Using Kern model to design, implement, and evaluate an infection control program for improving knowledge and performance among undergraduate nursing students: a mixed methods study.

BACKGROUND: Nurses and Nursing students are the front line of care in managing the care of infectious patients then they have more contact with patients than other students. Therefore, the aim of this study was designing, implementing and evaluating the infection control program among undergraduate nursing students using a mixed study. METHOD: The mixed method approach with sequential exploratory (qualitative-quantitative) method was used. Kern model was applied in six steps included: 1-Needs assessment 2- Initial design 3- Goals and specific objectives 4- Educational strategy 5- Program implementation 6- Program evaluation. Thirty nursing students and 3 nursing faculty members were selected through purposive sampling for focus group in need assessment. Single-group semi-experimental study with a pre-test and post-test design was used in partnership with all eighth semester nursing students in program evaluation. RESULT: Data analysis of focus group obtained two categories including: Need to improve knowledge in infection control and need to improve performance in infection control. With need assessment and literature review, educational content developed according to nursing students learning needs. Then, 3 faculty members prepared a course plan including goals, specific objectives, educational strategy for student assignments. One-way analysis of variance to compare the average score of knowledge, performance and its categories before, 2 weeks after the intervention and 2 months after the intervention shows a statistically significant difference (p > 0.001). Pearson's correlation coefficient shows that there is a negative linear relationship between work experience and knowledge score 2 weeks after and 2 months after the intervention (p < 0.05). CONCLUSION: According to our results, it is recommended the need to revise the curriculum for the integration of the infection control program in the undergraduate nursing education. Of course, it is necessary to conduct more studies in the field by dividing this program into internship and field internship.

The effect of the supportive care program based on Bandura's self-efficacy on stress and participation of the mothers of the neonates admitted to neonatal intensive care unit.

BACKGROUND: Maternal stress can affect both the neonate and the mother and deter them from participating in the care of preterm neonates. The purpose of the study was to determine the effect of the supportive care program (SCP) based on Bandura's self-efficacy on stress and participation of mothers of neonates admitted to the neonatal intensive care unit. MATERIALS AND METHODS: This quasi-experimental study was performed in 2020 on 90 mothers of premature infants admitted to the NICU of Hajar Hospital in Shahrekord, Iran. First, the control group and then the experimental group were selected and a training package based on Bandura's self-efficacy theory was implemented for the intervention group. The research instruments in this study were the Heidari mothers stress questionnaire and Melnyk mother's participation questionnaire which was completed before and after the intervention. The analysis was performed based on SPSS (version 24) and Chi-square, independent t-test, and paired tests. RESULTS: The results indicated that the demographic variables of mothers and neonatal characteristics of the two groups did not have significant differences except for the history of abortion and infertility in mothers and the weight of preterm neonates (P < 0.05). Mothers in the experimental group had less stress (t (88) = 29.50, P < 0.001) and more participation than the control group (t (88) = -27.18, P < 0.001) after the intervention. CONCLUSIONS: Using self-efficacy-based SCP for maternal education besides routine education could positively affect the reduction of stress and the increase of maternal participation in caring for preterm neonates during hospitalization. Thus, using this supportive program is suggested for mothers with preterm neonates admitted to NICU.

Life story of Iranian parents of a child with phenylketonuria: a qualitative study.

Parents of a child with phenylketonuria (PKU) face many challenges in childcare. It is crucial for health care workers to understand the situation of parents of a child with PKU and their needs. The purpose of this study was to explore the life story of parents with a child with PKU. This qualitative study has been done with a conventional content analysis approach. Twenty-four parents were selected purposefully. A semi-structured interview was conducted. Data analysis identified three main themes, which included parental reactions, consequences of a child with PKU in parents, and parents' needs. Parents of children with PKU can be considered people at risk for mental health because of their feelings of isolation and their lonely struggle to manage the disease and its effects on their child. This study shows that mothers need more support due to the misconceptions in and attitudes of their social environment. Therefore, it is necessary to understand this group, their needs and lives, and provide further support and promote empathy in the health system for the parents.

Evaluation of parental stress in neonatal intensive care unit in Iran: a national study.

BACKGROUND: More attention is paid to the survival and treatment of the sick infant in the neonatal intensive care unit (NICU) and parental stress is not considered. The purpose of this study was to determine samples of the level of parental stress in the NICU. METHOD: This study is a descriptive-analytical study in which Parental Stress and General Health were used in an analytical national survey in Iran. The research sample consists of 2456 parents of infants admitted to NICU. The sampling method was multi-stage random. We used 11- item parental stress questionnaire and 28-item general health questionnaire for the data collection. RESULT: Baloch ethnicity with an average of 11.52 had the highest level of stress. The mean stress score of mothers was higher than fathers. The mean score of all dimensions of physical symptoms, anxiety, social functioning, depression, and total mental health score in mothers was higher than fathers. There was a statistically significant difference in the length of hospitalization in terms of different levels of parental stress scores (p < 0.002). Lack of decisive response to parents was one of the most stressful issues (8.1%). CONCLUSION: Our result shows mothers' stress was higher than fathers. So that health policymakers should pay attention to stress risk factors to provide appropriate interventions according stress risk factors Future studies should design appropriate interventions to reduce parental stress, especially in high-risk mothers.

The Impact of Psychiatric Care Program on Empathy of Neonatal Intensive Care Nurses in Iran.

Background: The main role of nurses is not only to inform about the disease and treatment of the patient but also to establish an effective therapeutic relationship to address concerns and provide empathy, comfort, and support. This issue is very prominent in neonatal intensive care units (NICUs) and doubles the importance of empathetic communication between nurses and parents and promoting empathy skills in nurses working in neonatal intensive care units. Aim: This study aimed to evaluate the effect of a support program on the empathy of neonatal intensive care nurses across the Iran. Methods: This study was conducted in 2021 as a semi-experimental intervention in a group of 166 nurses working in the neonatal department all over Iran who met the inclusion criteria. Jefferson's empathy questionnaire was completed electronically by the participants before and after the online education program start. Data were analyzed using SPSS software (V 24.0). Results: The empathy score of nurses was 60.31 ± 5.76 before and 66.47 ±6.60 after the intervention. The empathy scores of nurses after the intervention increased statistically significantly. Conclusion: Nurses can communicate empathically with parents by training their verbal and nonverbal communication skills and gaining a common understanding of the feelings of parents of premature infants.

Design of a Palliative Care Program for Nursing Students in the Neonatal Intensive Care Unit: A Mixed-Method Study.

This study introduces an innovative design for a palliative care program by nursing students in an internship in a neonatal intensive care unit. An embedded mixed-method approach simultaneously collected quantitative and qualitative data. Themes identified were supporting and encouraging palliative care, changing the nursing culture, and promoting quality of care. Teaching palliative care during this internship rotation helped promote quality care by the students, with positive results for infants and their families, and empowerment of the students through increased knowledge and awareness of human needs for high-quality nursing care.

Perceived factors to providing palliative care for patients with cancer - a qualitative systematic review.

Palliative care (PC) is one of the necessary cares given throughout a patient's experience with cancer. The aim of this study was to identify the perceived factors to providing PC for patients with cancer. Our study was a systematic review of qualitative literature. To this end, electronic databases, including CINAHL, PubMed, PsycINFO, Ovid, and Web of Science as well as Persian databases were searched and qualitative studies on the role of PC in patients with cancer published between Jan 2008 and Dec 2017 were selected. Generally, 12 studies were reviewed. A thematic synthesis approach was used to analyze the data. Exploring the selected articles, the findings on the perceived factors to providing PC for patients with cancer were categorized into three themes, including organizational factors, ethical factors, and psychological factors. This qualitative systematic review expands our knowledge about factors influencing the provision of PC for patients with cancer. It is necessary for health system managers and caregivers to pay attention to all aforesaid factors in order to improve PC for cancer patients.

Decomposing socioeconomic inequality in poor mental health among Iranian adult population: results from the PERSIAN cohort study.

BACKGROUND: Socioeconomic inequality in mental health in Iran is poorly understood. This study aimed to assess socioeconomic inequality in poor mental health among Iranian adults. METHODS: The study used the baseline data of PERSIAN cohort study including 131,813 participants from 17 geographically distinct areas of Iran. The Erreygers Concentration index (E) was used to quantify the socioeconomic inequalities in poor mental health. Moreover, we decomposed the E to identify factors contributing to the observed socioeconomic inequality in poor mental health in Iran. RESULTS: The estimated E for poor mental health was - 0.012 (95% CI: - 0.0144, - 0.0089), indicating slightly higher concentration of mental health problem among socioeconomically disadvantaged adults in Iran. Socioeconomic inequality in poor mental health was mainly explained by gender (19.93%) and age (12.70%). Region, SES itself, and physical activity were other important factors that contributed to the concentration of poor mental health among adults with low socioeconomic status. CONCLUSION: There exists nearly equitable distribution in poor mental health among Iranian adults, but with important variations by gender, SES, and geography. These results suggested that interventional programs in Iran should focus on should focus more on socioeconomically disadvantaged people as a whole, with particular attention to the needs of women and those living in more socially disadvantaged regions.

Nurses' Perception of Family-Centered Care in Neonatal Intensive Care Units.

Family-centered care (FCC) is one of the important elements of care in neonatal intensive care units (NICUs). The aim of this study was to understand the nurses' perception of FCC in NICUs. This qualitative study was performed using conventional content analysis. Participants in this study included 18 nurses who were selected by a purposeful method. Semistructured, in-depth and face-to-face interviews were conducted with the participants. All interviews were written down, reviewed, and analyzed. Two categories were identified after the data analysis: (1) prerequisite for providing FCC and (2) parents' participation. Prerequisite for providing FCC consisted of two subcategories namely suitable facilities and adequate personnel. Parents' participation included subcategories of parents: neonate's attachment and parents' training. Nurses' perception of FCC in NICUs can facilitate an appropriate condition for the participation of family members in the care of neonates.

Erratum: Nurses' Perception of Family-Centered Care in Neonatal Intensive Care Units.

[This corrects the article DOI: 10.1055/s-0039-1695060.].

Iranian Nurses' Challenges in Caring for Older Adults: A Content Analysis Study.

The current study describes Iranian nurses' challenges in caring for older adults. Participants included 22 nurses who were selected by purposeful method and underwent semi-structured, face-to-face interviews. The interviews were reviewed, and three categories and seven subcategories were noted. The category older adults-nurse interaction challenges included: specific characteristics of older adults and inappropriate interaction between nurses and older adults. The category structural problems included: shortage of nurses, inappropriateness of ward environment, and service problems. The category educational gap included: lack of training on principles of older adult ethics in nursing curriculum and shortage of personnel training on manner of relationship with older adults. The current study is the first qualitative study regarding nurses' challenges in caring for older adults in Iran, and the results reveal aspects of nurses' understanding about the said challenges in this country. There is a need for culture-based caring programs that are responsive to older adults' needs. [Res Gerontol Nurs. 2017; 10(3):115-120.].

Stress Management among Parents of Neonates Hospitalized in NICU: A Qualitative Study.

Introduction: Infant hospitalization is stressful event for parent in NICU. Parents think that they have lost control because of unfamiliar environment. Therefore, stress management is very important in this period. The family as the main factor of strength and protection for infant is required as the bases of standard care in NICU. Therefore the aim of this study was to investigate stress management in Iranian NICU Parents. Methods: Using qualitative content analysis approach helped to collect and analysis data for open coding, classification, and theme abstraction. Twenty one parents with hospitalized neonates, physicians and nurses in the city of Isfahan were purposely recruited and selected for in-depth interviews. Results: The analyzed content revealed unique stress management approaches among the parents. The main themes were: 1) spirituality, 2) seeking information, 3) Seeking hope, 4) maintaining calm, 5) attachment to infant, and 6) communicating with the medical team Conclusion: Findings of this study highlights the importance of medical team's attention to stressed parents who are trying to make adjustment or adapt to the hospitalization of their infant. A revised management approach to address the emotional needs of parents of neonates in Iran seems essential for improving communication with physicians and nurses.

Cancer patients' effort to return to normal life: a hermeneutic study.

BACKGROUND: The increasing population of patients with cancer highlights the need to develop an understanding of the patients' lived experiences. OBJECTIVE: The purpose of our study was to explore the lived experiences of Iranian patients regarding living with cancer. METHODS: A hermeneutic phenomenological study was performed. Twelve patients with cancer were interviewed to understand their lived experiences. We employed the seven-stage hermeneutical process of data analysis. FINDINGS: One constitutive pattern 'cancer patients' effort to return to normal life' and two associated themes, namely 'pass through limitations and challenges' and 'emotional and informational support seeking', were identified. 'Pass through limitations and challenges' had two subcategories: 'acceptance of reality' and 'resist cultural taboos'. 'Emotional and informational support seeking' also had two subcategories: 'family and friends support' and 'healthcare providers support'. CONCLUSION: The findings present better understanding of the lived experiences of patients with cancer in Iran regarding the phenomena under the study. IMPLICATIONS FOR PRACTICE: Nurses have an obligation to educate patients with cancer about anticipated changes in their life.

Cancer Patients' Informational Needs: Qualitative Content Analysis.

Understanding the informational needs of cancer patients is a requirement to plan any educative care program for them. The aim of this study was to identify Iranian cancer patients' perceptions of informational needs. The study took a qualitative approach. Semi-structured interviews were held with 25 cancer patients in two teaching hospitals in Iran. Transcripts of the interviews underwent conventional content analysis, and categories were extracted. The results came under two main categories: disease-related informational needs and information needs related to daily life. Disease-related informational needs had two subcategories: obtaining information about the nature of disease and obtaining information about disease prognosis. Information needs related to daily life also had two subcategories: obtaining information about healthy lifestyle and obtaining information about regular activities of daily life. The findings provide deep understanding of cancer patients' informational needs in Iran.

The experiences of parents with infants in Neonatal Intensive Care Unit.

BACKGROUND: In recent years significant medical science advances have been made in the field midwifery and infant care. The premature, low birth weight and ill infants are admitted to the technologically advanced NICU for care and they often require long-term stay. This study addresses parental experiences with the infant care in NICU, explores their concerns regarding nursing supports for parents and offers nurses' perspectives on performing duties. MATERIALS AND METHODS: A qualitative inductive content analysis method was applied in 2011 that included a purposely selected group of parents, nurses and physicians from neonatal unit at the Medical Science University of Isfahan. Participants were surveyed and interviewed according to the institutional ethics committee approval and signed informed consents. RESULTS: THE CONTENT ANALYSIS IDENTIFIED TWO MAIN CATEGORIES: 1) the definition of stress, which consisted of misgivings, nervous pressure, imbalance, separation and 2) the parents' reaction to stress, which revealed emotional, psychotic and behavioral reactions as subcategories. DISCUSSION: The medical team awareness of NICU parent experiences is essential to the quality of care. Recognizing the type of parents' reaction to the whole process by the healthcare team seems essential to the optimum outcome.

The Iranian parents of premature infants in NICU experience stigma of shame.

INTRODUCTION: To explore experiences of Iranian parents with a hospitalized premature infant in Neonatal Intensive Care Unit (NICU) and examine socio-cultural factors associated with having a less than perfect infant. METHODS: Purposely selected 21 participants in this study were 6 fathers, 7 mothers, 5 nurses and 3 physicians specialized in neonatology. Semi-structured in-depth interviews using inductive approach and content analysis helped obtain and analyze data by open encoding for classification and theme abstraction. RESULTS: Findings revealed that parents of hospitalized NICU infants in Iran experienced: job and income loss; shattered confidence in parental role; challenges to family dynamics; shame as a social stigma; loss of control; overwhelmed with uncertainties; and stress induced physical and emotional problems. CONCLUSION: Unique and outstanding finding of this study was the social stigma of shame for parents of an NICU infant which directly explained the socio-cultural aspect of Iranian society where families place great importance on having a healthy and strong infant. Having a premature infant with anomalies is viewed as a family flaw. Physicians and nurses must focus more on communication with parents and fulfill an important role to educate, assure and comfort parents. Establishing support system for parents of NICU infants seem urgently needed to improve parent-infant bonding.