Exploring the concept and management strategies of caring stress among clinical nurses: a scoping review.

Objective: The concept of caring stress and its specific management has received less attention than other dimensions of stress in nurses. Therefore, to clarify the concept of caring stress, a scoping review study was designed. This scoping review aimed to investigate the concept of caring stress among clinical nurses and examine the strategies used for its management. Methods: This review employed a scoping review methodology to comprehensively map the essential concepts and attributes of the phenomenon by drawing on a wide range of sources. International databases including PubMed, Scopus, Web of Science, Google Scholar, and Scientific Information Database (SID) were searched to gather relevant studies published until October 1, 2023. MESH terms included "caring stress", "care", "stress", "nurse", and "stress management" were used. Two reviewers independently collected data from full-text papers, ensuring that each paper underwent assessment by at least two reviewers. Results: Out of 104,094 articles initially searched, 22 articles were included in this study. High workloads, transmitting the infection, stressful thoughts, stressful emotions, and stressful communications were the significant concepts and factors of caring stress among nurses. Also, rest breaks during patient care shifts, playing music in the ward, and denial of critical situations were examples of positive and negative coping and management ways to reduce caring stress. Conclusion: Effective stress management strategies can lead to better patient care and safety. Stressed nurses are more likely to make errors or become less vigilant in their duties, impacting patient outcomes. By addressing caring stress, clinical practice can prioritize patient well-being. Further research is required to delve deeper into this critical issue concerning nurses in the future.

Explaining the process of formation of ageism among the iranian older adults.

BACKGROUND: Ageism is considered as one of the consequences of the industrialization of societies, which appears in various forms in different cultures. This study aimed to explain the process of formation of ageism among the older adults people. METHODS: The research was conducted using grounded theory method. Data were collected from 28 participants using in-depth semi-structured interviews and field notes. Data were analyzed using open, axial, and selective coding. RESULTS: Fear of loneliness and rejection striving to tackle ageism "was identified as the core category of the study. Concepts such as "family context" and "cultural context" were relevant. After identifying the strategies used by the older adults in response to the context ("maintaining integrity", "socio-cultural care" and "proper health care", "striving to tackle ageism") was the most important process in ageism by the Iranian older adults. CONCLUSION: Findings of this study indicated that individual, family and social factors play an important role in the process of ageism among the older adults. These factors sometimes exacerbate or moderate the process of ageism. By recognizing these factors, various social institutions and organizations (including the health care system and the national media (radio and television)) can help the older adults achieve successful aging by emphasizing the issues related to the social aspect.

Experiences of Facilitators and Inhibitors to Treatment Adherence in Patients with Heart Failure.

Treatment adherence is a fundamental aspect of heart failure (HF) management. This study aimed to explore the experiences of facilitators and inhibitors of treatment adherence in patients with HF. This descriptive qualitative study was conducted from May 2020 to June 2021. Participants including people with HF, their family caregivers and physicians, and nurses were selected purposefully, with the aim of obtaining sufficient information power. Semi-structured interviews were used to collect data. Data were analyzed using thematic analysis. Two main themes "the driving forces behind treatment adherence" and "the deterrent forces behind treatment adherence" emerged from the analysis. The first theme contained the following subthemes: "supportive family," "positive personality characteristics," and "having health literacy." The second theme consisted of "negligence," "psychological problems," "cultural, social, and economic problems," "physical limitations," and "lack of self-care management knowledge." Nurses can consider facilitators and inhibitors of treatment adherence in designing educational and care programs for patients with HF.

Validity and reliability of the persian version of the modified telephone interview for cognitive status among community-dwelling older adults in Iran / Validade e confiabilidade da versão persa da Entrevista Telefônica para o Estado Cognitivo: modificada entre idosos da comunidade no Irã

ABSTRACT. Due to the increase in the population of the elderly, there is a growing trend in some diseases such as cognitive disorders (dementia) which are common in this era, and the diagnosis and treatment of this disease are still facing challenges. Therefore, early identification of cognitive disorders is of particular importance. In this regard, the use of any tool or cognitive tests may not be enough to diagnose dementia in the early stages and a special tool is needed. Objective: The validity and reliability of the Persian version of the Modified Telephone Interview for Cognitive Status (P-TICS-M) in older adults living in the Iranian community for a comprehensive screening of mild cognitive impairment and dementia was investigated. Methods: In the first phase, translation, re-translation, and word-taking were performed by using the face validity and content validity. In the second phase, a stratified convenient sampling with 150 participants aged ≥60 years was conducted based on cognitive status using the global deterioration scale in 2018. The external and internal reliability of the P-TICS-M using the interclass correlation coefficient and Cronbach's alpha coefficient of total items of this tool were estimated. Results: The mean age of the participants was 68.6 (standard deviation±7.4) years. According to global deterioration scale, 87 (58.0%) had normal cognition, 40 (26.7%) had mild cognitive impairment, and 23 (15.3%) had dementia. The Spearman's correlation coefficient between P-TICS-M scores and Mini-Mental State Examination scale was 0.764. In exploratory factor analysis, seven domains were detected, which were compatible with those defined by the tool developer. The Cronbach's alpha of the P-TICS-M was 0.920. The absolute agreement between test-retest score was >0.90. The sensitivity of 92.2, 94.8, and 100%, and also the specificity of 79.4, 88.2, and 89.8% were calculated for detecting subjects with dementia, respectively. Furthermore, a mild cognitive impairment cutoff of >28 was determined. Conclusion: The development and validation of a P-TICS-M tool can be useful in identifying older adult people with cognitive impairment. Demographic characteristics (level of education, age) can also affect the cutoff point of this tool.

RESUMO. Por causa do aumento da população de idosos, há uma tendência crescente de algumas doenças, como os distúrbios cognitivos (demência), que são comuns nessa época, e o diagnóstico e tratamento dessa doença ainda enfrentam desafios. A identificação precoce de distúrbios cognitivos é de particular importância. Nesse sentido, a utilização de qualquer ferramenta ou testes cognitivos pode não ser suficiente para diagnosticar a demência nas fases iniciais e é necessária uma ferramenta especial. Objetivo: A validade e a confiabilidade da versão persa da Entrevista Telefônica para o Estado Cognitivo - Modificada (P-TICS-M) em idosos que vivem na comunidade iraniana para uma triagem abrangente de comprometimento cognitivo leve e demência foram investigadas. Métodos: Primeira fase, tradução, retradução e tomada de palavras utilizando validade de face e validade de conteúdo. Na segunda fase, foi conduzida uma amostragem estratificada por conveniência com 150 participantes com idade ≥60 anos baseada em estado cognitivo por meio da escala de deterioração global em 2018. Estimaram-se a confiabilidade externa e interna do P-TICS-M por meio do coeficiente de correlação interclasses e o coeficiente alfa de Cronbach do total de itens deste instrumento. Resultados: A média de idade dos participantes foi de 68,6 (desvio padrão±7,4) anos. De acordo com a escala de deterioração global, 87 (58,0%) apresentavam cognição normal, 40 (26,7%) apresentavam comprometimento cognitivo leve e 23 (15,3%) apresentavam demência. O coeficiente de correlação de Spearman entre os escores do P-TICS-M e a escala do Mini-Exame do Estado Mental foi de 0,764. Na análise fatorial exploratória, detectaram-se sete domínios, os quais eram compatíveis com aqueles definidos pelo desenvolvedor da ferramenta. O alfa de Cronbach do P-TICS-M foi de 0,920. A concordância absoluta entre o escore teste-reteste foi >0,90. Calculou-se, respectivamente, sensibilidade de 92,2, 94,8 e 100%, e também especificidade de 79,4, 88,2 e 89,8% para a detecção de indivíduos com demência. Além disso, determinou-se um ponto de corte do comprometimento cognitivo leve >28. Conclusão: O desenvolvimento e validação de uma ferramenta P-TICS-M pode ser útil na identificação de idosos com comprometimento cognitivo. As características demográficas (escolaridade, idade) também podem afetar o ponto de corte dessa ferramenta.

Validity and reliability of the persian version of the modified telephone interview for cognitive status among community-dwelling older adults in Iran.

Due to the increase in the population of the elderly, there is a growing trend in some diseases such as cognitive disorders (dementia) which are common in this era, and the diagnosis and treatment of this disease are still facing challenges. Therefore, early identification of cognitive disorders is of particular importance. In this regard, the use of any tool or cognitive tests may not be enough to diagnose dementia in the early stages and a special tool is needed. Objective: The validity and reliability of the Persian version of the Modified Telephone Interview for Cognitive Status (P-TICS-M) in older adults living in the Iranian community for a comprehensive screening of mild cognitive impairment and dementia was investigated. Methods: In the first phase, translation, re-translation, and word-taking were performed by using the face validity and content validity. In the second phase, a stratified convenient sampling with 150 participants aged ≥60 years was conducted based on cognitive status using the global deterioration scale in 2018. The external and internal reliability of the P-TICS-M using the interclass correlation coefficient and Cronbach's alpha coefficient of total items of this tool were estimated. Results: The mean age of the participants was 68.6 (standard deviation±7.4) years. According to global deterioration scale, 87 (58.0%) had normal cognition, 40 (26.7%) had mild cognitive impairment, and 23 (15.3%) had dementia. The Spearman's correlation coefficient between P-TICS-M scores and Mini-Mental State Examination scale was 0.764. In exploratory factor analysis, seven domains were detected, which were compatible with those defined by the tool developer. The Cronbach's alpha of the P-TICS-M was 0.920. The absolute agreement between test-retest score was >0.90. The sensitivity of 92.2, 94.8, and 100%, and also the specificity of 79.4, 88.2, and 89.8% were calculated for detecting subjects with dementia, respectively. Furthermore, a mild cognitive impairment cutoff of >28 was determined. Conclusion: The development and validation of a P-TICS-M tool can be useful in identifying older adult people with cognitive impairment. Demographic characteristics (level of education, age) can also affect the cutoff point of this tool.

Por causa do aumento da população de idosos, há uma tendência crescente de algumas doenças, como os distúrbios cognitivos (demência), que são comuns nessa época, e o diagnóstico e tratamento dessa doença ainda enfrentam desafios. A identificação precoce de distúrbios cognitivos é de particular importância. Nesse sentido, a utilização de qualquer ferramenta ou testes cognitivos pode não ser suficiente para diagnosticar a demência nas fases iniciais e é necessária uma ferramenta especial. Objetivo: A validade e a confiabilidade da versão persa da Entrevista Telefônica para o Estado Cognitivo - Modificada (P-TICS-M) em idosos que vivem na comunidade iraniana para uma triagem abrangente de comprometimento cognitivo leve e demência foram investigadas. Métodos: Primeira fase, tradução, retradução e tomada de palavras utilizando validade de face e validade de conteúdo. Na segunda fase, foi conduzida uma amostragem estratificada por conveniência com 150 participantes com idade ≥60 anos baseada em estado cognitivo por meio da escala de deterioração global em 2018. Estimaram-se a confiabilidade externa e interna do P-TICS-M por meio do coeficiente de correlação interclasses e o coeficiente alfa de Cronbach do total de itens deste instrumento. Resultados: A média de idade dos participantes foi de 68,6 (desvio padrão±7,4) anos. De acordo com a escala de deterioração global, 87 (58,0%) apresentavam cognição normal, 40 (26,7%) apresentavam comprometimento cognitivo leve e 23 (15,3%) apresentavam demência. O coeficiente de correlação de Spearman entre os escores do P-TICS-M e a escala do Mini-Exame do Estado Mental foi de 0,764. Na análise fatorial exploratória, detectaram-se sete domínios, os quais eram compatíveis com aqueles definidos pelo desenvolvedor da ferramenta. O alfa de Cronbach do P-TICS-M foi de 0,920. A concordância absoluta entre o escore teste-reteste foi >0,90. Calculou-se, respectivamente, sensibilidade de 92,2, 94,8 e 100%, e também especificidade de 79,4, 88,2 e 89,8% para a detecção de indivíduos com demência. Além disso, determinou-se um ponto de corte do comprometimento cognitivo leve >28. Conclusão: O desenvolvimento e validação de uma ferramenta P-TICS-M pode ser útil na identificação de idosos com comprometimento cognitivo. As características demográficas (escolaridade, idade) também podem afetar o ponto de corte dessa ferramenta.

Training pain management to nursing students: Designing, implementing, and evaluating a mobile-based application.

BACKGROUND: Pain is a common health issue and acute pain is the main problem for patients after surgery and injury. Inadequate and inappropriate management of pain is dangerous and costly for patients and leads to undesirable health effects. To overcome this problem, empowerment of the health-care team, especially nurses, is essential. Today, to improve the quality of health-care provision, various methods are used that e-learning is one of them. MATERIALS AND METHODS: Based on the studies on pain management, existing parameters were extracted, and according to them, the educational content of the software was approved by nursing professors and anesthesiologists. The Unified Modeling Language diagrams were designed to provide a better understanding of the entities and the order in which the software operates. The software was implemented in the google android studio environment using Photoshop and JQuery mobile. Finally, the software was evaluated by using Questionnaire for User Interface Satisfaction. The software was evaluated by experts and students in two stages. The first stage was evaluated by eight anesthesiologists and nursing professors, and the second stage was evaluated with the participation of 55 undergraduate students and 28 M.Sc. nursing students. RESULTS: The software was developed with two main modules of training and testing, and sections of the report, about us and exit, and four scenarios for the test section. In the initial evaluation of software by experts with an average of 91.85%, and in the second assessment of students, with a mean of 78.15%, application software was evaluated at a good level. CONCLUSIONS: In order to teach academic and practical (clinical) materials to students, the use of digital teaching aids and e-learning, along with traditional methods such as lectures, increases the students' eagerness, and motivation to learn more and thereby enhance the level of learning and improving the quality of education.

Prevalence and Related Factors of Post-Traumatic Stress Disorder in Emergency Medical Technicians; a Cross-sectional Study.

INTRODUCTION: Ongoing exposure to a variety of Pre-hospital Emergencies (PE) has placed Emergency Medical Technicians (EMTs) at serious psychiatric compromise such as Post-Traumatic Stress Disorder (PTSD). The present study aimed to evaluate the prevalence and associated factors of PTSD among EMTs. METHODS: This prospective cross-sectional study was conducted on EMTs in the Emergency Medical Services (EMS) in west of Iran. A baseline information questionnaire including personal work-related characteristics and the PTSD checklist of DSM-5 (PCL-5) were used for data collection. Non-parametric tests and multivariate linear regression were used to evaluate the associated factors of PTSD in these participants. RESULTS: Among the participants, 22% of technicians had PTSD-diagnostic criteria. The mean total PCL-5 score was 21.60 ± 11.45, while the scores were 38.02 ± 6.08 and 17.47 ± 8.36 in the PTSD-diagnosed and undiagnosed groups, respectively. The most common symptom of the clusters was negative alterations in cognition with a mean score of 7.42 ± 4.63. After adjusting confounders, the number of missions (t= 2.50, P= 0.013), work experience (t= -3.24, P= 0.001) and number of shifts (t: 26.38, P < 0.001) were significantly corelated with PCL-5 score. CONCLUSION: The results indicated that the prevalence of PTSD among EMTs personnel of Hamedan province is high. EMTs with the age of ≤ 30 years, work experience of ≤ 10 years, married status, informal employment, emergency medical technician's degree, and more than 8 shifts per month, as well as no previous training history had a higher total PCL-5 score.

Lived Experiences of Adolescent Living with human immunodeficiency virus in Ghana: A Phenomenology Study.

Aim and objectives: To explore the meaning of living with HIV positive in Ghanaian adolescents. Design: Hermeneutic phenomenological approach developed by Van Manen methodology (1990). Method: A purposive sampling of 12 adolescents living with HIV was recruited. Data were collected between September 2019-January 2020 using semi-structured interviews and analysed using thematic analysis. Results: Two main themes emerged: Stigmatization and HIV disclosure and Living with a heavy burden. Seven subthemes were also found. Adolescents living with HIV in Ghana face discrimination, rejection and go through psychological distress such as suicidal thoughts, fear of death and hopelessness. Conclusion: The problems faced by adolescents living with HIV are a result of the inherent beliefs of the Ghanaian society about HIV. Nurses working with ADLHIV should concentrate on identifying challenges and provide support and care, in addition to their treatment.

Factors Moderating the Influence of Intergenerational Contact on Ageism: A Systematic Review.

The authors conducted a systematic review of factors that moderate the influence of intergenerational contact on ageism. MEDLINE (using PubMed), EMBASE, Scopus, Web of Science, and Proquest databases were searched, using terms and keywords including intergenerational conflict, intergenerational relation, intergeneration gap, and ageism, and no date restrictions. The search yielded a total of 247 articles, of which 23 met eligibility criteria for the review. Findings revealed that the experience of ageism for older adults is widespread and highly prevalent in Western and Eastern countries. In addition, culture, age, and gender played important roles in young people's decisions to contact older adults. These factors were important moderators of intergenerational relationships and ageism. Robust, trans-disciplinary research is needed to examine factors related to intergenerational relations, particularly with older adults in clinical populations. [Journal of Psychosocial Nursing and Mental Health Services, 58(8), 48-55.].

Designing a truth-based communication model in patient ethical care process.

INTRODUCTION: Providing information based on truth is very important in patients' treatment-related decisions and reduces emotional and physical sufferings as well as patient costs. The aim of this study was to design a model that is based on the culture and health-care context of Iran in order to establish a truth-based communication and provide accurate information to patient. MATERIALS AND METHODS: This qualitative study was conducted in 2019. Data were collected through semi-structured interviews with 18 nurses who had been selected by purposeful sampling method. Data analysis was performed in two steps. In the first step, the participants' experiences were determined using the grounded theory approach. In the next step, using Walker and Evant's (2011) method, the concepts and statements were combined and presented in a central concept. RESULTS: The central concept in this study was "an attempt to establish a truth-based communication with patient," and then, a truth-based communication model was presented. The components of the model were presented in three parts: improving patient communication skills, managing the situation in which the truth is presented, and the patient's participation in decision-making. CONCLUSION: To present the truth of the treatment, which can sometimes be unpleasant and bitter, it is very important to improve communication skills and choose an effective communication strategy. To establish a truth-based communication, it is necessary to create a suitable ground for communication, which should be provided in clinical setting and community.

White lies in pediatric care: a qualitative study from nurses' perspective.

Communication and sharing information with ill children are challenging. To protect a child from the bitter reality, sometimes use of well-intended untruths, or white lies is necessary. This research aimed at studying the experiences of nurses about the use of white lies in in pediatric clinical setting. In this qualitative, content-analysis study, 24 on-duty pediatric nurses were interviewed in 2019. Data were collected through purposeful sampling using semi-structured interviews, and the collected data were analyzed according to Granheim and Landman's method using MAXQDA-10 software. Eighteen female and six male nurses with the mean age of 42 ± 3/7 years and mean work experience of 16 ± 4/1 years were selected to participate in this study. Data analysis showed that use of white lies depends on both situation and several other factors classified into five general categories: nature of data, childhood characteristics, family norms, treatment team's capabilities and organization policies. Treatment team members need to improve their communication skills to convey therapeutic information to the ill child's family appropriately. To do so, special guidelines should be prepared for healthcare staff in pediatric clinical setting.

Predictors of Out of Hospital Cardiac Arrest Outcomes in Pre-Hospital Settings; a Retrospective Cross-sectional Study.

INTRODUCTION: Different potential factors can affect the outcomes of Out of Hospital Cardiac Arrest (OHCA). The present study aimed to identify important factors contributing to the Return of Spontaneous Circulation (ROSC) and Survival to Hospital Discharge (SHD) in these patients. METHODS: This cross-sectional study was conducted on all the OHCA patients who underwent Cardiopulmonary Resuscitation (CPR) in emergency medical service (EMS) of Hamedan province during 2016-2017. All the relevant data were retrieved from three sources, according to Utstein's style. In addition, univariate and multivariate logistic regressions were employed to identify predictive factors of ROSC and SHD using SPSS software, version 20. RESULTS: Among the 3214 eligible patients whose data were collected, most OHCA patients were female (59.7%) with the mean age of 58 years. Moreover, the majority of OHCAs (77.8%) occurred at home during 8pm-8am (65.1%) and about 26.3% of OHCAs were witnessed, with only 5.1% bystander-initiated CPR. Furthermore, the median ambulance response time and CPR duration were 6.0 and 20 minutes, respectively. Overall, ROSC and SHD success rates were 8.3 and 4.1%, respectively. Bystander CPR was found to be the most effective predicting factor for the success rate of ROSC (AOR=3.26, P<0.001) and SHD (AOR=3.04, P<0.001) after adjusting for the Utstein variables including the patients' age, gender, cardiac disease history, arrest time, CPR duration, response time, being witnessed, bystander CPR, and endotracheal intubation (ETI). CONCLUSION: The overall success rates of ROSC and SHD were 8.3% and 4.1%, respectively. The age, ambulance response time, CPR duration, and cardiac disease history were negatively associated with the outcomes of ROSC and SHD, while being witnessed, bystander CPR, ETI, and initial shockable rhythm were positively related to both of the above-mentioned outcomes.

The Most and Least Stressful Prehospital Emergencies from Emergency Medical Technicians' View Point; a Cross-Sectional Study.

INTRODUCTION: Exposure to different prehospital emergencies (PE) may have a different impact on Emergency Medical Technicians (EMTs) based on the characteristics and circumstances of the emergency. The present study aimed to prioritize PE types according to their stressfulness as well as their correlation with post traumatic stress disorders (PTSD). METHOD: In this cross-sectional study, all EMTs in the Emergency Medical Services (EMS) of Hamadan province were invited to participate, voluntarily. The study questionnaire comprised of two parts: a) personal characteristics and prioritizing PE types in terms of their stressfulness and b) The PTSD checklist. Kruskal-Wallis test was used for examining the relationship between total PTSD score and the most and the least stressful PEs. Multivariate logistic regression was also used to predict the impact of different types of PEs on PTSD. RESULTS: 259 EMTs with the mean age of 32.79±6.16 years were studied. The total mean score of PTSD on PCL-5 was 21.60±11.45. Also, 20.1% of technicians met the criteria for PTSD. The mean age of technicians who met PTSD criteria was less than that of technicians who did not meet PTSD criteria (28 vs. 33 years, P<0.001). The most and least stressful emergencies were cardiovascular (24.7%) and environmental (26.3%) emergencies, respectively. There was a significant correlation between the most (Kruskal-Wallis=40.92, df=12, p < 0.001) and the least stressful emergencies (Kruskal-Wallis=28.22, df=15, p = 0.02) from EMTs' viewpoint and PTSD score. Multivariate logistic analysis showed that gynecologic (aOR=2.28, Wald=5.83, p=0.016) and allergic (aOR=0.12, Wald=10.16, p=0.01) emergencies were significant predictive factors of PTSD. CONCLUSION: Based on the view point of the studied EMTs, cardiac and environmental emergencies were the most and least stressful emergencies. The frequency of PTSD in this series was about 20% and it significantly correlated with younger age, lower experience, higher number of shifts, non-official employment and EMT degree. Based on multivariate logistic analysis, gynecologic and allergic emergencies were the only significant predictive factors of PTSD.

Examining the ethical challenges in managing elder abuse: a systematic review.

Elder abuse is an increasingly intangible phenomenon that has created numerous ethical issues for care teams and caregivers. Although different studies have concentrated on various ethical issues regarding abuse, no study has arrived at a comprehensive conclusion. Therefore, the present study aimed to determine the existing ethical challenges in this context. For this purpose, two researchers familiar with systematic search approach examined national and international journals on PubMed, Excerpta Medica Database (EMBASE), Scientific Information Database (SID) and similar databases between January and February 2017. They were able to find 116 articles that met the inclusion and exclusion criteria, and finally selected 15 articles based on the predesigned questions. The findings were classified in five subtitles as follow: 1) the common definition of elder abuse, 2) a comprehensive legislation on elder abuse, 3) comprehensive ethical principles about elder abuse, 4) ethical considerations regarding patients without competency, and 5) reporting and sharing information about elder abuse. The study results revealed no common definition and no legislation about elder abuse, and also showed that health care providers' observance of ethical principles depends on the ethical and legal conditions of the community. Nowadays, elder abuse is a serious problem in many countries. Cultural and religious differences are the reasons for lack of a common definition and legislations, which comprises the biggest obstacle to protecting the rights of elderly people. It is clear that ethical principles should be respected as far as a person has competency. Furthermore, localization of clinical guidelines related to this issue leads to proper functioning of health care providers, especially nurses as the first line of treatment.

Comparative study of nursing curriculum in nursing faculties of Canada, Turkey, and Iran according to SPICES model.

BACKGROUND: Innovation in the development and review of curriculums is one of the requirements of medical education in the present era. SPICES model has been taken into consideration by nursing faculties to promote quality of nursing education and to eliminate conventional curriculums. In Iran, for competency-based nursing education, review and development of curriculums are necessary. OBJECTIVE: The objectives of the present study were to determine the implementation of SPICES model in nursing curriculums of Tehran (Iran), Western (Canada), and Hacettepe (Turkey) nursing faculties and also to present recommendations to operationalize it in the nursing curriculum of Iran. MATERIALS AND METHODS: This study using comparative method with Brady's model was conducted in 2018. In this study, curriculums of nursing faculties of Tehran, Western Canada, and Hacettepe were compared. Data were extracted through texts and documents available at electronic pages of universities. Curriculums of these nursing faculties were compared from the perspective of SPICES model strategies (student-based, problem-based, integration, community-based, elective, and systematic) at four steps of description, interpretation, juxtaposition, and comparison. RESULTS: The results showed that curriculums in Western Canada reside at the end of the innovative spectrum of SPICES model. Curriculums in Tehran and Hacettepe in most of the strategies of this model reside at the beginning of the spectrum, and in most cases, conventional methods were used. CONCLUSIONS: According to successful experiences of Western Canada in the implementation of SPICES model's strategies and also considering this fact that still conventional approaches are prevalent in Iran, it is recommended to focus on experiences and, according to social conditions and facilities of the nursing community, to implement necessary changes in the curriculums based on this model.

Development and Psychometric Evaluation of Coronary Artery Disease Treatment Adherence Scale.

INTRODUCTION: Poor treatment adherence reduces treatment effectiveness and increases healthcare costs. The promotion of treatment adherence necessitates valid and reliable tools to assess the effectiveness of adherence promotion strategies. This study was undertaken to develop and evaluate the psychometric properties of the Coronary Artery Disease Treatment Adherence Scale. METHODS: This methodological study was conducted in two phases. In the first phase, a literature review was done and a 62-item scale was developed. In the second phase, different methods were used to assess the psychometric properties of the scale, namely its face validity, content validity, construct validity, internal consistency, and test-retest stability. RESULTS: During face and content validity assessments, the number of items was reduced from 62 to 53. Moreover, in construct validity assessment via exploratory factor analysis, 18 items were deleted because their factor loading values were less than 0.3. The remaining 35 items were loaded on four factors, namely medication adherence, dietary adherence, exercise adherence, and healthy lifestyle adherence. The Cronbach's alpha values of the scale before and after factor analysis were 0.850 and 0.862, respectively. Its test-retest intraclass correlation coefficient was also 0.85. CONCLUSIONS: The Coronary Artery Disease Treatment Adherence Scale is a valid and reliable tool and can be used in different healthcare settings for the assessment of treatment adherence among patients' with coronary artery disease. TRIAL REGISTRATION: Tehran University of Medical Sciences, identifier, 35456.

Family members' beliefs and attitudes towards visiting policy in the intensive care units of Ghana.

AIM: This study aimed to investigate family members' beliefs and attitudes towards the visiting policies of intensive care units (ICUs). DESIGN: It employed a descriptive cross-sectional quantitative design. METHOD: This study recruited four public hospitals in Ghana with a sample of 200 family members. The study was conducted using a self-administered questionnaire. The data were collected and analysed with SPSS version 16. RESULTS: This study revealed that while family members believed in the beneficial effect of adhering to open visiting policies in ICUs, their attitudes were sceptical and restrictive. Most family members preferred the acceptable number of visitors within 24 hr to be two, and according to them, only one person should be allowed to enter at a time. There was a meaningful relationship between the families' beliefs and religion (p = 0.02), educational level (p = 0.03) and family status (p = 0.02). Furthermore, a meaningful relationship was also observed between the families' attitudes and status (p = 0.04) and their level of education (p = 0.05). The studied family members showed concern in this regard and did not want the community style of visiting to be implemented, which could hinder patients' recovery.

Dark and Bright-Two Sides of Family-Centered Care in the NICU: A Qualitative Study.

Nurses in the Neonatal Intensive Care Unit (NICU) have an important role in implementing family-centered care (FCC). The aim of the study was to explore the lived experiences of NICU nurses on implementing FCC. An interpretative phenomenological study was conducted and 11 employed nurses were interviewed from April 2015 to February 2016. The data were analyzed through the Diekelmann, Allen, and Tanner approach. Four main themes of "strain to achieve stability," "bewildered by taking multiple roles," "accepting the family," and "reaching bright horizon" were extracted. This study provided deeper understanding about nurses' perceptions of FCC implementation. In Muslim developing countries, FCC implementation is challenging and nurses are under extra pressure because of a shortage in nursing workforce; however, having positive experiences with family participation and valuing theism beliefs allowed them to support family involvement. Support of nurses to take FCC strategies in the NICU is needed by officials overseeing the health care system.

The effect of provision of information on serum cortisol in patients transferred from the coronary care unit to the general ward: A randomised controlled trial.

BACKGROUND AND AIM: Patients' transfer from coronary care units to general wards is a main source of anxiety for patients. Transfer anxiety is due to either lack of patients' knowledge or inadequacy of transfer-related information to patients. This study aimed to evaluate the effect of provision of information on the serum cortisol level, as an indicator of anxiety, in patients transferred from the coronary care unit to the general ward. METHODS: This pretest-posttest randomised clinical trial was conducted on fifty patients transferred from coronary care units to general wards. Patients were selected using a purposeful sampling method and randomly were allocated to control and intervention groups. After taking blood samples for a baseline cortisol measurement, the patients in the control group received routine verbal transfer-related information. The patients in the intervention group were provided with an educational pamphlet consisting of textual and visual data about patients' transfer, continuity of care and the target general ward. The second and the third blood samples were taken for a cortisol measurement half an hour after informing the patients about the transfer order and half an hour after entrance to the general ward, respectively. Descriptive and inferential statistics via the SPSS software v. 21 was used for data analysis. RESULTS: No statistically significant differences were reported between the groups in terms of demographic characteristics (p > 0.05). The serum levels of cortisol in the intervention group decreased from 40.16 (microgram per decilitre) at the baseline to 36.52 and 34.34 at the second and the third measurement time points, respectively. Conversely, the serum levels of cortisol in the control group increased from 37.48 at the baseline to 40.52 and 41.52 at the second- and the third-time points, respectively. While no statistically significant difference was reported between the groups in the baseline serum level of cortisol, between-group differences were statistically significant at the second- and the third-time points (p < 0.05). CONCLUSION: Provision of transfer-related information can reduce transfer anxiety among patients, that should be transferred from coronary care units to general wards.

Fathers: The Lost Ring in the Chain of Family-Centered Care: A Phenomenological Study in Neonatal Intensive Care Units of Iran.

BACKGROUND: The basic principles of family-centered care in neonatal intensive care unit (NICU) include the unlimited presence of parents and their participation in infant's care. Nurses play a central role in encouraging parental attachment with their infant. PURPOSE: This study was carried out with the aim of understanding NICU nurses' lived experiences of family participation in family-centered care. METHODS: This interpretative phenomenological study was conducted on the basis of Heideggerian philosophy. The data were collected using semistructured interviews and field notes and analyzed through the 7-stage Diekelmann, Allen, and Tanner approach. FINDINGS: Two overarching themes emerged including "mother's centrality in the care chain" and "fathers; the lost ring in the care chain" each of which consisted of 3 and 4 subthemes, respectively. Interviews indicated that in Iran's NICUs, conditions for the presence of parents were appropriate for the mothers and they were encouraged to engage in family-centered care but the fathers' participation was limited due to traditional attitudes, cultural-religious background, and difficulties relating to the hospitals' organizational rules. IMPLICATIONS FOR PRACTICE: Fathers' participation in family-centered care seems to be enhanced through providing facilities, altering the organizational rules, attempting to modify traditional social attitudes, and educating parents and nurses. IMPLICATIONS FOR RESEARCH: Future research should explore the experience of mothers and fathers of infants in NICU in Iran to achieve a comprehensive understanding of their role in family-centered care.