Cancer nurses' perspective of error disclosure from nurses to patients: A qualitative descriptive study.

PURPOSE: This study aims at exploring Cancer Nurses' Perspective of Error Disclosure. METHODS: This qualitative descriptive study was conducted in 2022, Iran. Data collection methods included observation (121 h), and semi-structured interviews (12 interviews with nurses, and nursing managers). Data analysis was performed using Graneheim and Lundman's approach. This study obtained ethical approval from Ethics Committee of Isfahan University of Medical Sciences. The COREQ checklist was used for study report. RESULTS: Data analysis resulted in three categories and nine subcategories: Error disclosure as a professional necessity (error disclosure as one of the patient's rights and error disclosure for self-and peer-learning), Error disclosure barriers (cancer-related factors, individual deterrents, nurses' intragroup culture, and organizational deterrents) and Error disclosure facilitators (culture of transparency, managerial support for error disclosure and development of error disclosure protocol). CONCLUSION: Creating a culture of error disclosure requires removing barriers, and providing facilitators. By reevaluating their professional performance and responsibilities, nurses may help foster a culture of error disclosure, and managers can do the same by encouraging employees and creating a clinical error disclosure manual. The promotion of an error disclosure to the patient culture may be greatly aided by managers. They facilitate this role by providing practical guidance (based on Iranian culture, needs and conditions of cancer patients and their families) to address nurses' concerns about managers' and the organization's negative responses.

Self-Compassion and Adherence to Treatment in Patients with Cancer.

BACKGROUND: Emotional disorders and depression make cancer patients reluctant about adherence to their treatment. The present study was conducted to determine the relationship between self-compassion and adherence to treatment in cancer patients. MATERIALS AND METHODS: This cross-sectional study was conducted on 214 patients with cancer in 2019. They were inpatients aged over 18 years. Two months had passed since their cancer was diagnosed, and they had undergone a course of chemotherapy. Data were collected using a personal details form, Neff's Self-Compassion Scale and the Modanloo Adherence to Treatment Questionnaire and were then analyzed using the mean, frequency, Pearson's correlation coefficient and linear regression analysis. RESULTS: The mean (SD) total score of self-compassion was 80.07 (15.68), and the mean (SD) total score of adherence to treatment was 134.44 (38.37). Pearson's correlation coefficient showed a direct relationship between the total score of self-compassion and the total score of adherence to treatment (p < 0.05). The linear regression analysis showed that the score of suffering as a common humanity (ß = 0.47, p ≤ 0.001) and the variable of education (ß = 0.27, p ≤ 0.001) were significant predictors of the total score of adherence to treatment (R2 = 0.33). CONCLUSIONS: According to the results, suffering as a common humanity and education were significant predictors of adherence to treatment. Oncology nurses are therefore recommended to get further educated about self-compassion, so that they take this concept more seriously in providing patient care. Nurses should also educate the patients with low levels of education about the consequences of not adhering to their treatment.

The Relationship between Self-Compassion and the Experience of Memorial Symptoms in Patients with Gastrointestinal Cancer.

BACKGROUND: Patients with Gastrointestinal (GI) cancer experience a range of physical and psychological memorial symptoms after developing cancer and beginning to receive medical care. The present study was conducted to investigate the relationship between self-compassion and the experience of memorial symptoms in patients with GI cancer. MATERIALS AND METHODS: This descriptive-correlational study was conducted in July to August 2019. The study sample included 190 patients admitted to Seyed Al-Shohada Hospital, with GI cancer who entered the study by convenience sampling. Data were collected using a patient demographic information form, Neff's Self-Compassion Scale (SCS), and the Memorial Symptoms Assessment Scale (MSAS) and then analyzed by Pearson correlation coefficient in SPSS-20. RESULTS: The mean (SD) total score of self-compassion was 86.67 (16.65) out of 130, and the mean (SD) total score of memorial symptoms was 1.40 (0.64) out of 4 in patients with GI cancer. The most frequently reported physical symptom was lack of energy, with an 86.84% prevalence, and the most frequently reported psychological symptoms included worrying and feeling nervous, with 70.52% prevalence rates. The total score of self-compassion was inversely correlated with the total score of memorial symptoms, the score of psychological symptoms, and the score of physical symptoms. Furthermore, the total score of the memorial symptoms was inversely correlated with the scores of all the self-compassion components (p < 0.001). CONCLUSIONS: Cancer patients had memorial symptoms in both physical and psychological domains. These symptoms decrease with an increase in self-compassion, so compassion-based educational interventions by nurses can be used to reduce these symptoms.

Nurses' Empathy in Different Wards: A Cross-Sectional Study.

BACKGROUND: Empathy is an important component of the nurse-client relationship and nursing care. The current study aimed to compare nurses' level of empathy with patients in critical care units, psychiatric, and emergency wards. MATERIALS AND METHODS: The present cross-sectional study was conducted on 112 nurses selected by convenience sampling in three educational hospitals affiliated with Isfahan University of Medical Sciences, Iran from June to September 2017. Data collection tool was a two-part questionnaire consisting of sociodemographic data (such as age, gender, and work experience) and Jefferson Scale of Empathy (JSE) containing 20 items, scored according to Likert scale from totally agree (7 points) to totally disagree (1 point). In total, the maximum score was 140 and the minimum score was 20. Data were analyzed using SPSS version 16 as well as descriptive and analytical statistical tests (multiple regression). RESULTS: The mean (SD) empathy score of nurses working in critical care units, emergency, and psychiatric wards was 87.51 (6.65), 87.59 (4.90), and 90.71 (7.12), respectively. Regarding the regression models, it was observed that only the work experience was a significant predictor for empathy (ß = 0.19, p = 0.04). This model predicted 3.50% of variances in the nurses' empathy. CONCLUSIONS: Nurses' level of empathy in this study was above average with equal scores in different wards. Therefore, increasing the nurses' level of empathy is essential in interventional studies.

The effect of an empathy role-play program for operating room nursing students.

PURPOSE: The purpose of this research was to investigate the effect of a role-playing training program for empathetic communication with patients on empathy scores of operating room nursing students. METHODS: This clinical trial was carried out on 77 operating room nursing students from the first to the fourth years studied in the School of Nursing and Midwifery at Isfahan University of Medical Sciences in the academic year 2017-2018. The intervention administered on the experimental group included a 12-hour training program with the theme of expressing empathy to patients using a role-playing technique. The Jefferson Scale of Empathy-Health Profession Students' Version was completed before, immediately after, and one month after the intervention by the samples. Comparison analysis was done among three stages. RESULTS: Comparing the total mean empathy scores before intervention in the control group and the experimental one did not reveal a significant difference (P=0.50); however, the total mean empathy scores in the experimental group, immediately after and one month after the intervention, was higher than that in the control group (P<0.001). CONCLUSION: Empathy training through a role-playing technique was effective on improving the empathy scores of operating room nursing students and it also highlighted the fact that empathy could be promoted by education. Making changes in educational curriculum of operating room nursing students was indispensable in order to make them familiar with the concept of empathy in operating room.

Improving Nursing Students' Learning Outcomes in Fundamentals of Nursing Course through Combination of Traditional and e-Learning Methods.

BACKGROUND: Fundamentals of nursing course are prerequisite to providing comprehensive nursing care. Despite development of technology on nursing education, effectiveness of using e-learning methods in fundamentals of nursing course is unclear in clinical skills laboratory for nursing students. The aim of this study was to compare the effect of blended learning (combining e-learning with traditional learning methods) with traditional learning alone on nursing students' scores. MATERIALS AND METHODS: A two-group post-test experimental study was administered from February 2014 to February 2015. Two groups of nursing students who were taking the fundamentals of nursing course in Iran were compared. Sixty nursing students were selected as control group (just traditional learning methods) and experimental group (combining e-learning with traditional learning methods) for two consecutive semesters. Both groups participated in Objective Structured Clinical Examination (OSCE) and were evaluated in the same way using a prepared checklist and questionnaire of satisfaction. Statistical analysis was conducted through SPSS software version 16. RESULTS: Findings of this study reflected that mean of midterm (t = 2.00, p = 0.04) and final score (t = 2.50, p = 0.01) of the intervention group (combining e-learning with traditional learning methods) were significantly higher than the control group (traditional learning methods). The satisfaction of male students in intervention group was higher than in females (t = 2.60, p = 0.01). CONCLUSIONS: Based on the findings, this study suggests that the use of combining traditional learning methods with e-learning methods such as applying educational website and interactive online resources for fundamentals of nursing course instruction can be an effective supplement for improving nursing students' clinical skills.

Barriers to empathy-based care: oncology nurses' perceptions.

Purpose The purpose of this paper is to explore oncology nurses' barriers to empathy-based care perceptions. Design/methodology/approach The authors used a descriptive qualitative method. In total, 18 oncology nurses were selected via purposive sampling. Data were collected through in-depth interviews and qualitative content analysis using an inductive approach. Findings Three main categories emerged from the data analysis: barriers related to nursing including: lacking compassion; disinterest in oncology nursing and self-criticism; psychological distress; barriers related to healthcare: job strain; task-centeredness; no formal training; poor manager support; nurse-patient gender imbalance; and barriers related to cancer care including: difficulty maintaining empathy with cancer patients; and inappropriate cancer patient Practical implications Oncology nurses provided insights into barriers to empathy-based care and the challenges they encountered while caring for cancer patients. Understanding these barriers is the first step to overcoming obstacles and creating an open and caring environment to provide an empathic care culture. Originality/value Given that oncology nurses experience several emotions, positive coping strategies for these distresses should be adopted. Healthcare systems should change cancer-caring culture from task-centered to patient-centered care. Compassion and empathy should become patient care values.

The perceptions of nurses, patients and family members regarding nurses' empathetic behaviours towards patients suffering from cancer: a descriptive qualitative study.

BACKGROUND: Although evidence suggests that empathic behaviour is an essential component in nursing care that affects the psychological distress experienced by cancer patients, it remains a neglected issue in nursing in Iran. METHODS: This study was conducted on 33 participants selected through purposive sampling. Data were collected using in-depth interviews and were then analysed using qualitative content analysis with an inductive approach. FINDINGS: Three categories of data thus emerged, comprising: (a) empathetic attention; (b) empathetic presence; and (c) the facilitators of empathetic behaviour. CONCLUSIONS: The findings can help oncology nurses provide more empathetic care to patients and their family members.

Empathy, Burnout, Demographic Variables and their Relationships in Oncology Nurses.

INTRODUCTION: Development of nurse-patient empathic communication in the oncology ward is of great importance for the patients to relieve their psychological stress, however, nursing care of cancer patients is accompanied with high stress and burnout. The present study aimed to define the level of empathy and its association with burnout and some demographic characteristics of oncology nurses. MATERIALS AND METHODS: This descriptive/correlation study was conducted in a professional cancer treatment center in Isfahan. Through census sampling, 67 oncology nurses were selected. The data collection tools were Jefferson Scale of Nursing Empathy, Maslach Burnout Inventory, and demographic characteristics questionnaire. RESULTS: Mean nurses' empathy and overall burnout scores were 62.28 out of 100 and 38.8 out of 100, respectively. Score of empathy showed an inverse correlation with overall burnout score (r = -0.189, P = 0.04), depersonalization (r = -0.218, P = 0.02), and personal accomplishment (r = -0.265, P = 0.01). Multiple regression test was used to detect which dimension of burnout was a better predictor for the reduction of empathy score. Results showed that the best predictors were lack of personal accomplishment (P = 0.02), depersonalization (P = 0.04), and emotional exhaustion (P = 0.14), respectively. The most influential demographic factor on empathy was work experience (r = 0.304, P = 0.004). One-way analysis of variance showed that official staff had a higher empathy score (f = 2.39, P = 0.045) and their burnout was lower (f = 2.56, P = 0.04). CONCLUSIONS: Results showed a negative relationship between empathy and burnout in oncology nurses. Therefore, nursing support from managers to reduce burnout increases empathic behavior of nurses.

Dying with dignity: a concept analysis.

AIMS AND OBJECTIVES: This article is a report of an analysis of the concept of dying with dignity. BACKGROUND: Dignity is an important component of providing care for dying patients and their families. Nevertheless, given that this concept is poorly defined, concept analysis is one of the best ways to define and clarify the concept of death with dignity with the aim to enhance its application in clinical practice, research and education. DESIGN: A search of multiple nursing and social sciences databases was undertaken, including Academic Search Complete, Science Direct, ProQuest, Scopus, Medline, PubMed, EBSCO, Ovid, Noormage, Cinahl, Magiran, PsycINFO and SID. METHODS: After an extensive review of the literature from 1998-2014, about 14 related articles were included in the study. Based on these articles, the applications, attributes and experimental results of and references to death with dignity were recorded. RESULTS: Based on this analysis, the most important attributes of this concept included respect for privacy, respect, spiritual peace and hope. The antecedents of this concept included consideration of moral values during caregiving, preservation of human dignity as a patient right and professional ethics, and belief in the dignity of self and others, consideration of culture in providing end-of-life care. The consequences of this concept included a sense of peace in the patient and their family, peaceful death and provision of patient privacy and comfort. CONCLUSION: The concept of patient dignity has been referred to in many contexts. However, considering the dignity of dying patients commensurate with their culture is the most important component of care provided by nurses to facilitate a peaceful death. RELEVANCE TO CLINICAL PRACTICE: Respecting the dignity of the patient results in the reduction of her/his suffering and prepares her/him for a comfortable death.

Comparison of the effects of two teaching methods on the nursing students' performance in measurement of blood pressure.

BACKGROUND: New teaching methods are essential in the promotion of competence in nursing students. Measuring blood pressure, which is one of the most essential skills, is the foundation of nursing care and clinical decision-making, and students should be trained to master this skill. This study aimed to determine the impact of two teaching methods on students' performance in blood pressure measurements. MATERIALS AND METHODS: In this semi-experimental study, 36 first-term nursing students from Isfahan University of Medical Sciences, Iran, were divided into six groups of six people each. The type of training for each group was determined by random draw. Blood pressure measurement training was given to three groups on a simulator and to the other three groups on human samples. Pre- and post-test evaluation of knowledge of the methods of measuring blood pressure was conducted using a researcher-made checklist and by observation of the students' actions. The knowledge and skill scores were compared using paired and independent t-tests. RESULTS: The mean performance scores of students in simulator (19.14 ± 1.60) and human (19.64 ± 1.08) groups were not significantly different. In both methods, there was no significant difference between systolic and diastolic blood pressures measured by students and by teachers (standard). Mean knowledge scores of both groups increased significantly after training compared to before training. CONCLUSIONS: According to the results of the study, the two training methods (on human subjects and simulator) provide the students with the necessary ability to measure the systolic and diastolic blood pressures correctly. Therefore, to enrich the educational program of nursing students, using simulators is recommended as an effective teaching strategy to facilitate learning and for the development of students' knowledge.

The relationship between mother's parenting style and social adaptability of adolescent girls in Isfahan.

BACKGROUND: Social adaptability is an important requirement of the social life of adolescents, which can be affected by their mother's parenting style (PS). The purpose of this study is to compare the social adaptability in four parenting styles (authoritative, authoritarian, permissive and neglectful) through which mothers interact with their adolescent girls. MATERIALS AND METHODS: This survey is a cross-sectional and analytical study on 737 adolescents that study in the all girls junior high schools in Isfahan. Data collection was done with a questionnaire. The questionnaires were completed by the adolescents. After data collection, the parenting styles were determined and the social adaptability of the four groups was compared. FINDINGS: The mean social adaptability in adolescents who their mothers have the authoritative parenting style was 49.6 ± 6.1, in the permissive parenting style 50.1 ± 5.8, the authoritarian parenting style 44.2 ± 6.5 and in the neglectful parenting style was 42.2 ± 7.5. The social adaptability of the four groups was significantly different (p < 0.001). CONCLUSIONS: This study shows that the permissive parenting style and after that authoritative parenting style were followed by higher social adaptability in adolescent girls.

A comparison of performing tube feeding with the standard procedures at selected educational and treatment centers of Isfahan University of Medical Sciences, Iran.

BACKGROUND: Tube feeding is used for patients, who are not able to eat orally but their digestive system can digest food. This method is safe and economical for patients, maintains the functions of the digestive system and reduces the risk of infection and sepsis. However, incorrect administration of this method of feeding results in problems such as aspiration pneumonia, infection, diarrhea, NG tube obstruction, and etcetera. If tube feeding is performed according to its standard procedure, it can have a major role in reducing complications, providing adaptability and the desired lifestyle, reducing the duration of hospitalization, and reducing the relevant costs. MATERIALS AND METHODS: This research is a descriptive-analytic cross-sectional study on 37 nurses who worked in the general surgery and neurology wards and fed patients suffering from gastrostomy. A valid and reliable checklist was used for data collection. To analyze the data, the descriptive statistical method (frequency and mean) and inferential method (paired t-test, Spearman Correlation Coefficient and variance Analysis with repetition of observations) were used. FINDINGS: The findings showed that the mean score of measures in all the stages (before, during, and after administration) was significantly lower than the standard (p < 0.001). There was a significant reverse relation between the score of measures in all the three stages (before, during, and after administration), and work record and work experience in the ward. Furthermore, the mean score of measures in all the three stages was significantly different between female and male subjects (p value = 0.031), in that the mean score of women was higher than that of men. There was also a significant difference between the mean score of measures in all the three stages, and the employment status of samples; so that the mean score of provisionally employed personnel was higher than that of permanently employed personnel. CONCLUSIONS: The findings of the research showed that the mean score of measures before, during, and after administration of feeding through gastrostomy was lower than the standard (p < 0.001). Therefore, a gastroenterology advisor, a clinical nurse and a nutrition specialist should train the patients and their families, and the personnel about preparation and storage of food, method of administering food, protection of tube entrance and NG tube by considering the problems and complications arising from this type of feeding. Based on the findings of the present research, it is necessary to retrain the nurses and especially male nurses, nurses with more work experience, and permanently employed nurses in terms of correct performance of clinical nursing skills including this type of feeding.

Effect of heat therapy on pain severity in primigravida women.

BACKGROUND: Labor pain relief has been considered since many years ago. Heat as a non pharmacological method of pain relief helps reducing the pain intensity and increases the pain consistency. The aim of the study was to determine the effect of the heat therapy on the labor pain in primigravida women. METHODS: In this clinical trial study, 64 low risk nulliparous women were randomly divided into two heat therapy and routine care groups. In addition to the routine cares, warm bag were used for the heat therapy group for the low back, from cervix dilatation of 3-4 cm to the end of the labor's first stage and for perinea at the second stage. The pain intensity was determined by McGill pain questionnaire in dilatation of 3-4, 6-7 and 9-10 cm and at the end of the labor's second stage. Data was analyzed using t-test and chi square test by using SPSS 11. RESULTS: Results of research showed a significant decrease in the pain intensity in the heat therapy group at the first stage and the second stage of labor and comparing two groups showed significant difference(p < 0.001). CONCLUSIONS: According to the results of this study, it seems that heat therapy in addition to its beneficial effects, causes the mother to sense the labor pain in a lower pain severity.