The effect of oropharyngeal mother's milk on nutritional outcomes in preterm infants: a randomized controlled trial.

BACKGROUND AND OBJECTIVE: Oropharyngeal interventions are an accepted method to improve the nutritional performance of premature infants. Considering the countless benefits of breast milk and the few studies on the use of breast milk as an oral-pharyngeal intervention, this study was conducted with the aim of determining the effect of oral-pharyngeal administration of breast milk on nutritional outcomes in premature infants. MATERIALS AND METHODS: In this clinical trial, 80 premature infants hospitalized in the neonatal intensive care unit of Amir al-Mu'minin Hospital in Semnan (a city in Iran) were randomly assigned to intervention (n = 40) and control groups (n = 40). Infants in the intervention group were given breast milk, and infants in the control group were given sterile water as a placebo. The data collection tool included demographic and clinical questions checklist, including sex, gestational age, weight, milk administration time, lavage and its amount, vomiting, abdominal distension, and so on. Data analysis was performed using SPSS23. RESULTS: The mean volume of total milk received by infants (p = 0.047) and the mean volume of milk received by mouth (p < 0.000) at the time of discharge were higher in the intervention group. Moreover, the time to start enteral nutrition in the intervention group was lower than in the control group (P = 0.012). Administering mother's milk through the oropharyngeal method led to a reduction in infants' length of stay in the hospital (P = 0.022). CONCLUSION: Based on the results of the present study, the oropharyngeal administration of breast milk in the first days after the birth of premature infants admitted to the hospital improves the outcomes related to their nutritional status. Therefore, it is suggested that this convenient, safe, and feasible method be used in hospitalized premature infants as soon as possible so that premature infants can benefit from the important advantages of breast milk.

The relationship between empowerment and compassion satisfaction, compassion fatigue, and burnout in nurses during COVID-19 outbreak.

BACKGROUND: The quality of nurses' professional life is at stake in crises such as COVID-19. Empowerment helps employees perform better and advance the goals of the organization. This study aimed to investigate the relationship between empowerment and the quality of nurses' professional life during the outbreak of COVID-19. MATERIALS AND METHODS: The current cross-sectional study was conducted in 2021 in the hospitals of Babol University of Medical Sciences with the participation of 200 nurses providing care for COVID-19 patients who were included in the study by convenience sampling method. Data collection tools included the Empowerment Questionnaire (Leader Empowerment Behaviors Scale, Structural Empowerment, and Psychological Empowerment) and the Professional Quality of Life Questionnaire. SPSS software version 23 was used to analyze the data. Multiple linear regressions were used to investigate the relationship between empowerment and quality of professional life. RESULTS: In the majority of nurses, compassion satisfaction 140 (70%), burnout 172 (86%), and compassion fatigue 126 (63%) were at moderate level. A significant relationship was found between compassion satisfaction and Leader Empowerment (R = 0.54, P =. 001), Psychological Empowerment (R = 0.55, P =. 001), and Structural Empowerment (R = 0.42, P =. 001) and Compassion Fatigue and Leader Empowerment (R = 0.35, P =. 001), psychological empowerment (R = 0.42, P =. 001), and structural empowerment (R = 0.49, P =. 001). CONCLUSION: Nursing managers' attention to empowerment strategies in crises such as COVID-19 can improve compassion satisfaction and reduce compassion fatigue in nurses. It is also necessary to implement policies and guidelines for the development of psychosocial support to health promotion of the workplace, education, informing, and empowering nurses.

Investigation of chronic diseases in patients with inflammatory bowel disease: A hospital-based case-control study.

Background: Inflammatory bowel disease (IBD) is a broad term that refers to a group of chronic inflammatory disorders that have an unknown origin and might be associated with other diseases. The aim of this study was to determine the frequency of chronic diseases in patients with IBD. Methods: In this case-control study, 280 patients with IBD were compared with 280 healthy individuals, frequency-matched by age, sex, place of residence and marital status. Random sampling was performed in patients that referred to the internal medicine and gastroenterology wards of hospitals affiliated to Babol University of Medical Sciences. Data collection tools included a demographic questionnaire and a checklist for chronic diseases, which were completed through interviews with the case and control groups. Results: Two hundred and twenty-nine (81.78%) patients with IBD had at least one chronic disease. Patients with IBD were at increased risks of rheumatoid arthritis (OR= 4.48, 95%CI: 1.48, 13.54, P= 0.008), eye diseases (OR= 3.49, 95%CI: 1.68, 7.28, P= 0.001), liver diseases (OR= 2.74, 95%CI: 1.40, 5.34, P= 0.003 ), anemia (OR = 2.53, 95%CI: 1.56, 4.13, P= 0.000), depression (OR= 2.43, 95%CI: 1.58, 3.74, P= 0.000), skin diseases (OR= 2.36, 95%CI: 1.18, 4.74, P= 0.015) and hypertension (OR= 1.77, 95%CI: 1.06, 2.95, P= 0.028). Conclusion: The frequency of chronic diseases associated with IBD has been high, therefore, physicians and health care professionals should consider the possibility of other chronic diseases when dealing with IBD patients.

The challenges of supporting nursing students in clinical education.

Clinical education requires creating a supportive atmosphere for learners and nursing students, who need support to be prepared for their future profession. The purpose of this study is to investigate the challenges of supporting the nursing students in clinical education. This article reviewed studies conducted between 2009 and 2019 with the keywords including support, challenge, students, education, and nursing using SID, Magiran, IranMedex, Google Scholar, Elsevier, and PubMed as databases. Among the 926 articles obtained during the two review stages, which were based on the inclusion and exclusion criteria and the first one analyzed the title and the abstract and the second one analyzed the whole article, ultimately 32 articles were selected for the study. The types of articles used in this study are as follows: qualitative (16 articles), descriptive analytical and cross-sectional (12 articles), review (3 articles), and mixed-methods (1 article). The focus of all studies was on the students' clinical education environment. The participants of the studies were undergraduate nursing students (in 22 articles), graduate students (in 2 articles), nursing instructors and students (in 4 articles), and nursing instructors and managers (in 1 article). Most of the challenges of supporting the students included violence, fear, and anxiety; socio-cultural challenges, environmental-organizational stresses; and ineffective clinical education. The findings of this study showed that nursing students face many challenges in the clinical setting. Therefore, the managers of educational and health-care centers should give a high priority to their students' support programs.

Qualitative study on the experiences of hepatitis B carriers in coping with the disease.

AIM: Hepatitis is a systemic infection that causes restrictions in the life of many patients due to its chronic nature and it necessitates the use of coping strategies to improve the quality of life. This study aims to demonstrate the experiences of hepatitis B carriers in coping with the disease. METHODS: The present study was conducted by using a qualitative content analysis. The data were collected through 18 unstructured and in-depth interviews from 2014 to 2016 at medical centers, a gastrointestinal and liver diseases research center in the cities of Babol and Amol (northern Iran) and Tabriz (north-western Iran) with patients infected with hepatitis B. The study was carried out by using purposive sampling. RESULTS: The data analysis led to the extraction of the main theme, "attempting an active expansion of interactions," and its three subthemes, including: "denial of the disease," "protecting oneself or others," and "coping with the disease." CONCLUSION: Patients with hepatitis B use different strategies to cope with this disease. In order for patients to properly face the disease and to live with minimum challenges and limitations, they need to be suitably understood and supported. Therefore, consideration of education and consultation programs regarding the different aspects of this disease is urgent.

Polypharmacy among the Elderly.

INTRODUCTION: Older people are at risk for polypharmacy due to multiple chronic diseases. Considering the lack of information in this regard, the aim of this study was to investigate the state of polypharmacy among the elderly in the city of Amirkola in northern part of Iran. MATERIALS AND METHODS: This descriptive/analytical cross-sectional study is a part of Amirkola Health and Aging Project that was conducted on 1616 individuals aged 60 years and over. The data about medications were gathered through interviews and observation of prescriptions and medications consumed by patients. The data were analyzed by SPSS software version 18, and P ≤ 0.05 was regarded significant. RESULTS: In this study, 1616 individuals including 883 men (54.6%) and 733 women (45.3%) were investigated. The average age of individuals was 69.37 ± 7.42. Among the investigated individuals, 526 including 368 men (41.7%) and 158 women (21.6%) consumed no medications. The prevalence of polypharmacy in this study was 23.1%, which was 32.7% in women and 15.2% in men (odds ratio = 1.51, 95% confidence interval: 1.10-1.93). The most prevalent group of medications used in both genders was cardiovascular drugs. CONCLUSIONS: Regarding the considerable prevalence of polypharmacy among the elderly, especially in aged women, serious efforts are required to manage polypharmacy. Provision of educational programs for physicians, personnel of pharmacies, and the staff of health-care centers in order for appropriate and safe consumption of medications in aged people is absolutely necessary.

The Prevalence of Anemia and its Association with Depressive Symptoms among Older Adults in North of Iran.

BACKGROUND: Anemia is the most prevalent blood disorder in older adults which can have negative effects on the quality of life and lead to the onset of depressive symptoms. We aimed to determine the prevalence of anemia accompanied by depression among older people in the city of Amirkola, north of Iran. STUDY DESIGN: A cross-sectional study. METHODS: Overall, 1616 older people aged 60 and over (883 males and 733 females) were enrolled in the city of Amirkola, north of Iran since 2011. To diagnose anemia we used WHO criterion which is a hemoglobin value of less than 12 and 13 g/dl in women and men, respectively. We also used Geriatric Depression Scale (GDS) to detect the presence of depression symptoms. The data were analyzed using SPSS version18.0 and statistical tests. RESULTS: The prevalence of anemia was 19% (302 out of 1616 participants). The prevalence of anemia in women was 20.3% and in men was 17.9%. In people with and without depressive symptoms it was 23.2% and 15.8%, respectively. The mean hemoglobin level in people with and without depressive symptoms was 13.29 ±1.63 and 13.96 ±1.50, respectively (P<0.001). According to logistic regression model, depressive symptoms were most highly related to gender (OR=3.67; 95% CI: 2.80, 4.81) and besides that smoking, Mini-Mental Estate Examination (MMSE), diabetes and anemia (OR=1.46; 95% CI: 1.09, 1.95) were related to depression. CONCLUSION: Significant prevalence of anemia and direct association with depressive symptoms in the elderly reflect the need for proper planning for prevention interventions, accurate and continuous screening of these diseases.

Support in Clinical Settings as Perceived by Nursing Students in Iran: A Qualitative Study.

BACKGROUND: Although support is one of the most substantial needs of nursing students during clinical education, it is not clearly defined in the literature. OBJECTIVES: The current study aimed to explore the concept of support in clinical settings as perceived by nursing students. MATERIALS AND METHODS: A qualitative content analysis was used to explore the meaning of student support in clinical settings. A purposive sampling with maximum variation was used to select the participants among bachelor nursing students in the nursing school of Babol University of Medical Sciences in the north of Iran. Semi-structured interviews were conducted to gather the perceptions and experiences of seventeen nursing students. Conventional content analysis was applied to analyze the data. RESULTS: In the current study, the main theme, nurturance, was emerged with seven subthemes of humanistic behavior with the student, respectful communication with students, accepting the student in the clinical setting, sustaining confidence, need based supervision, accepting the profession in the society and empowerment. CONCLUSIONS: Nursing students support in the clinical education requires a nurturing care; a care that leads to the sense of worthiness and respectability in students and contributes to the improvement of their clinical abilities.

Iranian nursing students' preparedness for clinical training: A qualitative study.

BACKGROUND: Clinical training plays a fundamental role in nursing students' acquisition of professional capabilities. Students' preparedness for learning in clinical setting is one of the most important factors that determine the quality of clinical training. Different studies indicate the nursing students' unpreparedness for entering clinical environment. AIM: The aim of this study was to explore Iranian nursing students' preparedness for clinical training. METHOD: This research is a qualitative research using content analysis approach. The participants consisted of seventeen nursing students, three nursing educators and one nurse, selected through the purposive sampling method and questioned in semi-structured interviews. The acquired data was analyzed by qualitative content analysis approach. RESULTS: Two main themes were captured in this study; including: 1) rejection of the profession and 2) fear and anxiety CONCLUSION: The findings indicated that the nursing students are not psychologically prepared for internship in clinical settings. Therefore we recommend in the first place reducing students' fear and anxiety of facing the reality and preparing them for a better beginning through conducting workshops in retraining and practicing clinical skills along with a course of visiting the hospital for students' confrontation and familiarization with real environment immediately before entering into the clinical setting. In addition, after the students' entrance to the setting the clinical educators should strive to heed students' level of preparedness especially their psychological needs and condition including the extent to which they accept their profession.