How mothers of a child with type 1 diabetes cope with the burden of care: a qualitative study.

INTRODUCTION: Caregiver burden is a complex construct that depends heavily on the context and culture of the community in which care takes place. This study aimed to explore the lived experience of being mothers of a child with type 1 diabetes aged 6 to 18 years. MATERIALS AND METHODS: We used a qualitative methodology utilizing conventional content analysis. We conducted 24 interviews with 20 mothers who had a child with type 1 diabetes aged 6 to 17 years. RESULTS: The mean age of mothers and children were 36.3 and 12.3 years, respectively. The mean of years with the disease was 4.3 years. Thirteen children were girls. The essential theme was coping with the burden of care through personalized coping and active acquisition of social support. The main theme consists of four sub-themes including Crisis in the family and burden of care, Losing the family equilibrium, Personalized coping strategies, and Active acquisition of social support. Mothers used personalized strategies and every support they could get to reach their aim. CONCLUSIONS: Families of children with type 1 diabetes need extensive and personalized care plans.

Cardiac rehabilitation using the Family-Centered Empowerment Model versus home-based cardiac rehabilitation in patients with myocardial infarction: a randomised controlled trial.

OBJECTIVE: To determine if a hybrid cardiac rehabilitation (CR) programme using the Family-Centered Empowerment Model (FCEM) as compared with standard CR will improve patient quality of life, perceived stress and state anxiety of patients with myocardial infarction (MI). METHODS: We conducted a randomised controlled trial in which patients received either standard home CR or CR using the FCEM strategy. Patient empowerment was measured with FCEM questionnaires preintervention and postintervention for a total of 9 assessments. Quality of life, perceived stress, and state and trait anxiety were assessed using the 36-Item Short Form Health Survey (SF-36), the 14-item Perceived Stress, and the 20-item State and 20-item Trait Anxiety questionnaires, respectively. RESULTS: 70 patients were randomised. Baseline characteristics were similar. Ejection fraction was significantly higher in the intervention group at measurements 2 (p=0.01) and 3 (p=0.001). Exercise tolerance measured as walking distance was significantly improved in the intervention group throughout the study. The quality of life results in the FCEM group showed significant improvement both within the group over time (p<0.0001) and when compared with control (p<0.0001). Similarly, the perceived stress and state anxiety results showed significant improvement both within the FCEM group over time (p<0.0001) and when compared with control (p<0.0001). No significant difference was found either within or between groups for trait anxiety. CONCLUSIONS: The family-centred empowerment model may be an effective hybrid cardiac rehabilitation method for improving the physical and mental health of patients post-MI; however, further study is needed to validate these findings. Clinical Trials.gov identifier NCT02402582. TRIAL REGISTRATION NUMBER: NCT02402582.

Work or retirement: Exploration of the experiences of Iranian retired nurses.

BACKGROUND: According to recent studies, the level of international interest in bridge employment, as return to work after retirement, has been growing. OBJECTIVE: This study aimed to explore the experiences of retired nurses in Iran with regard to making a decision about whether or not to seek bridge employment. METHODS: A qualitative study using a content analysis approach was conducted in an urban area of Iran. Semi-structured interviews were held with 20 Iranian male and female retired nurses chosen using purposive sampling. RESULTS: During the data analysis, two main themes were identified as the participants' thoughts supporting the decision of seeking bridge employment. The first theme was entitled motivational factors with categories of ``serving the society,'' ``maintaining and promoting health,'' ``tendency toward flexible work,'' and ``maintaining the role and activity.'' The second theme was entitled forcing factors with categories of ``ardent desire to work (pluralistic ignorance)'' and ``financial need.' ' CONCLUSIONS: While some Iranian retired nurses were not motivated to seek work for health reasons, most preferred to return to work after retirement. They were motivated to seek bridge employment out of a desire to serve the society, to promote their own physical and mental health, to continue to use their expertise and maintain the worker role, and because of financial needs and perceived societal expectations. Nurses seeking employment later in life tended to look for job flexibility and less stressful work. Therefore, the management of bridge employment by healthcare system authorities can be useful in making use of the invaluable experiences of retired nurses.

Working experiences of Iranian retired nurses: a content analysis study.

Understanding the experiences of retired nurses can be useful in increasing self-confidence, motivation to work and work enthusiasm among nurses. The purpose of this study was to explore the work experiences of Iranian retired nurses. A qualitative design was conducted using a content analysis approach. Purposive sampling was used to choose the study participants. Semi-structured interviews were held to collect the perspectives of 20 retired nurses (10 female and 10 male). Two main themes emerged in the data analysis: 'work problems and unpleasant experiences in a sense' with subthemes 'exhausting work', 'insufficient salary', 'inappropriate relation' and 'unsuitable social position'; and 'job satisfaction and pleasant experiences in a sense' with subthemes 'divine satisfaction and religious belief', 'satisfaction of patients and their companions' and 'love of nursing profession and relaxation experience'. The findings indicate the challenges that nurses face after retirement. These experiences will help nurse managers to adopt appropriate measures to support nurses after retirement.

A concept analysis of nursing based on islamic sources: seeking remedy.

PURPOSE: This study describes the concept of nursing through an analysis of Islamic sources. METHOD: The concept analysis method of Walker and Avant was used. FINDINGS: Nursing is a process of seeking remedy. Nursing includes a strong educative component to help the human to fulfill his/her human capacities. CONCLUSION: The human is viewed as having individual responsibility for self-care and development of human capacities in accord with human nature. When problems and barriers arise, the role of the nurse is to seek remedy. IMPLICATION FOR NURSING PRACTICE: The role of the nurse is to assist the human to fulfill his/her human potential. The person is viewed from a holistic lens and spiritual development is more important than physical care.

The effect of programmed distraction on the pain caused by venipuncture among adolescents on hemodialysis.

Pain is described as the fifth vital sign, and inadequate pain management is linked to numerous immediate and long-term negative outcomes. Venipuncture is one of the most painful medical procedures and one of the most frequently performed ones, and children and adolescents on hemodialysis are anxious about repeated venipunctures. Distraction is one of the most effective ways to relieve pain, and nurses are responsible for pain control. The purpose of this quasi-experimental study was to test the effect of programmed distraction on the pain caused by venipuncture among adolescents on hemodialysis. All of the pediatric hemodialysis centers in Tehran (three centers) were assigned to case group (one center with 21 patients) and control groups (two centers with a total of 21 patients) randomly. The Wong-Baker face pain scale was used to assess pain caused by venipuncture. Assessing of pain was done in 12 sessions in both case and control groups. Three first sessions were held without intervention (pretest) and the next nine sessions were held with distraction intervention (posttest). To cause distraction, the adolescents were asked to look at two similar pictures and tell the number of differences between them during venipuncture. Results showed that case and control groups matched in demographic variables and pain intensity. After distraction, pain intensity during venipuncture significantly decreased (p=.003); but this decrease began from the sixth session; at the five first sessions, pain intensity had not changed. This study shows the effect of distraction with a simple, inexpensive, and quick way for decreasing the pain caused by venipuncture. We recommend that the reasons of the intervention's delay in effect be assessed in future studies.