The effect of resilience training with mHealth application based on micro-learning method on the stress and anxiety of nurses working in intensive care units: a randomized controlled trial.

INTRODUCTION: Nurses in intensive care units (ICUs) face high stress and anxiety, impacting their well-being and productivity. Addressing this, this study evaluated the impact of resilience training via a mHealth application based on micro-learning on ICU nurses' stress and anxiety levels. MATERIALS AND METHODS: This study, a single-blind randomized controlled trial conducted in 2022-23, involved sixty ICU nurses from two Tehran hospitals. Nurses were chosen through purposive sampling and divided into intervention and control groups by simple randomization. The intervention group was taught resilience via an educational mHealth application based on micro-learning, with data collected using the anxiety and stress subscales of DASS-21. RESULTS: Before the intervention, there were no significant differences in stress and anxiety scores between the intervention and control groups (P > 0.05). Upon utilizing the mHealth application, the intervention group exhibited significant reductions in stress, from 10.77 ± 3.33 to 9.00 ± 1.66 (P = 0.001), and in anxiety, from 9.43 ± 3.35 to 7.93 ± 0.98 (P < 0.001). In contrast, the control group experienced a slight increase in stress levels, from 10.10 ± 2.19 to 10.73 ± 2.15 (P = 0.002), and in anxiety levels, from 9.10 ± 1.63 to 10.23 ± 1.65 (P < 0.0001). CONCLUSIONS: The micro-learning-based mHealth application for resilience training significantly reduced ICU nurses' stress and anxiety, recommending its adoption as an innovative educational method. TRIAL REGISTRATION: The study has been registered in the Iranian Registry of Clinical Trials (No. IRCT20221225056916N1, Date: 04/29/2023).

The effect of psychological first-aid virtual education on the communication skills of nurses in disasters: a randomized controlled trial.

BACKGROUND: Disasters have affected the physical and mental health of people around the world. Since nurses are frontlines in disasters, it seems necessary to prepare for this responsibility. This study investigates the effect of psychological first-aid virtual education on the communication skills of nurses in disasters such as COVID pandemic. METHODS: In a randomized controlled trial, 55 nurses were selected by purposive sampling method from two hospitals in Isfahan and Tehran, Iran in December-November 2022 and randomly replaced in the intervention group who participated in psychological first aid virtual training and control group. The data were collected through the personal information form and Communication Skills -Test-Revised (CSTR). RESULTS: Two groups were homogeneous in terms of communication skills (p = 0.177), the total score of communication skills was significant between the two groups after the intervention (p < 0.0001). Regarding communication skills, in the pre-intervention phase, the subscale of "the ability to receive and send messages" and "insight into the communication process" the difference before the intervention was not significant between the two groups (p > 0.05). However, it was significant between the two groups after the intervention (p < 0.05), and regarding "emotional control", "listening skills", and "communication along with assertiveness" the difference before and after the intervention was not significant between the two groups (p > 0.05). CONCLUSION: Pre-disaster training and virtual education can increase nurses' communication skills in their ability to handle a disaster such as COVID pandemic. Virtual education of post-disaster psychological interventions is suggested. TRIAL REGISTRATION: IRCT20220923056023N1; date: 2023-01-31.

Bisphenol A in dairy products, amount, potential risks, and the various analytical methods, a systematic review.

This systematic study deals with the amount of bisphenol A (BPA) in milk and dairy products, its analytical methods, and risk assessment. Milk is one of the drinks that has a high consumption. Bisphenol A can be present both in raw milk and its amount undergoes changes during the pasteurization process. This review was conducted by searching for the keywords Bisphenol A, BPA milk, dairy product, cheese, cream, butter, yogurt, measurement, detection, and analysis in different databases. The search was done in three databases, Scopus, PubMed and Science Direct. The largest number of studies on the determination of bisphenol A belonged to Asian and European countries. The amount of bisphenol A in milks was observed in the range from ND to 640 ng/mL. Furthermore, the amount of BPA in the tested cheese samples was observed in the ND range up to 6.1 ng/g and in the yogurt samples in the ND range up to 4.4 ng/g. The most used analytical method was based on liquid chromatography. The most used solvent for extraction was methanol or acetonitrile. HQ (Hazard Quotient) was also calculated in some studies. There was no risk in terms of milk consumption due to BPA contamination in extracted data.

Investigation of the effect of Jacobson's relaxation technique on the fatigue of family caregivers of hemodialysis patients: a single-blinded randomized controlled trial.

BACKGROUND: Caring for hemodialysis patients could be a heavy burden on family caregivers, causing them to become fatigued and decrease their quality of life. This study aimed to investigate whether Jacobson's relaxation can help alleviate the fatigue of family caregivers of hemodialysis patients. METHODS: This randomized controlled trial was conducted in 2021. Sixty-six family caregivers of hemodialysis patients were recruited by convenience sampling from a referral hospital in Tehran, Iran, and assigned randomly by coin toss to two groups of experimental (n = 32) and control (n = 34). Caregivers in the experimental group performed Jacobson's relaxation three times a week, each time for 30-45 min, for 30 days. The score and severity of fatigue before, 2 weeks after, and 1 month after the intervention were measured with the Fatigue Severity Scale. Data analysis was performed in the statistics software SPSS using descriptive statistics (frequency, percentage, mean, and standard deviation) and analytic statistics (Independent Samples t-test, Mann-Whitney U test, Chi-Square test, Fisher's exact test, and RM-ANOVA test). The significance level was less than 0.05. RESULTS: The fatigue scores of the experimental and control groups were not significantly different before the intervention (4.42 ± 0.42 vs. 4.38 ± 0.42, P = 0.696). However, the experimental group had significantly lower fatigue scores than the control group 2 weeks after the intervention (4.11 ± 0.63 vs. 4.39 ± 0.42, P = 0.036) and 1 month after the intervention (3.5 ± 0.71 vs. 4.4 ± 0.44, P = 0.001). The results also showed a significant drop in the fatigue score of the experimental group after the intervention (P < 0.0001), but no such change in the control group (P = 0.662). CONCLUSION: Jacobson's relaxation technique was effective in alleviating the fatigue of family caregivers of hemodialysis patients. Nurses are therefore recommended to promote the technique as a safe and easy method of fatigue management for family caregivers.

The identification of key genes and pathways in glioblastoma by bioinformatics analysis.

GBM is the most common and aggressive type of brain tumor. It is classified as a grade IV tumor by the WHO, the highest grade. Prognosis is generally poor, with most patients surviving only about a year. Only 5% of patients survive longer than 5 years. Understanding the molecular mechanisms that drive GBM progression is critical for developing better diagnostic and treatment strategies. Identifying key genes involved in GBM pathogenesis is essential to fully understand the disease and develop targeted therapies. In this study two datasets, GSE108474 and GSE50161, were obtained from the Gene Expression Omnibus (GEO) to compare gene expression between GBM and normal samples. Differentially expressed genes (DEGs) were identified and analyzed. To construct a protein-protein interaction (PPI) network of the commonly up-regulated and down-regulated genes, the STRING 11.5 and Cytoscape 3.9.1 were utilized. Key genes were identified through this network analysis. The GEPIA database was used to confirm the expression levels of these key genes and their association with survival. Functional and pathway enrichment analyses on the DEGs were conducted using the Enrichr server. In total, 698 DEGs were identified, consisting of 377 up-regulated genes and 318 down-regulated genes. Within the PPI network, 11 key up-regulated genes and 13 key down-regulated genes associated with GBM were identified. NOTCH1, TOP2A, CD44, PTPRC, CDK4, HNRNPU, and PDGFRA were found to be important targets for potential drug design against GBM. Additionally, functional enrichment analysis revealed the significant impact of Epstein-Barr virus (EBV), Cell Cycle, and P53 signaling pathways on GBM.

Comparing the effects of mHealth application based on micro-learning method and face-to-face training on treatment adherence and perception in haemodialysis patients: a randomised clinical trial.

OBJECTIVES: Comparing the effects of a mobile health (mHealth) application based on the micro-learning method with face-to-face training on treatment adherence and perception among patients undergoing haemodialysis. DESIGN: A single-blind randomised clinical trial. SETTING: A haemodialysis centre in Isfahan, Iran. PARTICIPANTS: Seventy patients. INTERVENTION: Patients were trained individually for 1 month via the mHealth application or face-to-face training. OUTCOME MEASURES: Treatment adherence and perception in patients were measured and compared. RESULTS: The scores of treatment adherence in the mHealth and the face-to-face training groups were not significantly different at the pre-intervention stage (720.43±209.61 vs 702.861±181.47, p=0.693) and immediately after the intervention (1007.14±134.84 vs 947.86±124.46, p=0.060), while 8 weeks later, treatment adherence in the mHealth group was significantly higher than the face-to-face training group (1018.57±129.66 vs 914.29±126.06, p=0.001). The scores of both groups before the intervention did not differ in various dimensions of treatment adherence and perception (p>0.05). Scores of these variables also elevated significantly after the intervention (p<0.05). CONCLUSIONS: The mHealth based on micro-learning and face-to-face training as interventions augmented treatment adherence and perception among the haemodialysis patients, but such improvements were detected much more in the patients trained with mHealth based on the micro-learning method than face-to-face training. TRIAL REGISTRATION NUMBER: IRCT20171216037895N5.

Relationship between fatigue and quality of life and related factors in family caregivers of patients on hemodialysis.

BACKGROUND: The incessant and stressful nature of providing care to patients with chronic diseases can cause fatigue in caregivers. Caregivers' fatigue and reduced quality of life can reduce the patient's quality of care. Since it is important to pay attention to the mental health of family caregivers, this study investigated the relationship between fatigue and quality of life and their related factors in family caregivers of patients on hemodialysis. METHODS: This cross-sectional descriptive-analytical study was performed in 2020-2021. One hundred seventy family caregivers were recruited by convenience sampling from two hemodialysis referral centers in the east of Mazandaran province, Iran. The data collection tools were the Family Caregiver Quality of Life questionnaire and Krupp's fatigue severity scale. RESULTS: The majority (88%) of caregivers had moderate to severe fatigue. Caregivers' fatigue was a major factor influencing their quality of life. There was a significant fatigue difference between some categories of kinship and the caregiver's income level (P < 0.05). Caregivers with lower income and education levels, those who were the patient's spouse, and those who could not leave the patient alone had significantly worse quality of life than other caregivers (P < 0.05). Also, caregivers living with the patient in the same house had a worse quality of life than those living separately (P = 0.05). CONCLUSION: Considering the high prevalence of fatigue among family caregivers of patients on hemodialysis and its adverse effect on their quality of life, it is recommended to perform routine screenings and implement fatigue alleviation interventions for these caregivers.

Relationship between resilience and death anxiety of the older adults during the coronavirus disease 2019 (COVID-19) pandemic.

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) caused an increase in the incidence of physical and psychological problems, particularly in the older adult. Considering the special physical and mental health conditions of the older adult, they were more exposed to psychological problems associated with the pandemic, such as death anxiety. Therefore, assessing the psychological status of this group is necessary in order to implement appropriate interventions. The present study aimed to investigate the relationship between resilience and death anxiety in the older adult during the COVID-19 pandemic. METHODS: This descriptive-analytical study was conducted on 283 older adult people over the age of 60 years. The older adult population was selected from 11 municipal districts of Shiraz, Iran, using the cluster sampling method. The resilience and death anxiety scales were used for data collection. Data analysis was performed in SPSS version 22, using Chi-square test, t-test, and Pearson's correlation coefficient test. A P-value less than 0.05 was considered statistically significant. RESULTS: The mean and standard deviation of the older adult's resilience and death anxiety scores were 64.16 ± 9.59 and 6.3 ± 2.95, respectively. There was a significant correlation between resilience and death anxiety scores (P < 0.01, r=-0.290). Also, sex (P = 0.00) and employment status (P = 0.00) were significantly associated with the older adult's resilience. Besides, sex (P = 0.010) and employment status (P = 0.004) were significantly related to death anxiety. CONCLUSIONS: Our findings showcase levels of resilience and death anxiety in older adults during the covid-19 pandemic and suggest that resilience and death anxiety are inversely linked. This has implications on policy planning for future major health events.

Comparing the effects of mHealth app use and face-to-face training on the clinical and laboratory parameters of dietary and fluid intake adherence in hemodialysis patients: a randomized clinical trial.

BACKGROUND: Numerous factors are likely to result in poor treatment adherence, which is one of the important factors contributing to increased complications and the low efficacy of hemodialysis (HD), particularly inadequate knowledge of patients. This study aimed to compare the effects of a mobile health (mHealth) app (the Di Care app) use and face-to-face training on the clinical and laboratory parameters of dietary and fluid intake adherence in patients undergoing HD. METHODS: This single-blinded, two-stage/two-group randomized clinical trial was fulfilled in 2021-22 in Iran. Seventy HD patients were recruited, using the convenience sampling method, and were then randomized into two groups: mHealth (n = 35) and face-to-face training (n = 35). ​ The patients in both groups received the same educational materials via the Di Care app and face-to-face training for one month. Before and 12 weeks after the intervention, the mean interdialytic weight gain (IDWG), potassium (K), phosphorus (P), total cholesterol (TC), triglyceride (TG), albumin (AL), and ferritin (FER) levels were measured and compared. The data were analyzed using the SPSS via descriptive statistics (mean, SD, frequency, and percentage) and analytical tests (independent-samples t-test, paired-samples t-test, Wilcoxon signed-rank test, Mann-Whitney U test, Chi-square test, and Fisher's exact test). RESULTS: ​Prior to the intervention, the mean IDWG and the K, P, TC, TG, AL, and FER levels, were not significantly different in both groups (p > 0.05). The mean IDWG (p < 0.0001), and the K (p = 0.001), P (p = 0.003), TC/TG (p < 0.0001), and FER (p = 0.038) levels in the HD patients in the mHealth group decreased. ​As well, the mean IDWG (p < 0.0001), and the K (p < 0.0001) and AL (p < 0.0001) levels showed a descending trend in the face-to-face group. The fall in the mean IDWG (p = 0.001) and the TG level (p = 0.034) in the patients in the mHealth group was significantly greater than that in the face-to-face group. CONCLUSIONS: The Di Care app use and the face-to-face training could improve dietary and fluid intake adherence in patients. However, mHealth could have more effect on the laboratory parameters than face-to-face training, largely reducing the IDWG. TRIAL REGISTRATION: This study was registered in the Iranian Registry of Clinical Trials (No. ID IRCT20171216037895N5).

Effectiveness of Psychological First Aid E-learning on the Competence and Empathy of Nurses in Disasters: A Randomized Controlled Trial.

OBJECTIVE: This study aimed to determine the effect of psychological first-aid (PFA) E-learning on the competence and empathy of nurses in disasters. METHODS: In a randomized controlled trial, 50 nurses were randomly assigned to 2 intervention and control groups, and psychological first-aid training sessions were implemented for the intervention group. The data were collected using the personal information form, a researcher-made questionnaire to measure competence, and the Davis Empathy Questionnaire. RESULTS: Two groups were homogeneous in terms of competency (P = 0.691) and empathy (P = 0.363) in the preintervention phase. The intervention group had more competence in the next stage than before the intervention (P < 0.0001). In the post-intervention phase, the intervention group had more competence compared with the control group (P < 0.0001). The overall effect size of PFA E-learning training on the nurses' competency was 1.9. Regarding empathy, in the post-intervention phase, the subscale of personal distress (P = 0.014) was significantly lower in the intervention group and the perspective-taking subscale was higher than in the control group (P < 0.0001). However, there was no significant difference between the groups in terms of all scores of empathy and the subscale of empathic concern (P > 0.05). The overall effect size of PFA E-learning training on the nurses' empathy was 0.44. CONCLUSIONS: It is suggested to provide training, including a PFA E-learning model, for nurses and other therapists in disaster situations.

Exploring perceived stress from caring for coronavirus disease (COVID-19) patients in nurses: a qualitative study.

Background: The coronavirus pandemic has increased the perceived stress among people worldwide. The new coronavirus issue has recently put nursing staff under severe stress. Aims: This study aimed to evaluate the stress perceived by nurses in caring for new coronavirus patients. Methods: This qualitative conventional content analysis was conducted from February and March 2021. Twelve nurses working in the inpatient care wards for COVID-19 patients in Tehran hospitals were enrolled using purposive sampling. Data were collected through in-depth and semi-structured interviews and collection continued until reaching data saturation. All interviews were recorded, transcribed, reviewed and analysed using the Graneheim and Lundman method. Results: One main category, five categories and 19 sub-categories emerged from the data. The nurses experienced 'the process of transition from unknown conditions'. Caregiving stress, impression on all aspects of life, COVID as a strange disease, stress caused by patient characteristics and stress reduction over time were issues in the formation of stress in nurses caring for patients with COVID-19. Conclusions: The findings indicated that nurses caring for COVID-19 patients experience varying levels of stress for a variety of interrelated reasons. Knowing how nurses perceive the stress of caring for patients with COVID-19 can aid in the development of practical steps to reduce stress and make nurses more comfortable.

The Effect of Auriculotherapy on Anxiety and Physiological Parameters of Male Coronary Angiography Patients: A Single-blind Randomized Clinical Trial.

PURPOSE: To determine the effect of auriculotherapy on anxiety and physiological parameters of male patients undergoing coronary angiography. DESIGN: A single-blind randomized clinical trial was performed in 2019 with 94 subjects selected by convenience sampling. METHODS: The subjects were divided into 2 groups via random allocation. Two hours before angiography, all patients completed the Depression, Anxiety, and Stress Scale-21 items (DASS-21) and their physiological parameters (blood pressure, pulse rate, and respiratory rate) were measured 60 minutes before angiography. Auriculotherapy was performed on ear acupoints of patients in the experimental group for 4 minutes. In the control group, patients were given auricular acupressure in sham points. The anxiety and physiological parameters were re-measured 10 minutes after the intervention. FINDINGS: Patients' anxiety was clinically lower in the experimental group (2.55 ± 0.27) compared to the control group (3.02 ± 0.33) (effect size = -1.42) after the intervention. There was no significant difference between 2 groups regarding physiological parameters after the intervention. However, the respiratory rates of patients were lower in the experimental group than in the control group (P < .001). After the intervention, physiological parameters significantly decreased in the experimental group compared to before the intervention (P < .001). CONCLUSIONS: Auriculotherapy reduces patient anxiety; therefore, it can be used as a complementary method before angiography.

The effect of the demonstration-based progressive muscle relaxation technique on stress and anxiety in nurses caring for COVID-19 patients: a randomized clinical trial.

BACKGROUND: Caring for patients with coronavirus disease 2019 (COVID-19) challenges nurses and causes them to experience stress and anxiety. From this perspective, it is of utmost importance to develop quick and effective intervention strategies to prevent numerous complications. This study aimed to investigate the effect of the progressive muscle relaxation technique, using the demonstration method on the stress and anxiety of nurses who care for COVID-19 patients. METHODS: This randomized clinical trial was conducted in 2021. Forty-six nurses working in two referral hospitals with wards for COVID-19 patients in Tehran, Iran recruited by convenience sampling method and then randomly assigned to experimental or control groups. The nurses in the experimental group educated the progressive muscle relaxation by the demonstration method, and they were encouraged to practice it. The Depression Anxiety Stress Scale-21 was utilized to measure the stress and anxiety levels in the nurses. RESULTS: Before the intervention, the levels of stress in the experimental and control groups were 13.91 ± 2.41 vs. 14.34 ± 2.74 (p = 0.571), and their anxiety was 13.34 ± 3.41 vs. 12.78 ± 2.21 (p = 0.510), respectively. After the intervention, the levels of stress in the experimental and control groups were 10.95 ± 2.01 vs. 14.17 ± 2.34 (p < 0.001), and their anxiety was 9.47 ± 2.37 vs. 12.91 ± 1.85 (p < 0.001), respectively. Moreover, the levels of stress and anxiety in the experimental group significantly diminished after intervention (p < 0.001), but no significant changes were observed in the control group (p > 0.05). CONCLUSION: Concerning the effectiveness of the progressive muscle relaxation technique in relieving the stress and anxiety of the nurses caring for COVID-19 patients, it is suggested to include this relaxation technique in nursing courses.

Effects of light stroking massage with olive oil on acute pain severity and number of taken non-steroidal anti-inflammatory drugs among outpatients with extremities trauma: A double-blind, placebo-controlled superiority trial.

INTRODUCTION: Currently, analgesics are used to alleviate acute pain after trauma; however, these drugs cause some undesirable adverse effects. Hence, there is a need for nonpharmacological methods to reduce trauma-induced pain. This study investigated the effects of massage with olive oil on acute pain severity and number of taken non-steroidal anti-inflammatory drugs (NSAIDs) among trauma patients. METHODS: In this double-blind, placebo-controlled superiority trial, 42 outpatients who suffered from superficial injury in upper or lower extremities were randomly assigned to olive oil and placebo groups. Patients received a 5-min light stroking massage on the trauma site twice a day for nine consecutive days with 10 drops of either olive oil or placebo (liquid paraffin). Also, they received NSAIDs and applied cold and warm compresses on the trauma site. The pain severity (a 0-10 numerical pain rating scale) and the number of NSAIDs were recorded at four points of time, including before the intervention (baseline), and on the third, sixth, and ninth days of intervention. RESULTS: There was a significant difference between the study groups in mean ranks of the number of NSAIDs taken on the baseline and third days (P = 0.02, P = 0.009). Considering the number of NSAIDs taken during nine days as a covariate, a significant decrease in the pain severity was found in two groups during the nine days (Ptime< 0.001). However, pain reduction over time was more significant in the olive oil group (Ptime*group = 0.001). Also, mean changes in the pain severity compared to the baseline were significant on the sixth (P = 0.001) and ninth (P = 0.002) days of the intervention in favor of the olive oil group. CONCLUSION: Administration of light stroking massage with olive oil as a complementary method seems to be potentially effective in reducing the pain severity and use of NSAIDs among patients with trauma to the extremities.

Comparison of Iran's nursing education with developed and developing countries: a review on descriptive-comparative studies.

BACKGROUND: Iran's nursing education has undergone significant modifications in the last decades, especially following the Islamic revolution and the Iran-Iraq war. This review outlined changing trends in Iran's nursing education and evaluate its status compared to other developing and developed countries. METHODS: Six international and two national electronic data sources were searched up to May 2021, using relevant keywords and terms. The studies were included if they addressed history, development, or evolutionary aspects of Iran's nursing education or evaluated its status by comparing it with developing or developed countries, using Bereday's model. To obtain more relevant information, the organizational documents of the Iranian Ministry of Health and Medical Education and the Iranian Ministry of Culture and Higher Education were searched. Of 753 evidence found in the initial search, 73 were considered eligible for this review. A systematic and unbiased data synthesis was performed and a narrative and tabulated summary was presented. RESULTS: The evolution in Iran's nursing education has resulted in the establishment of Bachelor, Master, and Ph.D. PROGRAMS: Iran's nursing education system plays an important role in fulfilling the healthcare system's mission, and it does not hold a dissatisfactory position in comparison with other developed and developing countries. However, this system is expected to be more versatile for the upcoming changes and advancements. CONCLUSION: Iran's nursing education has a moderate rating despite recent changes. Hence, this system has to be modified in some aspects by adopting experiences of other countries, with an appropriate and successful education system, to prepare future highly competent nurses.

Comparative effectiveness of demonstration using hybrid simulation versus task-trainer for training nursing students in using pulse-oximeter and suction: A randomized control trial.

BACKGROUND: Educating medical professionals on the emergency protocol for cardiac arrest can improve survival. OBJECTIVES: This study aimed to compare the effectiveness of demonstration using hybrid simulation versus task-trainer for training nursing students in using pulse-oximeter and suction following cardiac arrest. DESIGN: This randomized clinical trial was conducted in 2019. SETTING: The study was carried out in a nursing school in Tehran, Iran. PARTICIPANTS: Nursing students. METHODS: Nursing students were recruited and randomly assigned to one of three groups: a demonstration training group using hybrid simulation (standardized patient and task-trainer) in a transport ambulance (N = 15), a demonstration training group using task-trainer in skill lab (N = 15), and a control group (N = 15). No education was performed in the control group. Each student was evaluated pre and post-training on the use of a pulse-oximeter along with knowledge and skill of suction. Students were evaluated using a knowledge questionnaire and an appraisal checklist. RESULTS: All three groups increased their abilities in using pulse-oximeter and suction two weeks post-training session. The trial groups demonstrated better scores on the knowledge questionnaire and skill checklist in comparison to the control group. However, hybrid simulation and task-trainer groups showed no significant difference in knowledge and skill on the use of two modes. CONCLUSION: The use of demonstration using hybrid simulation in a transport ambulance and task-trainer in skill lab were equally effective in educating nursing students on the use of pulse-oximeter and suction following a cardiac arrest.

Caring for Patients in a Coma Following a Traumatic Brain Injury in Iran.

The study described here is the process of caring for patients in a coma following a traumatic brain injury (TBI) in Iran. The data that were analyzed come from in-depth semistructured interviews of 20 key participants and associated memos and field notes. The MAXQDA 10 qualitative analysis software was used to assist with the coding of the data. Ten catagories and 26 subcategories were identified from the primary analysis, which fit well into four themes. The main themes that were identified were chaos and confusion, inconsistent quality, multilateral support, and improving care. The processes of caring for persons in a coma following a TBI were found to be an ever-changing, multidimensional, context-dependent process.

Investigating the relationship between quality of life and hope in family caregivers of hemodialysis patients and related factors.

BACKGROUND: Family caregivers of hemodialysis patients are the first and most crucial source of care at home. They experience many problems in the care of hemodialysis patients, which can affect their quality of life and hope, affecting the quality of care provided to patients. This study aimed to determine the relationship between quality of life and hope in family caregivers of hemodialysis patients. METHODS: A cross-sectional (descriptive-analytical) study performed on 300 family caregivers in the east of Mazandaran province in Iran. Data were collected using the Family Caregiver Quality of Life (FQOL), SF8 and adult hope scale. Data analysis was performed in SPSS version 16, and a P-value of below 0.05 was considered statistically significant. RESULTS: The results showed that, there was a direct and significant relationship between hope and quality of life. However, the quality of life was significantly lower in suburban residents, the unemployed, spouses, people with lower education and income levels, caregivers who cannot leave their patients alone, those living with their patients in the same house, and those taking care of male patients, compared to other participants (P < 0.05). Suburban residents, the unemployed, people with an insufficient level of income, and those living with their patients in the same house had significantly lower hope, compared to other subjects. CONCLUSION: Since an increase of hope and quality of life of caregivers can cause improved quality of patient care, it is recommended that hope-based educational programs and interventions be implemented for caregivers.

Explaining the experiences of nursing administrators, educators, and students about education process in the COVID-19 pandemic: a qualitative study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) has severely influenced various aspects of human life, particularly education. This study aimed to explain the impact of the COVID-19 pandemic on nursing education from administrators, educators, and students' perspectives. METHODS: This qualitative study with a conventional content analysis approach was conducted from June to October 2020 at a nursing school in Tehran. Thirteen participants were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation. Nursing administrators, educators, and students constructed interviews to understand nursing education changes during the pandemic. All interviews were recorded, transcribed, reviewed, coded, and analyzed using the Graneheim and Lundman methods. RESULTS: Interviewed respondents included administrators and professors (n = 6) and nursing students (n = 7). The respondents reported five main topic areas: (1) safe management in ambiguous situations; (2) perceived situations; (3) adaptive coping; (4) educational facilitators and challenges, and (5) continuing education in an uncertain context. The central theme was "close conflict of education with COVID-19". CONCLUSIONS: The current study noted instability and challenges placed on nursing education during the pandemic. Opportunities were addressed during the pandemic to improve the nursing training process using planning, scientific management, emerging technology, innovative educational opportunities, and comprehensive support from institutional stakeholders. Clear guidelines and recommendations are needed to ensure medical education safety during the pandemic.

Comparison of the effectiveness of position change for patients with pain and vascular complications after transfemoral coronary angiography: a randomized clinical trial.

BACKGROUND: Prolonged immobilization after transfemoral coronary angiography (TFA) may cause pain and vascular complications in patients. This study aimed to evaluate the effectiveness of a change in position to decrease pain and vascular complications for patients after TFA. METHODS: This randomized clinical trial was conducted in 2020. Purposive sampling of 72 eligible patients undergoing TFA were selected and randomly assigned to either an experimental or control group. Patients in the experimental group (EG) were placed in a supine position for 2 h after angiography, followed by a semi-seated position with the bed angle gradually increased to 45° over 4 h. Patients in the control group (CG) remained in the supine position for 6 h. Vital signs, groin, back and leg pain, hematoma, hemorrhage, and urinary retention were assessed in both groups before, immediately after, and over 6 h after angiography. The Visual Analogue Scale was used to measure pain, the Christensen scale to measure hematoma, counting bloody gases to measure hemorrhage, and patient self-rating to determine urinary retention. RESULTS: There was no significant difference between EG and CG on score of groin (2.69 ± 1.00 vs. 2.61 ± 1.00, P = 0.74), back (2.19 ± 0.98 vs. 2.47 ± 0.87, P = 0.21), and leg pain (2.14 ± 0.71 vs. 2.50 ± 1.08, P = 0.27) before the TFA. However, from the second hour to the sixth hour after the TFA, the pain in the EG was significantly less than the CG (P < 0.001). So that pain in the groin (1.36 ± 0.48 vs. 3.28 ± 0.81), back (1.25 ± 0.50 vs. 3.81 ± 1.06), and leg (1.44 ± 0.55 vs. 3.28 ± 0.81) for the EG patients was significantly less than the CG in the sixth hour after TFA (P < 0.001). No patients experienced hematoma. No differences were noted between groups in hemorrhage and urinary retention. CONCLUSIONS: Position change to a semi-seated position in patients after TFA is effective and safe for reduction of pain without increasing vascular complications. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT registration number: IRCT20200410047011N1, Registration date: 30/04/2020.