Barriers and Facilitators of Palliative Care in Older Adults With Heart Failure: A Qualitative Content Analysis.

Objectives: The progressive and unpredictable course of heart failure (HF) has made the provision of palliative care (PC) services to older adults with HF a serious challenge. This study aimed to explain the barriers and facilitators of PC in older adults with HF. Methods: This qualitative study was conducted using the content analysis approach. A sample of 15 participants, including 6 patients, 2 family caregivers, and 7 healthcare team members (4 nurses, a psychiatric nurse, a nutritionist, and a PC physician) were selected by purposive sampling over 10 months (November 21, 2020 to September 1, 2021). The data were collected using semistructured in-person interviews until data saturation and analyzed with conventional qualitative content analysis. Results: The findings revealed the main category of "neglecting the provision of PC," with 4 subcategories of "weak organizational structure," "poor social support," "older adults' and healthcare teams' poor knowledge," and "limited financial resources" as the barriers of PC and the main category of "enjoying support potentials" with 3 subcategories of "the cooperation of the government, benefactors, and nongovernmental organizations," "empathy from the family and relatives," and "benefiting from the presence of healthcare workers" as PC facilitators. Conclusions: The findings of this study explained the barriers and facilitators of PC in older adults with HF. Removing the barriers and supporting the facilitators give older adults with HF better access to PC. Therefore, to expand PC centers for older adults with HF, health system officials, and policy-makers should pay attention to organizational infrastructures and remove the barriers at organizational, social, educational, and economic levels with the cooperation of governmental organizations, benefactors, and nongovernmental organizations.

The relationship of moral intelligence and social capital with job satisfaction among nurses working in the emergency department.

INTRODUCTION: Nurses' job satisfaction has a direct impact on the quality of their performance, especially in the emergency department, which is a showcase of care in hospitals, since, nurses' moral performance is greatly affected by moral intelligence, Adherence to ethics by nurses, underlies the social capital of the organization. METHODS: The present study was a cross-sectional, descriptive-correlational study. 99 nurses working in the emergency department of medical educational centers in Semnan, Iran, were selected by simple random sampling. Data were collected by questionnaires: demographic information, job satisfaction, moral intelligence and social capital of nurses. Data were analyzed using descriptive statistics and analytical statistics in SPSS software. All P-values <0.05 were considered statistically significant. RESULTS: The mean and standard deviation of job satisfaction, moral intelligence, and social capital scores were 51.24 ± 12.03, 148.48 ± 19.05, and 43.45 ± 7.28, respectively. Job satisfaction did not have a significant relationship with moral intelligence and its domains, but it had a significant relationship with social capital and its domains (P = 0.002). CONCLUSION: Due to the significant relationship between job satisfaction and social capital, Nurses' satisfaction and attitude toward the job can be improved by creating a context for progress and self-actualization.

Comparing the effects of two Swedish massage techniques on the vital signs and anxiety of healthy women.

BACKGROUND: Anxiety is an inseparable part of our lives and a serious threat to health. Therefore, it is necessary to use certain strategies to prevent disorders caused by anxiety and adjust the vital signs of people. Swedish massage is one of the most recognized techniques for reducing anxiety. This study aims to compare the effects of two massage techniques on the vital signs and anxiety of healthy women. MATERIALS AND METHODS: This quasi-experimental study with a two-group, crossover design was conducted on 20 healthy women who were selected by simple sampling method and were randomly assigned to BNC (Back, Neck, and Chest) or LAF (Leg, Arm, and Face) groups. Massage therapy was carried out for a 14-week period (two 4-week massage therapy sessions and 6 weeks washout stage). Gathered data were analyzed using paired t-test with a significance level of P < 0.05. RESULTS: Both BNC and LAF methods caused a significant decrease in systolic BP in the first stage (P = 0.02, 0.00); however, diastolic BP showed significant decrease only in BNC group (P = 0.01). The mean average of body temperature of LAF group showed a significant decrease in the first stage (P = 0.0.3), and pulse and respiratory rate showed significant decrease in both groups during the second stage (P = 0.00). In addition, anxiety scores showed no significant difference before and after massage therapy (P < 0.05). CONCLUSIONS: Massage therapy caused a decrease in systolic BP, pulse, and respiratory rate. It can be concluded that massage therapy was useful for decreasing the vital signs associated with anxiety in healthy women.