Ethical care in patients with Covid-19: A grounded theory.

BACKGROUND: Providing ethical care during the Covid-19 pandemic has become an inevitable challenge due to facing limitations such as fear of contracting the disease, lack of equipment and emergence of ethical conflicts; So that there is no clear picture of how to provide ethical care for patients with Covid-19. The study aimed to explain the ethical care process of patients with Covid-19. METHOD: This qualitative study was conducted in 2021-2023 using the grounded theory research method. Data were collected through conducting 21 semi-structured interviews with 19 participants (16 staff nurses, and 3 supervisor). Sampling was started purposively and continued theoretically. Data analysis was performed by the method proposed by Strauss and Corbin. RESULTS: The results indicated that starting the process with a problem means a challenge of how to do the right or correct thing for the patient. This process is driven by the feeling of duty and inner commitment to do the right thing. The sense of responsibility or commitment is directly related to the degree of faith in a person. The actions that a nurse takes to fulfill her sense of commitment is called the faith-based behavior process. The process of behavior based on faith is done through two steps. Attaining the satisfaction of God and as well as the satisfaction of one's conscience is the nurses' ultimate goal of doing the right work and being committed. CONCLUSION: The process of ethical care of patients with Covid-19 can be different according to the degree of faith and environmental conditions. A higher level of faith and more helpful environmental conditions, the greater the nurse's inner commitments in the first and second steps, as a result, the satisfaction of God and conscience will be greater.

Effect of Comprehensive Pain Management Training Program on Awareness and Attitude of ICU Nurses.

BACKGROUND: Pain is one of the main complaints of many patients in intensive care units. However, most nurses and physicians are unable to properly monitor and relieve pain in these patients. Factors such as patients' inability to describe their pain and insufficient knowledge of nurses and physicians have made pain management difficult. Given that the knowledge and attitude of nurses play an important role in the effective implementation of the pain management process, this study aimed to investigate the effect of comprehensive pain management training program on the awareness and attitude of intensive care unit nurses. METHODS: This quasi-experimental single-group study was conducted in two phases (pre and post-intervention) to investigate the awareness and attitude of all nurses employed in the intensive care unit of Tehran Modarres Hospital, based on the determined inclusion and exclusion criteria. In the pre-intervention phase, the awareness and attitudes of the nurses were assessed using a questionnaire. After conducting the pain management training course, an executive program and algorithm were implemented for pain management in ICUs. Then, the nurses' awareness and attitude toward pain management were assessed again. Finally, changes in the scores of the nurses' awareness and attitude were analyzed by SPSS V. 22 software in two phases before and after applying the interventions using the Wilcoxon test. The relationship between some demographic variables and the level of awareness and attitude of nurses was also investigated using the Kruskal-Wallis and Mann-Whitney tests. RESULTS: The results of this study indicated that the mean score of the nurses' awareness was significantly different in pre- and post-intervention phases (P < 0.05). Despite an increase in the post-intervention mean score of the nurses' attitude (71.03), no statistically significant change was observed. Additionally, among the demographic variables, there was only a significant relationship between the nurses' job experience in ICUs and their attitudes. CONCLUSIONS: Based on the results of this study, teaching and implementing a comprehensive program for pain management can play an effective role in promoting the nurses' awareness. Therefore, it is proposed to use pain management models to improve the nurses' knowledge and attitude toward pain management in ICU patients.

The relationship between organizational commitment and nursing care behavior.

INTRODUCTION: Nursing care encompasses physical, emotional, mental and social needs, in order to improve a patient's health and wellbeing. Caring is the central core and the essence of nursing. The important issue of care is access to proper care and increasing patients' satisfaction. Job performance of nurses is affected by many factors including organizational commitment. This study aimed to determine the relationship between organizational commitment and nurses caring behavior. METHODS: In this cross-sectional study, 322 nurses from selected Hospitals of Shahid Beheshti University of Medical Sciences in Tehran were randomly selected and enrolled in the study in 2015. The self-reported data by nurses were collected through demographic characteristics questionnaire, Meyer & Allen organizational commitment model and Caring Behavior Inventory (CBI). Data were analyzed with SPSS statistical software version 20, using t-test and ANOVA. FINDINGS: The majority of nurses (63%) were female. The mean score and standard deviation of organizational commitment and caring behavior of nurses were 74.12±9.61 and 203.1±22.46, respectively. The results showed a significantly positive correlation between organizational commitment and caring behavior (p=0.001). CONCLUSION: In this study the caring behavior of nurses with higher organizational commitment were significantly better than the others. Managers and nurse leaders should pay more attention to improve organizational commitment of nurses, in order to improve nurses' performance.

Health locus of control and self-care behaviors in diabetic foot patients.

BACKGROUND: Diabetic foot affects more than 25% of diabetic patients and finally up to 20% of cases result in amputation. The most important factor resulting in severe complications or even death is lack of self-care. Health locus of control has been introduced as one of health factors and predicting factors of self-care. This research was performed for analyzing the correlation between self-care behaviors and health locus of control in diabetic foot patients. METHODS: In this descriptive study, 120 patients with diabetic foot were chosen using convenience sampling from endocrine clinic and wards of endocrine and vascular surgery of Teleqani Hospital of Shahid Beheshti Medical University. The data were gathered by demographic, self-care behavior, and health locus of control questionnaires. The t-test, analysis of variance (ANOVA) and spearman coefficient were used to analyze the data. RESULTS: RESULTS of this research showed that there is a direct and significant relation between selfcare behaviors and internal health locus of control (p<0.001), and also in contrast with chance health locus of control (p<0.001). CONCLUSION: We have to consider these factors' role in nursing interventions and patient-care education programs and plans. Probably, interventions and programs that will lead to the strengthening of internal health locus of control improve and strengthen patients' self-care behaviors and their involvement in treatment.

The perceived information in obtained from the informed consent in Iranian patients with cancer in clinical studies.

OBJECTIVE: One of the basic issues in clinical studies is to receive the informed consent; that is to say, all the activities applied in patient's involvement in the information, decision-making, ability and volunteering in diagnosis, cure and care. In as much as most cancer patients require information about their individual needs, the present study is conducted to determine the perceived information from the informed consent of clinical studies in cancer patients. METHODS: This is a descriptive study. Fifty cancer patients hospitalized for participating in the clinical study was chosen according to the convenience sampling. Tools used in this research included the questionnaire (individual and social features) and the check list about patient's right and cancer patient's information before and after receiving informed consent in clinical studies (10 items on a Likert rating scale). To validate the study, content and formal validation was used. Data in this research were analyzed using descriptive statistics (frequency, mean and standard deviation) and the software of SPSS 16. RESULT: In general, the mean of the scores obtained from cancer patients' perceived information before completing the informed consent of the clinical studies was 14 ± 3.5 and after consent of the clinical studies was 16 ± 2.4. The cancer patients' perceived information before and after consent of the clinical studies was weak. CONCLUSIONS: Based on the findings of the present study, the rate of the information the cancer patients received, before completing the informed consent form, was low, but after completing the informed consent form this rate was again low. Therefore, conducting similar and wider studies is recommended to unveil the factors affecting perceiving information and how to promote the quality of the informed consent in other hospitals in Iran.

Humanistic approach to nursing education: lived experiences of Iranian nursing students.

The nurse teachers tried to have a complete understanding of the educational contents, to transfer knowledge to nursing students better, and to facilitate the process of education. The purpose of this study was to explore the lived experiences of Iranian nursing students regarding the characteristics of academic nurse teachers. In this hermeneutic phenomenological study, data were collected via in-depth, semi-structured interviews with 12 Iranian nursing students and the audio-taped and transcribed interviews analyzed according to Van Manen´s method. The main theme emerged during data analysis, was "humanistic approach to nursing education". The theme was extracted from 2 sub-themes including 'ethical necessities' and 'effective interaction'. The findings present greater understanding of humanistic approach to nursing education.

Liver transplant recipients quality of life instrument: development and psychometric testing.

BACKGROUND: Liver transplantation is a life-saving intervention for many patients with end-stage liver disease. In the past, evaluation of successful liver transplantation was based on patients' survival rate. However, in recent years this evaluation has been based on patients' quality of life. Various instruments have been developed to evaluate patients' quality of life. Nonetheless, scholars still believe that it is crucial to develop a standardized and disease specific instrument for evaluating the quality of life in liver transplant recipients. OBJECTIVES: The aim of this paper was to describe the development and psychometric testing process of a quality of life instrument specific to liver transplant recipients. MATERIALS AND METHODS: Initial items of this instrument were extracted from a conventional content analysis study, and then were completed with findings of related international literature. The face validity was assessed by interviewing with four liver transplant recipients, and the content validity was evaluated by eleven experts in the field of transplantation. The construct validity was achieved by involving 250 liver transplant recipients through exploratory factor analysis method, and reliability was calculated by Cronbach's alpha. RESULTS: Three main factors with 40 items were extracted from the exploratory factor analysis: Health Satisfaction, Concerns, and Complications. Reliability of the instrument was confirmed (alpha = 0.922). CONCLUSIONS: Given the special considerations regarding liver transplant recipients, this questionnaire is more accurate in evaluating the success of liver transplantation.