Unexpected changes and associated factors of care burden among caregivers of cancer patients one year after COVID-19 outbreak.

Purpose: The study aimed to evaluate the changes in the care burden and quality of life of caregivers of cancer patients and correlates of care burden during the COVID-19 pandemic. Methods: This cross-sectional study used the census sampling technique with 260 cancer patients and their caregivers during January to March 2020 in northeast Iran. Data collection tools included the Novak and Guest Care Burden Scale, the SF-36 Quality of Life Questionnaire, and the Stress, Anxiety, and Depression Scale (DASS-21). Data were analyzed using descriptive and inferential statistics (independent t-test and multiple linear regression analysis). Results: Baseline scores of care burden and quality of life in caregivers suggested mild to moderate care burden and a reasonable quality of life and moderate levels of stress, anxiety, and depression in patients. The post-outbreak mean scores of care burden and quality of life significantly decreased and increased, respectively (p < .001). Regression analysis showed that 39.3% of the changes in the care burden score during the pandemic could be predicted by studied variables. In exchange for increasing the quality-of-life score and daily care hours, the care burden score decreases and increases. The burden of care in caregivers was also related to the type of cancer. Care burden in the caregivers of patients with breast and neurological malignancies was lower than the caregivers of patients with gastrointestinal cancer (p < .05). Conclusion: Despite the results obtained, supportive and educational interventions are needed to reduce the caregiver burden and improve the quality of life of caregivers and measure its impact on levels of psychological distress in their patients clinically.

The relationship between teamwork, moral sensitivity, and missed nursing care in intensive care unit nurses.

BACKGROUND: Teamwork, moral sensitivity, and missed nursing care are important healthcare challenges for Intensive Care Unit (ICU) nurses and the existence of a relationship between these variables can be useful for developing better care improvement strategies. This study aimed to determine the relationship between teamwork, moral sensitivity, and missed nursing care in ICU nurses. METHODS: This is a descriptive cross-sectional study conducted on a total of 200 ICU nurses working at teaching hospitals affiliated to Semnan and Shahroud Universities of Medical Sciences, Semnan, Iran in 2022. Sampling was conducted using the census method. Data collection was conducted using a demographic checklist, the TeamSTEPPS Team Perception Questionnaire (T-TPQ), Lützén Moral Sensitivity Questionnaire (L-MSQ), and Kalisch and Williams Missed Nursing Care (MISSCARE) Survey. The examination of the relationship between the three variables was conducted using Pearson's correlation coefficient and multiple regression analysis. RESULTS: The mean and standard deviation of teamwork, moral sensitivity, and missed nursing care was 3.47 ± 0.69, 64.19 ± 13.43, and 55.04 ± 34.10, respectively. The variable of teamwork had a significant positive relationship with moral sensitivity (p < .001) and a significant negative relationship with missed nursing care (p < .001). Teamwork was also a positive predictor of moral sensitivity (p < .001) and a negative predictor of missed nursing care (p < .001). The clinical experience of ICU nurses was a positive predictor of teamwork (p = .01) and a negative predictor of missed nursing care (p = .001). The age of ICU nurses was a positive predictor of moral sensitivity (p = .001) and a negative predictor of missed nursing care (p = .008). CONCLUSION: The findings showed that a higher level of teamwork was associated with increased moral sensitivity and reduced missed nursing care among ICU nurses. Therefore, focusing on planning interventions on teamwork improvement can lead ICU nurses to improve moral sensitivity, lower missed nursing care, and promote the quality of patient care.

Comparison of Autar scale and Wells criteria in DVT risk assessment by nurses in patients with lower extremity trauma.

BACKGROUND: Deep vein thrombosis (DVT) is a common and preventable complication in patients with lower extremity trauma. DVT prediction is considered to be necessary. PURPOSE: This study aimed to compare the Autar DVT risk assessment scale with modified Wells criteria in predicting DVT by nurses in patients with lower extremity trauma. METHODS: Patients with lower extremity trauma patients who met the requirements for this study were assessed by both the Autar and Wells tools for DVT risk assessment during the first 24 hours after their admission. Statistical analysis was performed using SPSS 18. RESULTS: There was a significant and direct statistical relationship between the results of risk assessment of these two tools based on Pearson correlation (r= 0.731, P<0.0001). Kappa coefficient between the two was 53%. Sensitivity and specificity of the Autar scale were 100% and 68%, respectively, which revealed a higher degree of sensitivity than that of the Wells criteria. CONCLUSION: Although the results of DVT prediction for the Autar scale and modified Wells criteria were consistent, the Autar DVT risk assessment scale showed higher sensitivity. Therefore, it is recommended that the Autar scale be used to achieve more precise DVT predictions.

Factors affecting triage accuracy in patients with a definitive diagnosis of acute myocardial infarction.

BACKGROUND: Triage is important to identifying patients with patients acute myocardial infartction (AMI) patients' triage accuracy, this research aims to study it in the ED, regarding factors affecting it. METHODS: This retrospective study analyzed data from patients with an ultimate diagnosis of AMI who had been admitted to the ED of Imam Hossein Hospital in Shahroud, Iran, over the last three years and had met the study criteria. Data were collected from the hospital archives. RESULTS: The triage accuracy was 82 % for a total of 400 patients with an ultimate diagnosis of AMI. Men, smokers, and those who had complained about chest pain and sweating at the time of their admission, as well as patients who had used pre-hospital medical services, had higher triage accuracy; indigestion or burning sensation had led to under triage. Based on multiple regression analysis, gender, chest pain, and sweating were found to be significant predictors of triage accuracy. Accordingly, male patients and those with chest pain and sweating had higher triage accuracy. CONCLUSIONS: Despite the increase in triage accuracy rate in this study compared to previous studies, under triage continues to be a problem in the triage of patients with an ultimate diagnosis of AMI.