Designing, implementing, and evaluating a mobile app-based cultural care training program to improve the cultural capacity and humility of nursing students.

BACKGROUND: Given the growing cultural diversity among healthcare clients, it is crucial for nursing education to have a clear mission: to effectively train future nurses by incorporating cultural care curricula. The goal is to equip them with the necessary cultural capacity and humility. This study focused on designing, developing, and evaluating a mobile app-based cultural care training program, with the aim of enhancing the cultural capacity and humility of nursing students. METHODS: This experimental study utilized the five steps of the ADDIE instructional model (analysis, design, development, implementation, and evaluation) to design a mobile app-based cultural care training program. The first three steps involved designing and developing the program, drawing upon Purnell's model for cultural competence and Foronda's rainbow model of cultural humility. In the fourth step, the cultural care training program was implemented in 16 modules among 80 internship nursing students. These students were randomly assigned to either the intervention or control groups, with 40 students in each group. Finally, in the fifth step, the effectiveness of the mobile app-based program was evaluated by administering the Cultural Capacity Scale, and the Foronda Cultural Humility Scale before and one month after the cultural care training. The collected data were analyzed using SPSS22, employing techniques such as paired t-test, chi-square test, and independent samples t-test. RESULTS: A total of 76 students completed the study, with 39 students in the intervention group and 37 students in the control group. Prior to the mobile app-based cultural care training program, there were no significant differences in cultural capacity and humility scores between the two groups (p > 0.05). However, following the completion of the program, the intervention group exhibited higher scores in cultural capacity and humility compared to the control group (p < 0.05). CONCLUSION: Based on the findings, it can be concluded that the mobile app-based cultural care training program had a positive impact on the cultural capacity and humility of undergraduate nursing students. These results indicate the importance of nurse educators designing comprehensive training programs that incorporate innovative approaches to enhance cultural capacity and humility among nursing students at all academic levels.

A virtual training program for improving cultural competence among academic nurse educators.

BACKGROUND: Everyday, nursing students interact with culturally diverse clients. Nursing education recognizes that cultural competence is a necessary outcome of nursing programs. Nurse educators expect all nursing students to provide culturally congruent care to multicultural clients. Therefore, nurse educators must be culturally competent in order to prepare culturally competent nursing students for clinical practice. This study aimed to evaluate the effect of virtual training program on the cultural competence of academic nurse educators. METHODS: This randomized controlled study included nurse educators working in six nursing schools affiliated with medical universities of Kerman province in southeastern Iran. Sixty-nine nurse educators were randomly assigned to the intervention (n = 35) and control (n = 34) groups. The training program consisted of three 2-hour sessions for a month. Cultural Diversity Questionnaire for Nurse Educators Revised (CDQNE-R) was used to evaluate the cultural competence of educators before and one month after the virtual training program. RESULTS: Both the intervention (3.29 ± 0.58) and control (3.24 ± 0.58) groups demonstrated a similar level of cultural competence before the training program (t = 0.05, p = 0.95). After the training, the intervention group showed a significant increase in cultural competence (3.80 ± 0.7) compared to the control group (3.23 ± 0.67). This improvement resulted in culturally competent participants becoming culturally proficient, as evidenced by a large effect size (t = -4.76, p = 0.001). CONCLUSION: The virtual training program had a positive impact on the cultural competence of nurse educators. Given the importance of cultural competence in nursing education, continuing education programs that focus on strengthening the cultural competence of nurse educators should be prioritized. The experiences gained from implementing virtual training programs can serve as a valuable resource for nurse educators seeking to enhance their cultural competence.

Comparing the Efficacy of Breast Milk and Coconut Oil on Nipple Fissure and Breast Pain Intensity in Primiparous Mothers: A Single-Blind Clinical Trial.

Background: Nipple fissure is a prevalent problem for breastfeeding mothers. Virgin coconut oil (VCO) is an herbal medicine that can heal microbial infections and wounds. Objective: This study aims to evaluate the efficacy of VCO and breast milk on nipple fissures in primiparous mothers. Design, Setting, Participants, and Intervention: A single-blind clinical trial was conducted with 106 breastfeeding primiparous mothers suffering from nipple fissures in health centers of Zarand, Kerman, from August 2020 to November 2020. The participants were selected randomly and allocated to two 60-member groups using block randomization. Mothers in the first group were asked to apply 0.5 mL of coconut oil on their nipples three times a day. Mothers in the second group were trained to apply three to four drops of their milk on their nipples after every breastfeeding session. The level of nipple fissures and pain intensity were examined using Storr's scale and visual analog scale, respectively. The results were analyzed using the chi-square test, repeated measures analysis of variance, and the independent samples t-test in SPSS 22. In this study, the significance level was set at p < 0.05. Results: Within-group comparisons revealed a significant difference between baseline scores and the scores on the 7th and 14th days (p < 0.001). Between-group comparison indicated no significant difference in nipple fissure (p = 0.419) and pain intensity (p = 0.405) at baseline. Nonetheless, there was a significant difference on the 7th day (pfissure = 0.002, ppain <0.001) and on the 14th day (pfissure <0.001, ppain = 0.036). Conclusion: Given its effect on nipple fissures, VCO may be used as a complementary substance to treat nipple fissures. Trial Registration: This trial is registered with the Iranian Registry of Clinical Trials with the identifier: IRCT20190724044318N1.

Using mindfulness-based stress reduction group therapy to reduce perceived stress of vulnerable women in south of Iran.

Provision of educational and health services to vulnerable women in drop-in centers can reduce their traumas. Mindfulness-Based Stress Reduction (MBSR) group therapy is a psychological intervention to reduce perceived stress these women. This quasi-experimental study aimed to evaluate the effectiveness of MBSR group therapy in the perceived stress of 63 vulnerable women who referred to two drop-in centers in southeastern Iran. The participants were assigned into the intervention (n = 30) and control (n = 33) groups. The intervention group members were required to attend the MBSR intervention held in eight 90-minute sessions. Perceived Stress Scale (PSS) was administered to collect data before and one month after the MBSR. Based on the findings, the pre-test scores of perceived stress were not significantly different between the intervention (38.16 ± 6.04) and control (39.06 ± 5.30) groups (t = -0.62, p = 0.53). However, the perceived stress scores reduced significantly in the intervention group (30.20 ± 2.89) than the control group scores (37.96 ± 4.18) in the posttest (t = -8.35, P = 0.001). Given the significant reduction of perceived stress in participants after attending the MBSR group therapy, expert counselors, psychologists, and psychiatrists are recommended to conduct this therapy to reduce perceived stress in vulnerable women.

The Development and Validation of Elder Self-Neglect Scale (ESNS) in Iranian Community-dwelling Older Population.

The aim of this study was to develop a valid and reliable elder self-neglect scale (ESNS) for field research on Iranian community-dwelling older adults. This mixed-method exploratory study was conducted in three stages: (1) item generation using literature review, (2) item reduction by expert panels, and (3) assessing the psychometric properties. In the third stage, the face, content, and construct validity (exploratory factor analysis) were performed on the first sample (n = 450), and the final 26-item scale was developed. After that, confirmatory factor analysis and reliability were assessed on the second sample (n = 250). Data were analyzed using IBM-SPSS v.23 and AMOS v.24. Exploratory factor analysis identified six factors with a total variance of 77.53%. The goodness of fit was indicated by Structural Equation Modeling. The Cronbach's alpha was estimated at 0.85. The optimal cutoff point was 73. This scale with 26 items seems to be an effective tool in screening elder self-neglect.

Efficacy of the herbal formula of Foeniculum vulgare and Rosa damascena on elderly patients with functional constipation: A double-blind randomized controlled trial.

BACKGROUND: Constipation is a common chronic bowel disorder with an incidence of more than 50% in the elderly population. Complementary and alternative medicine is a cost-effective and satisfactory treatment for constipation used widely by the elderly. OBJECTIVE: This study evaluates the efficacy of an herbal formula made from Foeniculum vulgare Mill. and Rosa damascena for the treatment of constipation in an elderly population and consequent changes to their quality of life. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: This double-blind randomized active controlled clinical trial, with parallel group allocation ratio of 1:1, was conducted in a referral clinic in Afzalipour Hospital, affiliated to Kerman University of Medical Sciences in Kerman, Southeastern Iran. Individuals over 60 years of age, diagnosed with functional constipation (based on the Rome IV criteria), were included in this study. Participants received a sachet of 10 g F. vulgare and R. damascena (herbal formula group) or polyethylene glycol 4000 (PEG 4000 group) with a glass of warm water two times a day for 4 weeks and were followed up for 4 additional weeks. MAIN OUTCOME MEASURES: Constipation severity, stool consistency, and the quality of life were used as the primary outcomes. Drug side effects were used as a secondary outcome. The outcomes were assessed using the Constipation Assessment Scale, the Bristol Stool Form Scale, and the Patient Assessment of Constipation Quality of Life questionnaire. RESULTS: A total of 25 participants in each group completed the four-week treatment cycle and the eight-week follow-up. At the end of the four-week treatment cycle, all clinical outcomes had significant improvements in both groups (P < 0.05). The analysis of constipation severity (P < 0.001), stool consistency (P < 0.001), and the quality of life (P < 0.001) showed significant improvements with fewer side effects (mild diarrhea) and a longer duration of symptom relief in the herbal formula group compared to the PEG 4000 group. CONCLUSION: Although both interventions significantly improved the treatment outcomes, constipation severity, stool consistency and the quality of life were improved more effectively by the herbal formula than by PEG 4000; however, the mechanism of action is not yet understood. TRIAL REGISTRATION: This trial was registered in the Iranian Registry of Clinical Trials (IRCTID: IRCT20200108046056N1).

The effect of mindfulness-based stress reduction on resilience of vulnerable women at drop-in centers in the southeast of Iran.

BACKGROUND: Female sex workers and addicted women are among the vulnerable groups who impose high costs on the health system of every society. They are prone to psychological problems such as anxiety, stress, and reduced resilience due to their lifestyles. Since mindfulness-based stress reduction (MBSR) has been applied frequently by many psychotherapists to treat stress and anxiety, the present study investigated the effectiveness of MBSR on resilience of the vulnerable women. METHODS: The statistical population of this quasi-experimental study consisted of all eligible women who referred to the drop-in centers in Kerman in the southeast of Iran. Followed by random sampling, 63 vulnerable women were randomly assigned into the intervention (n = 30) and control (n = 33) groups. The MBSR intervention was conducted for the intervention group in eight 90-min sessions. Demographic information questionnaire and Connor-Davidson resilience scale were administered to collect data prior to and one month after the MBSR intervention. RESULTS: The pre-test resilience score was not significantly different between the intervention (53.40 ± 10.49) and the control (54.5 ± 9.27) groups (t = 0.43, p = 0.66). However, the posttest resilience score in the intervention group (60.66 ± 6.71) was significantly higher than the control group (53.88 ± 7.54) (t = 3.58, P = 0.001). Moreover, a comparison between the pretest and posttest scores revealed a significant decrease in resilience scores of the control group (t = 2.81, p = 0.009). CONCLUSION: Since MBSR intervention increased resilience of the vulnerable women in the intervention group, researchers, managers, counselors, community health nurses, and psychiatric nurses are suggested to implement related interventions to promote the health of women, especially vulnerable ones.

Communication Behaviors in Nursing Homes in South-East Iran: An Ethnographic Study.

BACKGROUND: Because of the increasing number of the elderly, the need for care in aged nursing homes (NHs) is increasing. As a cultural perspective toward care is new, it is very important to understand the communication behavior of the elderly in various cultures. This study aimed to explore the communication behaviors among the elderly in NHs in Kerman, Iran. MATERIALS AND METHODS: This ethnographic focused study was conducted on 25 staff members and 8 residents in two NHs in 2015. Data were collected through observation of the participants, field notes, and semi-structured deep interviews in Kerman. Cuba and Lincoln method was used to ensure the trustworthiness of the data. The collected data were analyzed through content analysis. RESULTS: By analyzing primary codes, 3 categories and 8 subcategories were extracted through content analysis including fluctuation in communication (task-oriented communication, avoidance of communication, and establishment of effective communication), artificial collaboration (fake friendships, jealousy, and its consequences, and cooperation in concealing error), and lack of collaboration among team members (fragmented teamwork, extreme working conditions, and physical burnout among the elderly). CONCLUSIONS: The results of this study indicate that communication problems between caregivers and the elderly are high. Thus, it is necessary that people who care for elderly indiviuals are trained regarding special communication strategies and skills, and they are not influenced by fatigue and burnout resulting from caring.