Total Hip Arthroplasty in Patients Who Have Crowe Type IV Developmental Dysplasia of the Hip: A Systematic Review.

BACKGROUND: Developmental dysplasia of the hip (DDH) is one of the principal causes of secondary hip osteoarthritis, giving rise to considerable pain, impaired mobility, and a reduced quality of life. The optimal approach to managing individuals who have Crowe type IV DDH remains controversial. This study aimed to review the existing literature on the application of total hip arthroplasty (THA) as a treatment modality for Crowe type IV DDH, assessing its efficacy in addressing this severe hip deformity. METHODS: A comprehensive search across the PubMed, Scopus, and Web of Science databases identified relevant studies. Inclusion criteria encompassed investigations reporting outcomes of THA in Crowe type IV DDH patients. Data extraction and quality assessment were performed independently by 2 reviewers. Utilizing R software, the prevalence of THA complications was analyzed through proportion analysis, employing the inverse variance method. RESULTS: In this systematic review, a total of 74 studies were included, comprising a collective sample size of 2,829 patients (3,356 hips) diagnosed with Crowe type IV DDH. The posterior or posterolateral approach was the most commonly utilized surgical approach, followed by the lateral Hardinge and direct lateral approaches. The majority of studies have employed subtrochanteric osteotomies. Notably, post-THA, leg length discrepancy decreased, Trendelenburg sign resolved, and back pain was reduced. Patient-reported outcome measures like the Harris Hip Score improved significantly. The pooled prevalence rates of major postoperative complications were also assessed, including dislocation (7.2%), revision (8.7%), intraoperative fractures (10.5%), loosening (5.7%), nerve paralysis (5.6%), deep vein thrombosis (3.6%), infection (3.8%), heterotopic ossification grade 2 and above (6.1%), and a complicated patient rate of 11.0%. CONCLUSIONS: Synthesizing diverse study data, an overview of THAs performance emerges, demonstrating significant enhancements in function, pain reduction, quality of life, and the correction of substantial leg length discrepancy. While THA has shown positive outcomes, instances of complications have been reported. The decision to undergo THA should involve a collaborative assessment between the surgeon and the patient, considering potential benefits and complications.

Social Life After Hip Fracture: A Qualitative Study.

The return to social life after a hip fracture is a major concern for patients and a determinant factor in their recovery. However, patients' perceptions of social life after hip fracture are variable and context-dependent. By identifying these perceptions and strategies of patients, interventions can be strengthened and modified. The aim of this study was to identify patients' perceptions of their social life after hip fracture. This qualitative study used inductive content analysis. Twenty patients with hip fractures who were referred to Tehran University of Medical Sciences hospitals were purposefully selected and included in the study. Data were collected through individual, face-to-face, in-depth, semi-structured interviews conducted by a researcher experienced in carrying out such interviews. The interviews were recorded, immediately transcribed verbatim, and analyzed in MAXQDA-10. The interviewing process continued until data saturation was reached. The data analysis led to the extraction of three categories: Disruption of normal social life, Minimal social life, and Social isolation. The results indicated that the social life of these patients is influenced by physical conditions and contextual factors and progresses over time. All patients experienced meaningful disruption of their social life after experiencing hip fractures and movement limitations. The interdisciplinary perspectives provided by these findings can increase awareness of patients' post-fracture social life perceptions and conditions. These findings can also be used to design future programs for interdisciplinary interventions (involving sociology and medical sciences) to improve social life and increase the ability to return to a normal social life. Recovery management for patients with hip fractures should be preventive and organized by an all-around team (involving medicine, psychology, and sociology) based on patient-centered, community-based, and modern care strategies.

The process of social death in patients with hip fracture.

People with chronic disability and uncontrollable long-term complications following hip fracture have characterist.ics that may predispose them to social death. Continuous physical disability can have negative physical, psychological, and social consequences in these patients. To design care interventions for preventing and controlling social death, it is essential to identify the dimensions and characteristics of this process. Therefore, the present study aimed to explain the process of social death in hip fracture patients. In this study, which was conducted using a grounded theory approach, 20 patients were selected with maximum diversity and 9 professional and non-professional caregivers also through purposive sampling followed by theoretical sampling. Data were collected through semi-structured in-depth interviews, field notes, and observations. Data were analyzed using the approach proposed by Corbin and Strauss in stages including data analysis for concepts and their dimensions and characteristics, the context, process extraction, and integration of the categories. One core category and 16 main categories, which consisted of 55 subcategories and 212 primary concepts, were extracted. The results showed that the core process of social death in hip fracture is an intentional self-destruction for getting liberated from the conditions of the illness and the disrupted social life after the fracture, which ultimately leads to outcomes such as isolation-seeking and death ideations in these patients. The core category of liberating self-destruction reflects the close relationship between the context, process, and outcomes of social death. The process of social death is social, multidimensional, and complex. So far, no explanatory theory has been presented for this group of patients. Therefore, the results of this study can play an important role in designing helpful interventions for preventing, modifying, and changing the phenomenon of social death.

Computational and statistical analyses of blood hemodynamic inside cerebral aneurysms for treatment evaluation of endovascular coiling.

Diagnosis of aneurysm and possibility of aneurysm rupture are crucial for avoiding brain hemorrhage. In this work, blood stream inside internal carotid arteries (ICAs) are simulated in diverse working conditions to disclose the importance of hemodynamic factors on the rupture of aneurysm. The main attention of this study is to investigate the role of hemodynamic on the aneurysm rupture. Statistical and computational methods are applied to investigate coiling porosity and blood hematocrit in 9 specific real ICA geometries. Response surface model (RSM) develops 25 runs to investigate all features of selected geometrical parameters and treatment factors. Computational fluid dynamic is used for the simulation of the blood stream in the selected aneurysms. The effects of sac section area and mean radius of parent vessel on blood hemodynamics are fully investigated. Hemodynamic factors are examined and compared at the peak systolic time instant, including pressure distributions, and velocity. Achieved results indicate that the increasing sac section area (from 36.6 to 75.4 mm2) results in 20% pressure reduction on the sac wall.

Psychometric properties of the Persian version of the quality of recovery-15 questionnaire.

BACKGROUND: Recovery after surgery is a complex process since it depends on many factors, such as the patient's sex, age, surgery type, and presence of other diseases. This study aimed to translate and evaluate the psychometric properties of the Persian version of the quality of recovery-15 (QoR-15) questionnaire in Iranian patients undergoing surgery. METHODS: The Persian version of the QoR-15 questionnaire was developed after translating and culturally validating the instrument. Content validity was assessed with a sample of clinicians (n = 15) and face validity was assessed in a sample of patients (n = 15) undergoing elective surgery. The final questionnaire was completed by 450 patients (n = 450) 24 h after surgery. Construct validity was assessed using exploratory factor analysis in patients (N = 250). Convergence and divergent validity were also assessed. Internal consistency was assessed using Cronbach's alpha and construct reliability was also assessed. Test-retest reliability was assessed on a randomly selected sub sample of 50 patients. Finally, the questionnaire was completed by a further sample of 200 patients 24 h after surgery and construct validity was assessed using confirmatory factor analysis. RESULTS: According to Lawshe, all items received at least an acceptable ratio for content validity ratio (CVR). Item content validity index (I-CVI) of each item was greater than 0.79. Construct validity indicated good fit statistics in the five components of CFA, and CFI was > 0.93. The reliability of the QoR-15 questionnaire was acceptable based on Cronbach's alpha score (> 0.001), test-retest reliability value (0.81), and CR (> 0.7). CONCLUSION: The Persian version of the QoR-15 questionnaire was equivalent to the original one regarding both conceptual and linguistic aspects. This study also confirmed the validity and reliability of the Persian version of the QoR-15 questionnaire. Therefore, the Persian version of the QoR-15 questionnaire can be a suitable and brief instrument to assess the recovery quality in Iranian patients undergoing surgery.

Social death in patients: Concept analysis with an evolutionary approach.

Social death is an important concept that should be considered in a wide range of patients, especially in chronic diseases. Despite, there is still no clear and comprehensive definition of social death in medicine. The present study was thus conducted with Rodgers' evolutionary concept analysis method to identify the key features and provide a clear definition of social death in patients and understand its background and consequences. Considering the stages of concept analysis, an initial search was carried out in scientific databases (PubMed, Science Direct, Google Scholar, Magiran, and SID) without time limit until 2020. The search resulted in 400 articles in the first stage, which were screened according to the study objective and, all the items and points consistent with the concept's attributes, antecedents, consequences, associated concepts, alternative terms and definition were extracted. According to the results of different studies, the attributes of social death in patients can be classified into three main themes: The loss of social identity, loss of social relations (social isolation), and deficiencies related to the inefficiency of the body and various diseases. Generally, antecedents' social death in patients can be including; the factors related to the patient, Family neglect, Medical personnel's treatment of the patient as a corpse, Having no social situation. Also, there is little information available about the effect of social death on the patients themselves and their families, specialists, health care institutions and the society. Mankind's perception of social death is multidimensional and may have consequences such as bad death, disgraceful death deprivation of belonging to the society, financial vulnerability, removed or weakened legal support, stigma, and the loss of social identity. The proper understanding of social death in patients not only determines the role and importance of care in the process of incidence of this phenomenon, but also paves the way for designing an evidence-based care program for its prevention and control.

Clarifying the concept of the four-season symphony (I SEA) in nursing practice: A Wilson's approach to concept analysis.

Acquired knowledge provides one with intuitive rationality as a means of achieving a goal. Spiritual, ethical and esthetic competencies are also required for acquiring intuitive rationality. Nurses pay less attention to intuitive rationality, think only with their brain rather than observe with their heart and therefore deprive themselves of proper, immediate and comprehensive cognition of their environment. An initiative to harmonize sensory receptors in charge of thinking, speaking, and acting in nurses is required for establishing a symphonic intellectual, spiritual, ethical, and aesthetic (I SEA) nursing practice. The present research was conducted to clarify the concept of four-season symphony of I SEA in nursing practice. The present study was conducted by employing Wilson's method of concept analysis and searching databases including Google Scholar, ScienceDirect, Scopus, PubMed, SID, and Magiran using symphony, rationality, intellectuality, spirituality, ethics, aesthetic, and nursing practice as keywords. According to the integrated concept of the four-season symphony in nursing care, nursing practice refers to performing the symphonic action of four seasons of I SEA in orderly and smart thinking, speaking and acting in looking, listening, speaking, heartfelt sympathy and using the hands for caregiving and steps for accompanying patients. This symphony provides an opportunity for the emergence of perfect nurses of four seasons and helps with individual and organizational symphonic improvements in nursing care and nurses. According to this perspective, nurses should always ask themselves whether their thought, speech, and action are intellectual, spiritual, ethical and aesthetic.

Concept analysis of the Four-Season-Symphony of Intellectuality-Spirituality-Ethics-Esthetics (FSS: I SEA) in nursing research.

BACKGROUND: The Four-Season-Symphony of intellectuality, spirituality, ethics, and esthetics (FSS: I SEA) in nursing research is a new concept that has not been addressed in previous nursing theories and studies. AIM: This study was conducted to clarify the concept of the FSS: I SEA in nursing research. DESIGN: Wilson's method of concept analysis was used. DATA SOURCE: Empirical and conceptual literature. REVIEW METHOD: This study has been conducted based on Wilson's 11-step approach by searching keywords with Symphony, Rationality, Intellectuality, Spirituality, Ethics, Esthetics, and Nursing research in databases including Google Scholar, PubMed, Scopus, CINAHL, Sid, Oxford Dictionary, Dehkhoda Dictionary, and nursing theory textbook. RESULTS AND CONCLUSION: Richness and elegance of the symphony in nursing research cannot be achieved by a single-tool benchmark; rather, a more integrated assessment can be achieved with the use of a tool combining different intellectuality, spirituality, ethics, and esthetics tools. This symphony contains a philosophical and deep understanding of the meanings of researcher, research problem, research process, and symphonic product. Through identifying the facilitators and barriers of this concept, nursing researchers, professors, and practitioners will be able to design and implement their research activities on FSS basis to pave the way for the continued transcendence of comprehensive nursing care.

Nurses' adaptation instrument in the oncology wards: Development and psychometric testing.

INTRODUCTION: Understanding adaptation is strongly influenced by the culture and beliefs of every society. By increasing knowledge about the different dimensions which require the adaptation in different aspects requiring the nurse adaptation in oncology, a clear definition of the problem can be stated. Because of the lack of a standard and appropriate tool for the culture of the Iranian society, this aimed at developing and validating the nurse adaptation tool in the oncology departments. METHODS: This research is a methodological study and an exploratory mixed method being conducted in three main steps of conceptualization, production of items, and field test. Inductive conceptualization was performed through qualitative methodology and conventional content analysis approach; in the second step, developed instrument was evaluated in terms of face validity, content validity, and construct validity. In the third step, sampling of oncology nurses was done and exploratory factor analysis was performed for evaluating the construct validity, adequacy of sampling, and dimensioning. Cronbach's alpha was calculated for checking the reliability of the instrument. RESULTS: The oncology nurse adaptation questionnaire was formed with twenty items in four main dimensions, including "emotional factors," "supportive factors," "work-related factors in the ward," and "factors related to job conditions." The reliability of the tool was confirmed by evaluating the internal consistency with Cronbach's alpha, which was above 0.7 for each dimension and 0.82 for the whole instrument. CONCLUSION: This instrument can be used as a practical tool for determining the adaptation of oncology nurses for providing evidence to improve the work conditions of nurses by improving the working conditions in the workplace and providing facilities with individual intervention, and the outcome will be care of patients with high quality.

Nursing students' perception of patient-centred care: A qualitative study.

Aim: This study aimed to explain the understanding of nursing students from the concept of patient-centred care. Design: This is an explorative and descriptive-qualitative design. Methods: The participants consisted of 15 nursing students who were selected through purposeful sampling, and data were collected through in-depth, semi-structured interviews and analysed using a qualitative content analysis. Results: Data analysis led to the identification of three categories including the following: the inevitability of patient-centred care, the patient-centredness in comprehensive care and the importance of nursing process in patient-centred care. Introducing students to the concept of patient-centred care and how it can be achieved seems necessary during nursing education. Introducing a module on patient-centred care to the nursing curriculum is suggested to familiarize students with this concept.

The effect of supportive educative program on the quality of life in family caregivers of hemodialysis patients.

BACKGROUND: Previous studies showed that family caregivers of hemodialysis patients have low level of quality of life. However, these caregivers are mostly neglected, and no studies are available on improving their quality of lives. Therefore, this study aimed to examine the effects of supportive educative program on the quality of life in family caregivers of hemodialysis patients. MATERIALS AND METHODS: A randomized controlled clinical trial was conducted on 76 family caregivers of hemodialysis patients referred to Shahid Hasheminejad Hemodialysis Center in Tehran, Iran in 2015. The subjects were equally allocated into two groups of 38. Caregivers of patients were randomly assigned into the intervention group and the control group. The intervention group received six training sessions on supportive educative program. Both groups answered demographic information and short form-36 questionnaires before and 6 weeks after the intervention. Descriptive statistics, Chi-square and Fisher exact tests, independent samples t-test, and t-couple, was used to analyze the data. RESULTS: No significant difference was found between the baseline mean scores of "quality of life" of the intervention and the control groups (P = 0.775). However, the mean scores of quality of life of the intervention group increased at the end of the study, and the two groups were significantly different in this regard (P < 0.001). CONCLUSIONS: Supportive educative program improved the quality of life in caregivers of hemodialysis patients. Therefore, it is suggested that health system managers encourage their staff to implement such programs for improving the health status of the caregivers.

Effectiveness of Problem-Focused Coping Strategies on the Burden on Caregivers of Hemodialysis Patients.

BACKGROUND: Studies have shown that family caregivers of hemodialysis patients experience high levels of burden. However, these caregivers are often neglected, and no studies are available on the effectiveness of coping strategies on the burden of care among these caregivers. OBJECTIVES: This study aimed to examine the effectiveness of problem-focused coping strategies (communication skills, anger management, and deep breathing) on the burden on caregivers of hemodialysis patients. PATIENTS AND METHODS: A randomized controlled clinical trial was conducted on 76 family caregivers of hemodialysis patients referred to Shahid Hasheminejad hemodialysis center in Tehran, Iran. The subjects were equally allocated into two groups of 38. Through a coin-tossing method, caregivers of patients who referred on even or odd days of the week were randomly assigned into the intervention group or the control group, respectively. The intervention group received four training sessions on problem-focused coping strategies, but the control group did not receive any intervention. Both groups answered the caregiver's burnout inventory at the start and six weeks after the last educational session. Descriptive statistics, chi-square, Fisher's exact test, independent-samples t-test, and Mann-Whitney U test were used to analyze the data. RESULTS: The majority of caregivers (54%) were in the age range of 35 - 55 years, female (68.4%), and married (70%). No significant difference was found between the baseline mean caregivers' burden scores of the intervention and control groups (88.56 ± 11.74 vs. 84.97 ± 15.13, P = 0.308). However, the mean caregivers' burden in the intervention group decreased, and the two groups were significantly different at the end of the study (58.77 ± 6.64 vs. 87.84 ± 11.74, P < 0.001). CONCLUSIONS: The current study showed the effectiveness of problem-focused coping strategies on reducing the burden on caregivers of hemodialysis patients. Authorities and policymakers in the healthcare system are responsible for developing strategies to integrate educational programs, such as the program implemented in the current study, into the country's healthcare system.