clinical Competency of Mental Health Nursing Students" with 73 items was developed. Content validity ratio was. 83 and content validity index was. 98. Measurment of reliability with the use of internal consistency [Cronbach's alpha] was .98 and inter-observer correlation was.70

Conclusion: Check list of "Clinical Competency of Mental Health Nursing Students" in two issues include general and specific competencies with 73 items was developed .It seems for assessment of different dimensions of clinical competencies of mental health nursing students is appropriate tool

[ qualitative study of managers' perspectives related to change management in schools of nursing and midwifery]

Introduction: The objective of this study was to explain the perspectives of managers regarding change management in nursing and midwifery faculties

Methods: This study was conducted according to the qualitative approach; in fact, a descriptive exploratory method was applied with triangulation. Snow ball sampling method was used. Subjects composed of managers in nursing schools in Tehran and the inclusion criterion was at least 1-year experience. In qualitative phase, no variable was measured. Data were gathered by semi-structured interviews in which a guide and field notes were used. Data were saturated after observing the repetition of codes. Content analysis was used for data analysis. The trustworthiness was achieved by a prolonged field experience, member check, peer check and sharing the content with two experts in qualitative research

Results: Ten participants [7 females and 3 males] between 38 and 54 were interviewed. 2 of them had Master degree and 8 with Ph.D of nursing; only 3 of them were in high-level management of their faculties. After interviews, 124 conceptual codes, 15 sub concepts and 3 core concepts were extracted

Conclusion: Accordingly, the concept of change management was postulated as the purpose of this study. Furthermore, its influencing factors were identified. The implication of the study is in the faculties of nursing and midwifery to use the model according to organizational culture

[ effective factors on comatose patient's caring: a hermeneutic phenomenology approach]

Introduction: During of caring of comatose patients, caregivers involve in a lot of factors which effect on caring. This caring is a holistic care undergoing caregiver's preferences. Our purpose was to examine the effective factors on comatose patient's caring

Methods: Van Manen's conception of hermeneutic phenomenology with purposeful sampling of caregivers of comatose patients was used in Tehran in 2012. The data were collected through 10 semi-structured interviews and were analyzed using Van Manen's phenomenology

Results: The participants were 5 males and 5 females, 8 nurses and 2 family members and working in critical care units between 6 and 23 years and working as a teacher. 7 essential sub themes were elicited: effective communication, mutual satisfaction, Depression and disappointment of caregiver, Hopefulness of caregiver, Guilty feeling of caregiver, Belief of death in caregiver and Compassion and sympathy then were classified into 1 theme: caregiver's preferences. This caring means that the caregivers have to realize, percept, understand and evaluate of the caring because the comatose patients are unable to do them. The trustworthiness of sub themes and themes were achieved in our study

Conclusion: The caring in coma is a holistic care and the caregiver is instead of comatose patient. To enhance caring process and to achieve our goals, we created an assessment tool based on the findings of our study; it seems that the results can be used in this regard

[ effect of reflexotherapy on chemotherapy-induced vomiting of patients]

Vomiting as a side effect of chemotherapy causes to refuse or delay in treatment by most cases. Nowadays, for controlling these side effects researchers attempt to use noninvasive-, safe- and low cost methods, instead of expensive drugs with various side effects. This study aimed to assess effect of reflexotherapy on vomiting reduction among patients under chemotherapy, in oncology-hematology ward of Zahedan's Ali Ebn Abitaleb Hospital in 2010. This study was a before and after clinical trial [pre-test and post-test] with a group of 37 patients. The participants were selected using purposeful sampling method and based on the results of a pilot study. They were also considered once in the control group [receiving anti-vomiting drug Granisetron] and after 15 to 20 days in the interventional group [receiving reflexotherapy in a period of 10 minutes for each leg]. The Summary of Morrow Questionnaire and CTCv[2.0] [Common Toxicity Criteria Version 2] of National Cancer Institute of America were used for making a questionnaire to data collection. Face and content validity of questionnaire and its reliability [Chronbach alpha Coefficient =0.73] was confirmed beforehand. Data was analyzed using central and dispersion indexes as well as Wilcoxon and Mann-Whitney tests and Marginal modeling [generalized estimating equations GEE]. The mean age of samples was 44.73 +/- 13.38 [years]. Majority of participants were married and women. Patients were in their second to 15th cycle of chemotherapy; receiving Cisplatin-Gemzar or Adriamycincyclophosphamide and were from breast cancer cases. Assessment of severity of vomiting during first 24 hours showed more sever vomiting in the first 4 hours among control group than interventional group [p<0.001], but it was more severe in interventional gropup than control group in third 4 hours [p<0.001] and the second 12 hours [p=0.006]. During the second 4 hours, severity of vomiting was not significantly different between the two Groups [p=0.313]. Finnally, the results showed no significant difference between two treatment methods respecting their effect on severity [p=0.153] and the number of vomiting [p=0.239] during the 24 hours after treatment. Although reflexotherapy was not shown to have positive effect on chemotherapy induced vomiting of patients but it caused to reduce severity and number of vomiting in the first 4 hours after chemotherapy among patients with moderate and sever vomiting. Therefore, experimental study using reflexotherapy is recommended in multiple sessions.

[Observance of infection control precautions at cupping centers in Tehran]

Cupping is a therapeutic method in which the skin is incised for phlebotomy. Therefore, if infection control precautions are not taken, patients are susceptible to infection. This descriptive study was conducted to assess the observance of infection control precautions before, during, and after the procedure at cupping centers in Tehran. Subject population consisted of 49 practitioners including physicians as well as nurses and 33 cupping units in 16 centers. Data collection tools included a demographic questionnaire and a checklist. Results show that 87.9% of the units had a satisfactory structure and 21.1% was relatively satisfactory. 69.4 % [34], 69.4 % [34], 53.1 % [26] of practitioners took the precautions relatively satisfactory, satisfactory, and relatively satisfactory before, during and after the procedures respectively. In general, 35.2% of practitioners took the precautions satisfactorily. Findings of this study can be used by educators, mangers, and practitioner at different health settings particularly cupping centers