Perceptions of professional challenges by emergency medical services providers: a qualitative content analysis study.

INTRODUCTION: Emergency medical services (EMS) providers encounter a variety of challenges due to the unpredictable, uncontrollable, and dynamic conditions in the pre-hospital field. This study explored the perceived professional challenges among EMS providers. MATERIALS AND METHODS: This study was conducted using a qualitative research approach and the method of content analysis. Eighteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. The collected data were then analyzed based on the Granheim and Lundman's method. RESULTS: Based on data analysis, five categories and one theme were identified. The extracted theme was professional challenges. The five categories were as follows: Ineffective policies; multicultural and multidisciplinary factors; ambulance dispatch route problems; legal issues; and abuse against the emergency medical services CONCLUSION: In general, it has been found that EMS providers encounter numerous and complex professional challenges during their work. EMS managers can utilize the findings of the present study to develop strategies for reducing the professional challenges faced by EMS providers. By doing so, they can improve the quality of care in the prehospital field.

Designing and psychometric assessment of the moral intelligence scale for healthcare professionals.

The moral intelligence of healthcare professionals in the cardiac operating room is one of the most important aspects of professional competence. However, moral intelligence is an abstract and multidimensional concept that needs to be clarified and described based on organizational culture and environment. Therefore, there is a need to design a specific scale for measuring the moral intelligence of healthcare professionals in the cardiac operating room. This study aims to design and assess the psychometric properties of a moral intelligence scale for healthcare professionals in the cardiac operating room. The present study was a mixed method study with a sequential exploratory approach. The research was conducted in 2023-2024 in Iran. The first phase data were collected from 20 healthcare professionals and were analyzed by conventional content analysis method. In the second phase, the validity and reliability of the instrument were evaluated by involving 300 healthcare professionals in the cardiac operating room. The moral intelligence of health care professionals in the cardiac operating room was defined as moral sensitivity combined with moral commitment and moral courage for the provision of quality care that respects the principles of medical ethics. After deducing the conceptual framework, the moral intelligence scale for healthcare professionals in the cardiac operating room was developed with three dimensions: "moral sensitivity," "moral commitment," and "moral courage." 11 items were removed during testing to ensure content validity. Face validity was confirmed with impact scores > 1.5 for all items. A scale was developed through factor analysis with three factors that accounted for 73.04% of the observed variance. The instrument's reliability using Cronbach's alpha coefficient calculation was reported as 0.94 for the entire instrument. The testretest showed no statistically significant difference between the pre and post-test scores of moral intelligence (p = 0.51). The moral intelligence scale demonstrated acceptable psychometric properties. The moral intelligence scale for health care professionals in the cardiac operating room demonstrated acceptable psychometric properties. This instrument may serve to assess the moral intelligence of healthcare professionals and determine the need for educational interventions to reduce the ethical challenges and improve the moral intelligence of this healthcare.

Effect of acupressure on pain intensity and physiological indices in patients undergoing extracorporeal shock wave lithotripsy: a randomized double-blind sham-controlled clinical trial.

BACKGROUND: Despite the widespread use of extracorporeal shock wave lithotripsy (ESWL) as a treatment for kidney stones, it is essential to apply methods to control pain and improve patient comfort during this procedure. Therefore, this study aimed to investigate the effect of acupressure at the Qiu point on pain intensity and physiological indices in patients undergoing ESWL. METHODS: This randomized, sham-controlled clinical trial was conducted at the Shahid Beheshti Educational-medical Center in Hamadan City (western Iran) from May to August 2023. Seventy-four eligible patients were split into intervention (n = 37) and sham (n = 37) groups. Ten minutes before lithotripsy, the intervention group received acupressure at the Qiu point, while the sham group received touch at a neutral point. The primary outcomes were pain intensity measured by the Visual Analog Scale (VAS) and physiological indices such as blood pressure and heart rate at baseline, 1, 10, 20, 30, 40, and 50 min after the intervention. The secondary outcomes included lithotripsy success and satisfaction with acupressure application. RESULTS: The analysis of 70 patients showed no significant differences in the demographic and clinical information of the patients across the two groups before the study (P > 0.05). Generalized estimating equations revealed that the interaction effects of time and group in pain and heart rate were significant at 30 and 40 min (P < 0.05). The results of this analysis for systolic blood pressure revealed a significant interaction at 30 min (P = 0.035). However, no significant interaction effects were found for diastolic blood pressure changes (P > 0.05). CONCLUSIONS: Acupressure at the Qiu point positively impacts pain in patients undergoing ESWL treatment and increases their satisfaction. However, these results for physiological indices require further studies. Thus, acupressure can be considered a simple, easy, and effective option for pain management in patients during this procedure. TRIAL REGISTRATION: [ https://en.irct.ir/trial/69117 ], identifier [IRCT20190524043687N4].

Investigating the relationship between domestic violence with substance abuse and suicide resilience in mothers with disabled children.

Introduction: Mothers with disabled children are among the most critical groups exposed to domestic violence. Although domestic violence strongly affects these mothers' physical and mental health, it subsequently affects their drug addiction and resilience to suicide. Based on this, it is crucial to investigate domestic violence, drug addiction, and resilience against suicide in mothers with disabled children. This study investigated the relationship between domestic violence, substance dependence, and resilience against suicide in mothers with disabled children in Iranian society. Methods: From January to April 2023, a cross-sectional study was conducted in central and western Iran with the participation of 267 mothers with disabled children. The mothers of disabled children were selected through convenience and snowball sampling. Then they completed questionnaires included domestic violence, substance dependence and resilience against suicide. The collected data were analyzed using SPSS version 22 with descriptive statistics, such as prevalence, percentage, mean, and standard deviation, and expository measurements, including ANOVA, independent t, and regression tests. Results: The study revealed that there was a strong direct correlation between domestic violence and substance abuse (r = 0.89, p < 0.001), as well as a strong indirect correlation between domestic violence and suicide resilience (r = -0.90, p < 0.001). Additionally, substance abuse and suicide resilience were negatively correlated (r = -0.93, p < 0.001). Other variables, such as the severity of children's disability, education, financial status, and the fathers' involvement, were predictors of domestic violence, accounting for 73.28% of the variance. Conclusion: Mothers with disabled children reported moderate levels of domestic violence, which strongly impacts their physical and mental well-being, leading to drug dependency and suicide. So, it is essential to implement comprehensive planning and provide extensive support to reduce domestic violence against them. By doing so, we can enhance their physical and mental health and ultimately improve their overall quality of life.

Experiences of persons with multiple sclerosis of a collaborative care programme: A qualitative study.

AIM: This study aimed to explain the experiences of individuals with multiple sclerosis (MS) about the collaborative care programme. DESIGN: This qualitative study was conducted from July 2021 to March 2022. METHODS: We conducted this study with individuals with MS who participated in the collaborative care programme in Hamadan, Iran. A purposive sampling with maximum variety was applied to recruit patients until data saturation. Eventually, 18 patients consented and were interviewed using a semi-structured interview guide. The transcriptions of audio-checked interviews were analysed using a conventional content analysis approach of Graneheim and Lundman by MAXQDA 10, 2010 edition. RESULTS: The study identified three main categories. that emerged from the participants' experiences of collaborative care: the 'Beginning of Communication', which included two subcategories, 'Introduction and Acquaintance with Each Other' and 'Formation of Trust'; 'Mutual Interaction', which included three subcategories, 'Dialogue', 'Mutual Goal Setting' and 'Mutual Agreement of Care Solutions'; and 'Exchange of Targeted Behaviors', which included six categories, Implementation of Strategies for 'Nutritional Behaviors', 'Sleep and Rest', 'Constipation Relief', 'Promotion of Physical Activity and Exercise', 'Fatigue Reduction' and 'Stress Management'. CONCLUSIONS: The findings highlight the statistically significant role of collaborative care in MS management. Utilizing these research findings can update the development of interventions based on collaborative care, which can provide appropriate support to individuals with MS. PATIENT OR PUBLIC CONTRIBUTION: Individuals with multiple sclerosis.

Nurses' healing presence: A panacea for the comfort of acute coronary syndrome patients in CCU, A qualitative study.

AIM: The study aimed to explain the acute coronary syndrome (ACS) patients' perception of the nurse's healing presence in their comfort in the critical care unit. DESIGN: This descriptive qualitative study was conducted from December 2020 to September 2021. METHODS: Twenty-seven ACS patients were purposively selected from a cardiovascular university Hospital, Iran. Data were collected through semi-structured interviews (45-60 min). Data analysis was performed based on the contractual content analysis method of Graneheim and Lundman. RESULTS: In the data analysis, the main theme 'nurses' healing presence' includes two categories: 'Nurse-patient communication' with two subcategories and the category 'Compassionate care' with three subcategories.

Evaluation of the effect of fish oil in the prevention of pressure ulcers in patients admitted to the intensive care unit.

Introduction: Today, the anti-inflammatory property of fish oil is used to heal wounds, but this property has not been investigated to prevent the occurrence of pressure ulcers. So the research team decided to evaluate this feature as well. Materials and methods: This clinical trial study was performed on 102 patients admitted to the intensive care unit located at Besat Hospital in 2020. Samples were assigned to three groups control, placebo, and intervention using permutation blocks. Before the intervention, the questionnaire of demographic and clinical variables, level of consciousness, Braden scale, and short nutritional status questionnaire was completed by the main researcher. In the intervention group, in addition to routine care, 2 cc of fish oil was gently rubbed into the sacrum once a day for 5 days. The same intervention was repeated in the placebo group, with the difference that soybean oil was used instead of fish oil, and the control group received only the usual care. The daily evaluation of pressure ulcers by one of the ICU nurses lasted up to 6 days. Results: The results showed that there was a significant difference in the incidence of pressure ulcers in the three groups (P = 0.043). The risk of pressure ulcers in the control group was 11.9 and 2.7 times higher than the fish oil group and placebo group (P = 0.023) & (P = 0.132). Conclusion: The use of topical fish oil can be effective in preventing pressure ulcers.

The effect of applying the nursing process based on the Theory of Goal Attainment on activities of daily living and quality of life in persons with multiple sclerosis during COVID-19 pandemic: a clinical trial.

BACKGROUND: The chronic nature of multiple sclerosis (MS) affects patient's activities of daily living (ADL) and quality of life (QOL). Nursing interventions based on patients' active participation in goal-setting can be beneficial in improving ADL and QOL. AIMS: This study aimed to determine the effect of applying the nursing process based on King's Theory of Goal Attainment (TGA) on ADL and QOL of persons with multiple sclerosis (PwMS) during the COVID-19 pandemic. METHODS: In this clinical trial, 70 patients referred to the MS Society of Hamadan, Iran, were recruited using the convenience sampling method and randomly assigned into 2 groups. A 4-stage TGA was developed and implemented for the intervention group for a month. Data were gathered by ADL, instrumental ADL (IADL), and QOL questionnaires, and Goal of Attainment Scale (GAS) before and 2 months after the intervention. RESULTS: Intervention group achieved a higher number of prioritized goals (p < 0.001) and reported higher QOL (P < 0.001) and instrumental ADL (IADL; P = 0.002) than the control group. CONCLUSIONS: Given the results, TGA could effectively promote mutual goal attainment, QOL, and IADL for PwMS during the COVID-19 pandemic. TRIAL REGISTRATION: ClinicalTriasl.gov Identifier: IRCT20201210049668N1.

Suicide resilience, identity crisis and quality of life in burned adolescents.

AIM: The aim of this study was to investigate the relationship between identity crisis and suicide resilience and quality of life in adolescents with burns in Iranian society. DESIGN: A cross-sectional study. METHODS: Four hundred thirty adolescents with burn in three hospitals were selected via convenience sampling. They completed questionnaires online. Data were analysed by SPSS software version 22. RESULTS: Findings showed a strong and inverse correlation between identity crisis with suicide resilience (r = -.92, p < .001) and quality of life (r = -.87, p < .001). Variables of suicide resilience, being a child of a divorced family, cause of burns, extent of burn, financial situation, gender and age can predict 68.74% of the variance in identity crisis in these patients. PATIENT OR PUBLIC CONTRIBUTION: Adolescents with burns suffer from an identity crisis, and although they report high resilience to suicide, they have a mediocre quality of life. Therefore, it is suggested that basic planning and extensive support be taken to improve physical and mental health, promote the quality of life and consequently reduce the identity crisis in these adolescents.

Perception of facing life's challenges in patients with spinal cord injury in Iran: a qualitative study.

BACKGROUND: Spinal cord injury (SCI) is one of the most serious types of physical trauma and has become a major life-threatening condition in the recent decade. It is essential that the life perception and experiences of patients with SCI be studied and evaluated in different cultural contexts so that their needs and the challenges they face can be properly determined. The present study aims to explore the how patients with SCI in the south of Iran perceive facing life's challenges. METHODS: The present study is a qualitative research with a descriptive phenomenological design. Participants were identified through purposive sampling of patients with spinal cord injury admitted to two state hospitals affiliated with a university of medical sciences in western Iran. The researchers collected data using semi-structured, in-depth interviews with 25 SCI patients conducted between August and October 2021. Data was analyzed according to Colaizzi's method using MAXQDA v. 2007. RESULTS: Analysis of the data led to the emergence of three themes and nine sub-themes. The three main themes were emotional shock (crisis making and mental rumination, persistent depressive disorder, pitying behaviors, fear of the future), loss of dignity (poor self- care, sexual dysfunction, loss of job and educational status), and lack of effective support (lack of financial institutions and sponsors, lack of social support). CONCLUSION: Patients with spinal cord injuries face various issues in their care and social lives. Attention to their psycho-emotional needs along with comprehensive health support play key roles in generating a sense of self efficacy and promoting the mental well-being and dignity of patients with spinal cord injuries. Accordingly, healthcare administrators and caregivers are recommended to provide more comprehensive health support to SCI patients to meet their needs more effectively.

Care burden, coping styles and involvement in care in mothers of autistic children in pandemic of COVID-19.

AIM: The aim of the present study was to investigate the burden of care, coping styles and involvement in the care of mothers of autistic children in the pandemic of COVID-19 in Iranian society. DESIGN: A cross-sectional study. METHODS: A total of 134 mothers completed questionnaires online. Data were analysed by descriptive statistics (frequency, percentage, mean and standard deviation) and independent t-test, ANOVA and multiple linear regressions. The significance level was considered p < .05. RESULT: Findings of the study found that burden of care has a strong and direct correlation with involvement in care (p < .001, r = .78) and strongly and indirectly correlated with coping styles (p < .001, r = -.82). Variables of coping styles, involvement in care, mothers' occupation and number of children, age and functional level of autism can predict 81.27% of the variance in care burden in these mothers.

Healthcare professionals' families' perception of life during COVID-19 in Iran: a qualitative study.

BACKGROUND: The families of healthcare professionals are one of the most vulnerable groups whose lives have been severely damaged by the COVID-19 pandemic. So far, the experiences and perceptions of these individuals have not been explored. The present study aims to investigate the experiences and perceptions of the family members of the healthcare professionals during COVID-19. METHODS: The present study is a qualitative research with a phenomenological design. The participants were 25 family members of healthcare professionals which were selected from the medical centres in Iran via purposeful sampling from August 2021 to October 2021. The sampling was kept on until the data became saturated. To collect data, individual semi-structured interviews were conducted online. The Colaizzi approach was used to analyse the data collected. RESULTS: The findings of the study emerged as two main themes: psychological tension with five categories (indescribable fear and worry, longing to see their loved ones, patient stone, bitter farewell, fear of the future) and dignity with four categories (acclamation, appreciation, feeling proud, spiritual growth). CONCLUSION: During the COVID-19 pandemic, the family members of healthcare professionals have experienced dignity combined with the degrees of psychological tension which were beyond the experiences of the majority of people in the society, but similar to the psychological tension experienced by the families of COVID-19 victims. The families of healthcare workers are continuously anxious about the safety of their loved ones who are responsible to obtain the treatment of COVID-19 patients, which potentially jeopardizes their physical and psychological well-being. Therefore, the appreciation and support of people in the community of the family members of healthcare professionals have increased their tolerance. Healthcare providers can successfully promote the health of healthcare professionals' families by providing comprehensive assistance to healthcare personnel and their families.

Emergency Medical Service Providers' Perception of Health-Threatening Stressors in Emergency Missions: A qualitative Study.

BACKGROUND: Unknown and unpredictable situations cause emergency medical service (EMS) providers to experience various stressful factors. These factors are affected by sociocultural conditions and expectations of the casualty and affect EMS providers' performance and health at the incident scene. The present study was conducted to explore EMS providers' perception of stressful and health-threatening factors in emergency missions. METHOD: This qualitative conventional content analysis was conducted in 2020. The participants included 16 EMS providers working at the Emergency Medical Services Department in Hamadan Province, Iran. The participants were selected using purposive sampling and underwent semi-structured interviews until data saturation. Data were analyzed using the Graneheim and Lundman method. RESULTS: Analysis of the interview data yielded six subcategories (i.e., incident scene hazards, violence-related injuries, physical injuries caused by patient care/handling, ambulance crash-related injuries, emotional impact of patients' suffering and ailments, and highly stressful missions), two main categories (i.e., physical injuries and psychological tensions), and a theme of occupational injuries. CONCLUSIONS: According to the results, in addition to having concerns about caring for patients and saving the injured, EMS providers also worry about potential threats to their own health. The present study identified and described some major stressors in emergency missions. Thus, for a better and more effective efficiency, the present study results can be used to reduce or modify stressors in EMS providers.

Perceived occupational stressors among emergency medical service providers: a qualitative study.

INTRODUCTION: Emergency medical services (EMS) providers are at continuous exposure to occupational stressors which negatively affect their health and professional practice. This study explored perceived occupational stressors among EMS providers. METHODS: This qualitative study was conducted from December 2019 to April 2020 using conventional content analysis. Sixteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. Semi-structured interviews (with length of 45-60 min) were held for data collection. Data were analyzed through Graneheim and Lundman's conventional content analysis approach. FINDINGS: Data analysis resulted in the development of two themes, namely critical conditions of EMS provision, and personal and professional conflicts. The six categories of these two themes were complexity of patients' clinical conditions, interruption of EMS provision, health hazards, interpersonal problems, interprofessional interactions, and legal conflicts. CONCLUSION: Besides the stress associated with emergency patient care, EMS providers face many different occupational stressors. EMS managers can use the findings of the present study to develop strategies for reducing occupational stress among EMS providers and thereby, improve their health and care quality.

The Effect of Ostrich Oil as a Complementary Medicine on the Severity of Pruritus and Quality of Life in Hemodialysis Patients.

INTRODUCTION: Pruritus is one of the most common problems in a uremic syndrome that reduces the quality of life due to the constant unpleasant feeling. The purpose of this study was to investigate the effect of ostrich oil massage on the severity of pruritus and quality of life in hemodialysis patients. METHODS: In this study, 68 hemodialysis patients with pruritus were selected based on the available sampling method. The intervention group used 1 mL ostrich oil on the pruritus area for 10 min each night for 1 month. The control group received a placebo massage. Pruritus severity questionnaire-based itch severity scale and quality of life questionnaire were completed, respectively, at the end of each week and at the end of the period. Statistical analysis was done using SPSS software version 23 and applying on independent t test, paired t test, and analysis of covariance. RESULTS: During the first and second weeks after the treatment, there was no statistical difference between the mean scores of pruritus severity in both groups (p > 0.05); however, in the third and fourth weeks after the treatment, the mean severity level of pruritus in the ostrich oil group was lower than in the placebo group, and these differences were statistically significant between the two groups (p < 0.05). There was no significant difference in quality of life between two groups of ostrich and placebo. CONCLUSION: The use of ostrich oil was effective in reducing pruritus in hemodialysis patients. This method can be proposed as a complementary method for relieving pruritus in hemodialysis patients.

Topical Almond Oil for Prevention of Pressure Injuries: A Single-Blinded Comparison Study.

PURPOSE: The aim of our study was to determine the effect of topical almond oil for prevention of pressure injuries. DESIGN: Single-blind randomized clinical trial. SAMPLE AND SETTING: Patients admitted to an intensive care unit in Besat Hospital, Hamadan, Iran, were invited to participate in the trial. Data were collected over an 8-month period. METHODS: A convenience sample of 108 patients, using a permuted block randomization method was assigned to 3 equal groups that received the intervention almond oil, placebo (liquid paraffin), or control (standard of care). Data included demographic information, Braden Scale score, and National Pressure Ulcer Advisory Panel-European Pressure Ulcer Advisory Panel (NPUAP-EPUAP) pressure injury staging system classification score. The intervention and placebo groups received daily application of 6.5 cc of topical almond oil or paraffin to the sacrum, heels, and shoulders for 7 consecutive days. The skin was evaluated for pressure injuries by an expert nurse who was blinded to groups. Chi-square test, analysis of variance, and regression analyses were used to evaluate relationships within and between groups for study variables, incidence of pressure injuries, and duration of time of onset of pressure injuries. P values less than .05 were deemed statistically significant. RESULTS: The incidence of pressure injury in the almond oil group (n = 2; 5.6%) was lower than that in the placebo (n = 5; 13.9%, P = .189) or control groups (n = 9; 25.1%, P = .024). The incidence of pressure injuries in the control group was 6.8 and 2.12 (P = .227) times higher than that in the almond and placebo groups, respectively. The onset day of a pressure injury occurred 5.4 days after initiation of the protocol in the almond oil group compared to 4.22 days in the control group (P = .023) and 5 days in the placebo group (P = .196). CONCLUSION: The topical application of almond oil was associated with a lower incidence of pressure injuries and that developed later during the study compared to participants who received paraffin or standard of care only. Further study is recommended to advance this work in populations at risk for pressure injury.

Association between incidence of atrial fibrillation and duration of cardiopulmonary bypass in coronary artery bypass graft surgery (CABG): a cohort study.

BACKGROUND: Open heart surgery is one of the most common and valuable treatment methods for cardiovascular diseases, a common side effect of which is atrial fibrillation that occurs due to various reasons. OBJECTIVE: To determine the relationship between incidence of atrial fibrillation (AF) and duration of cardiopulmonary bypass (CPB) in patients after open heart surgery. METHODS: The present retrospective cohort study was conducted on 330 patients in Farshchian Heart Center through census. The required data were collected from medical records of the patients undergoing coronary bypass surgery using data collection between April 2015 and March 2015. Then, data analysis was performed using SPSS software (ver.16) at error level of p<0.05. The tests used in this study included independent-samples t-test, Mann-Whitney, and chi-squared tests. RESULTS: Based on the results, mean age of the patients was 61.76±9.2, the majority of the patients (70.1%) were male. The association between Incidence of Atrial Fibrillation and cardiopulmonary pump time (minute) was not meaningful. Incidence of atrial fibrillation had statistically significant relationship with variables of mean age, BMI, PAC, PVC, creatinine and duration of hospitalization (p<0.05); on the other hand, variables of gender, cross clamp time (minute), intubation time (hour), and clinical history had no effect on atrial fibrillation incidence rate (p>0.05). CONCLUSION: Since the pathogenesis of AF after cardiac surgery is believed to be multifactorial, including clinical variables and technical intraoperative factors, the relation between incidence of AF with mean age, BMI, PAC, PVC, creatinine and duration of hospitalization was significant. But AF was not related to cardiopulmonary pump time (minute). It is necessary to conduct further research on factors affecting incidence of atrial fibrillation.

Effects of the First Phase of Cardiac Rehabilitation Training on Self-Efficacy among Patients Undergoing Coronary Artery Bypass Graft Surgery.

Background: Heart surgery is vital for patients with coronary artery diseases that do not respond to drug treatments. We aimed to determine the effects of the implementation of the first phase of a cardiac rehabilitation program on self-efficacy in patients after coronary artery bypass graft surgery (CABG). Methods: This clinical trial study was conducted on 60 post-CABG patients by convenience sampling method in 2016. Those selected were randomly assigned to intervention (n=30) and control group (n=30). Overall, 72 hours after CABG, the first phase of the cardiac rehabilitation program both in theory and in practice (face-to-face and group methods) was conducted. Data were collected using a self-efficacy questionnaire completed by the patients in 3 stages: before the intervention, at discharge, and at 1 month after discharge. Data was analyzed by using analysis of covariance and repeated measures. Results: The mean of age in the intervention and control groups was 61.60±11.72 and 57.97±13. 4 years, respectively. There were 16 (53.3%) male patients in each group. The mean score of self-efficacy was not significantly different between the 2 groups before the intervention (P=0.076), whereas it had a meaningful statistical difference between the 2 groups at discharge and 1 month afterward (P<0.001). Conclusion: The implementation of the first phase of the cardiac rehabilitation program not only augmented self-efficacy in regard to independent daily activities but also lessened the need for the second phase of the program among our post-CABG patients.

Effect of Mealtime During Hemodialysis on Patients' Complications.

Introduction: Food intake during hemodialysis increases the risk of problems such as hypotension, nausea, and vomiting in patients undergoing hemodialysis. This study aimed to determine the effect of mealtime during dialysis on the patients' complications. Methods: This is a quasi-experimental study consisted of all eligible hemodialysis patients in Hamadan teaching hospitals. All of 48 patients were selected through census method. The research was conducted in two sessions. At both sessions, patients were kept fasting prior to hemodialysis. In the first session, after one hour and in the second session after two hours of hemodialysis, a meal containing 350 kcal of energy was given to the patients. Blood pressure and intensity of nausea and vomiting was measured and recorded immediately before the start of hemodialysis, and then every half an hour before the termination of the hemodialysis. Results: The results showed that in both sessions, food intake caused a drop in the systolic and diastolic blood pressure, but changes in the mealtime had no effect on the systolic and diastolic blood pressure. Also, statistical test showed that changes in the mealtime had no significant impact on the intensity of nausea and vomiting. Conclusion: Food intake during hemodialysis had no effect on the nausea and vomiting, but caused a drop in the systolic and diastolic blood pressure, the drop continued for one hour and one and a half hour after the meal. It is suggested, mealtime in the early hours of hemodialysis could be better managed during the hemodialysis process.

Patients' perception of comfort facilitators during hemodialysis procedure: a qualitative study.

BACKGROUND: The patients receiving hemodialysis spend a lot of their lifetime in the hemodialysis departments, which is an unpleasant experience. Therefore, some interventions are necessary to relieve this experience. OBJECTIVES: The current study aimed to explore the hemodialysis patients' perceptions of comfort facilitators during the hemodialysis procedure. PATIENTS AND METHODS: This study was conducted by a qualitative content analysis approach. Twenty four patients receiving hemodialysis participated in this study by purposive sampling. The sampling was over when the data saturation occurred. The semi-structured interviews were applied as the main data gathering tool. The data analysis was conducted by conventional qualitative content analysis in eight phases. RESULTS: THREE THEMES EMERGED: The presence of competent nurses, the delightful presence of the others, and coping with comfort obstacles. Each theme consisted of some categories. CONCLUSIONS: It seems that to achieve the patients' comfort during the hemodialysis procedure, the health care teams, hospitals in charge and the patients themselves have to do their best to provide the patients' comfort.