Nurse-mother communication and support: Perceptions of mothers in neonatal units.

Introduction: Having a hospitalized neonate is a stressful experience for parents, especially mothers. Thus, in recent years, a paradigm shift occurred in the neonatal units, focusing on the needs of parents and supporting them in addition to caring for neonates. The aim of this study was to evaluate the nurse-mother communication and support in neonatal units in Bushehr, Iran. Method: This descriptive cross-sectional study was performed in neonatal units of 6 hospitals in Bushehr, Iran, in 2022. Using the census method, all eligible mothers who met the inclusion criteria were included in this study. Data collection tools included demographic information form, nurse-parent support tool and nurse-parent communication questionnaire. The collected data were analyzed by SPSS version 24 using descriptive statistics, independent t-test, one-way ANOVA and Pearson correlation test. Results: The total mean score of nurse-parent support tool was 3.72 ± 0.72 and the total mean score of nurse-parent communication questionnaire was 59/27 ± 12/82. Caregiving support had the highest mean score (4.07 ± 73 0.73) and emotional support had the lowest (3.42 ± 91 0.91). Also, a statistically significant difference was seen between the admitted unit variable and the mean score of nurse-mother communication and support. Additionally, there was a statistically significant difference between the mechanical ventilation status of the neonate and the mean score of nurse-mother support. A significant positive correlation was seen between the neonatal gestational age and the mean score of nurse-mother communication. Conclusions: The total mean score of nurse-parent support and communication was moderate. Therefore, nursing support and communication need to be improved. Planning is needed to enhance the role of neonatal nurses and strengthen their support and communication skills in line with the family-centered care approach.

The effect of durability of knowledge transfer through reminiscence on the moral sensitivity of nurses.

BACKGROUND: Nursing is a moral attempt and endeavor. Moral sensitivity training is one of the most important ways to strengthen nursing moral decision making. Thus, the purpose of this study was to determine the effect of durability of knowledge transfer through reminiscence on nurses' moral sensitivity. METHODS: The present study is a controlled randomized clinical trial conducted in pre- and post- interventional forms. The research population consisted of all nurses working at Bushehr Persian Gulf martyrs training hospital in 2017, 68 nurses participated as samples in the study selected by available sampling method and then randomly assigned to two groups of intervention and control groups. In this study, Morphological Sensitivity Questionnaire of Lautzen was used. Validity and reliability of the questionnaire have been confirmed. The pre-test was obtained from the control and intervention group. An 8-hour reminiscence training session was held for the intervention group. In order to study, the durability of training, posttest was obtained from both groups. Data were analyzed by SPSS software version 19 and using t-test, Chi-square, paired t-test. RESULTS: The mean moral sensitivity score in nurses before intervention in both groups was not statistically different (P = 0.42). The comparison of the mean scores of nurses' moral sensitivity after intervention in the control and intervention groups, which in fact, indicates the durability of education, showed a significant difference. (P < 0.001). CONCLUSION: The results of this study showed that the transfer of knowledge and education through reminiscence has a lasting effect on enhancing the moral sensitivity of nurses. Therefore, its inclusion in nursing educational programs as a training strategy can be considered as a step toward facilitating the training of nurses' moral sensitivity. TRIAL REGISTRATION: This study is registered by Iranian Registry of Clinical Trials with decree code: IRCT2016021612830N18 on May 17, 2017. This study adheres to the CONSORT 2010 statement guidelines.

Effect of an Interactive Training on Choosing Delivery Method among Primiparous Pregnant Women: An Interventional Study.

OBJECTIVES: To evaluate the effect of interactive training conducted during pregnancy on choosing delivery method among primiparous women. METHODS: Quasi-experimental study carried out in 2017 in two hospitals in the city of Bushehr (Iran), with the participation of 108 primiparous pregnant women in an educational program consisting of eight 2-hour sessions every two weeks in which interactive training activities were performed (group discussions, classroom sessions, and delivery of printed educational material) on themes related with physiological delivery, painless vaginal delivery methods, and complications of cesarean delivery without indication, among others. Before and after the intervention, the Knowledge and Preferred Method of Delivery Questionnaire by Moradabadi et al., was used to obtain information. RESULTS: The results indicated that the level of knowledge in the group of mothers increased significantly between the pre-intervention and post-intervention assessment (13.2 versus 19.4, of 20 possible maximum points; p < 0.001). Additionally, significant difference was observed in the selection of the vaginal delivery method before and after the intervention (74.1% versus 98.1%; p < 0.001). CONCLUSIONS: Implementation of interactive training increased knowledge of pregnant women on the delivery and induced a positive effect to encourage the primiparous mothers to have a vaginal delivery.

Effect of an Interactive Training on Choosing Delivery Method among Primiparous Pregnant Women: An Interventional Study

Objective. To evaluate the effect of interactive training conducted during pregnancy on choosing delivery method among primiparous women. Methods. Quasi-experimental study carried out in 2017 in two hospitals in the city of Bushehr (Iran), with the participation of 108 primiparous pregnant women in an educational program consisting of eight 2-hour sessions every two weeks in which interactive training activities were performed (group discussions, classroom sessions, and delivery of printed educational material) on themes related with physiological delivery, painless vaginal delivery methods, and complications of cesarean delivery without indication, among others. Before and after the intervention, the Knowledge and Preferred Method of Delivery Questionnaire by Moradabadi et al., was used to obtain information. Results. The results indicated that the level of knowledge in the group of mothers increased significantly between the pre-intervention and post-intervention assessment (13.2 versus 19.4, of 20 possible maximum points; p <0.001). Additionally, significant difference was observed in the selection of the vaginal delivery method before and after the intervention (74.1% versus 98.1%; p<0.001). Conclusion. Implementation of interactive training increased knowledge of pregnant women on the delivery and induced a positive effect to encourage the primiparous mothers to have a vaginal delivery.

Objetivo. Evaluar el efecto de un entrenamiento interactivo realizado durante el embarazo sobre la elección del método de parto en mujeres primíparas. Métodos. Estudio cuasiexperimental realizado en 2017 en dos hospitales de la ciudad de Bushehr (Irán). 108 mujeres embarazadas primíparas participaron en un programa educativo consistente en ocho sesiones de dos horas de duración cada dos semanas, en las que se realizaron actividades de capacitación interactiva (discusiones grupales, clases magistrales y entrega de material educativo impreso) sobre temas relacionados con el parto fisiológico, los métodos de parto vaginal sin dolor, las complicaciones del parto por cesárea sin indicación, entre otros. Antes y después de la intervención se utilizó, para la toma de información, el Knowledge and Preferred Method of Delivery Questionnaire de Moradabadi et al. Resultados. Los resultados indicaron que el nivel de conocimiento en el grupo de madres aumentó significativamente entre la evaluación preintervención a la posintervención (13.2 versus 19.4, de 20 puntos máximos posibles; p<0.001). Además, se observó una diferencia significativa en la selección del método de parto vaginal antes y después de la intervención (74.1% versus 98.1%; p<0.001). Conclusión. La implementación de la capacitación interactiva aumentó el conocimiento de las embarazadas sobre el parto e indujo un efecto positivo para alentar a las madres primíparas a tener un parto vaginal.

Objetivo. Avaliar o efeito de um treinamento interativo realizado durante a gravidez na escolha do método de parto em mulheres primíparas. Métodos Estudo quase experimental realizado em 2017 em dois hospitais na cidade de Bushehr (Irã). 108 gestantes primíparas participaram de um programa educacional composto por oito sessões de duas horas a cada duas semanas, nas quais foram realizadas atividades de treinamento interativas (discussões em grupo, master classes e entrega de material educacional impresso) sobre questões relacionadas ao parto métodos fisiológicos, parto vaginal sem dor, complicações do parto cesáreo sem indicação, entre outros. Antes e após a intervenção, o Questionário de Conhecimento e Método Preferido de Entrega de Moradabadi et al. Resultados Os resultados indicaram que o nível de conhecimento no grupo de mães aumentou significativamente entre a avaliação pré-intervenção e a pós-intervenção (13.2 versus 19.4, de 20 possíveis pontos máximos; p<0.001). Além disso, foi observada diferença significativa na seleção do método de parto vaginal antes e após a intervenção (74.1% versus 98.1%; p<0.001). Conclusão A implementação do treinamento interativo aumentou o conhecimento das gestantes sobre o parto e induziu um efeito positivo para incentivar as primíparas a terem um parto vaginal.

The Effects of Preanesthetic Parental Presence on Preoperative Anxiety of Children and their Parents: A Randomized Clinical Trial Study in Iran.

INTRODUCTION: Parental presence during induction of anesthesia (PPIA) has been a controversial issue, with some studies showing its effects on reducing anxiety. Hence, this study aimed to investigate the effects of PPIA on preoperative anxiety of children as well as their parents. MATERIALS AND METHODS: This clinical trial was conducted among 60 children aged 2-10 years and their parents. Children were randomly assigned to intervention (n = 30) and control (n = 30) groups. Children in the control group were taken to the operating room (OR) alone, while those in the intervention group were taken to the OR with one of their parents. When the anesthetic mask was placed on the children's face (induction), the children's preoperative anxiety in both groups was assessed using Modified-Yale Preoperative Anxiety Scale (M-YPAS), and after that the parents in the intervention group were escorted to the waiting area. Parents' anxiety in both the groups was measured by the Spielberg State-Trait Anxiety Inventory (STAI) in the waiting area. Data were analyzed using descriptive and inferential (independent t-test and Chi-square test) statistic methods through the Statistical Package for the Social Sciences version 18 software. RESULTS: Results showed no significant difference between children's anxiety in the intervention (70.83) and control (70.39) groups in the preanesthetic period. In addition, no significant difference was seen between the intervention (79.23) and control (85.86) groups regarding total parents' anxiety. CONCLUSIONS: PPIA was not successful in reducing the children's preoperative anxiety as well as parents' anxiety. Future studies in this area are needed to clarify the effects of this intervention in pediatric populations.

Transition from being OK to NOT OK with tooth loss among a selection of older people in Iran: a qualitative study.

BACKGROUND: Several studies have covered oral health and dental decay in old age, but these studies mostly applied standard quantitative tools and did not include consideration of older people's views on oral problems, partial edentulism in particular. OBJECTIVE: To explore people's perceptions in terms of the transition from being OK to NOT OK with tooth loss among a selection of older people in Iran. MATERIALS AND METHODS: A qualitative content analysis study was chosen for the research by interviewing 15 older people using open-ended questions. Criteria for participation in the study were as follows: fitting the Kennedy class I or class I modification I category, having a minimum of four teeth but not more than 20 and being aged 60 years or more. The recorded interviews were then transcribed, and a coding process was applied based on a qualitative, conventional content analysis. RESULTS: The four main themes that emerged were as follows: (i) gradual realisation of the need to deal with the problem; (ii) the search for information on dental health; (iii) the challenge of adaptation; and (iv) tendency towards dental rehabilitation. CONCLUSION: The turning point in the transition from being OK to NOT OK seemed to be associated with an edentulous crisis that had occurred from another problem such as stomach ache, distention, or nocturnal dyspnoea due to swallowing food that had not been properly chewed and had an affect on an elderly person's life, physically and mentally. It is important to recognise the concept of healthy eating in relation to edentulism.

Barriers to Practical Learning in the Field: A Qualitative Study of Iranian Nursing Students' Experiences.

BACKGROUND: Clinical training is an integral part of nursing education; however, some studies have shown that it is not always efficient. OBJECTIVES: This study aimed to find out the factors that can impede nursing students' clinical learning. MATERIALS AND METHODS: In this qualitative study, data were collected via reflective journal writing. Purposeful sampling was used, and 12 senior nursing students were recruited to the study. The data were analyzed using a content analysis method. RESULTS: Three main categories were derived, including inappropriate communication, ineffective role models, and theory-practice gaps. Students perceived that inappropriate communication between instructors, staff members, and students had the greatest impact on student learning. The competence of clinical instructors and staff is an important factor affecting students' training. The clinical learning environment does not always integrate theory and practice together. CONCLUSIONS: Nursing students did not experience effective clinical learning. Having expert instructors and supportive communication are important factors in creating a clinical learning environment.

The Effects of Kangaroo Mother Care and Swaddling on Venipuncture Pain in Premature Neonates: A Randomized Clinical Trial.

BACKGROUND: Hospitalized premature babies often undergo various painful procedures. Kangaroo mother care (KMC) and swaddling are two pain reduction methods. OBJECTIVES: This study was undertaken to compare the effects of swaddling and KMC on pain during venous sampling in premature neonates. PATIENTS AND METHODS: This study was performed as a randomized clinical trial on 90 premature neonates. The neonates were divided into three groups using a random allocation block. The three groups were group A (swaddling), group B (KMC), and group C (control). In all three groups, the heart rate and arterial oxygen saturation were measured and recorded in time intervals of 30 seconds before, during, and 30, 60, 90, and 120 seconds after blood sampling. The neonate's face was video recorded and assessed using the premature infant pain profile (PIPP) at time intervals of 30 seconds. The data was analyzed using the t-test, chi-square test, Repeated Measure analysis of variance (ANOVA), Kruskal-Wallis, Post-hoc, and Bonferroni test. RESULTS: The findings revealed that pain was reduced to a great extent in the swaddling and KMC methods compared to the control group. However, there was no significant difference between KMC and swaddling (P ≥ 0.05). CONCLUSIONS: The results of this study indicate that there is no meaningful difference between swaddling and KMC on physiological indexes and pain in neonates. Therefore, the swaddling method may be a good substitute for KMC.

Lived Experience of Caregivers of Family-Centered Care in the Neonatal Intensive Care Unit: "Evocation of Being at Home".

BACKGROUND: In recent decades, family-centered care (FCC) has come to be known, accepted, and reported as the best care strategy for admitted children and their families. However, in spite of the increasing application of this approach, the experiences of the caregivers have not yet been studied. OBJECTIVES: The present study aimed at the description and interpretation of the FCC experience in two neonatal intensive care units (NICU) at Shiraz University of Medical Sciences. METHODS: This study was conducted through the hermeneutic phenomenological approach. Semi-structured interviews were conducted with 17 professional and familial caregivers, and their interactions were observed in three work shifts. The interviews were audiotaped and transcribed verbatim. After observations, field notes were also written. Finally, the data were analyzed through van Manen's methodology. RESULTS: One of the essential themes that emerged in this study was the "evocation of being at home" among familial and even professional caregivers. This theme had three subthemes: i.e., "meta-family interaction," "comprehensive support," and "reconstruction of a normal family." Accordingly, FCC eliminated borders between professional and non-professional caregivers and built close relationships among them in the NICU. It also provided for the needs of neonates, their families, and even professional caregivers through perceived and received support. CONCLUSIONS: Parents of the neonates admitted to the NICU experience hard moments. They not only play the role of primary caregivers, but they also receive the care. Focusing on the different meanings of this care from the caregivers' points of view and having managers provide certain requirements can guarantee the establishment of comprehensive care for clients and proper support for the staff in this unit.

The Obstacles against Nurse-Family Communication in Family-Centered Care in Neonatal Intensive Care Unit: a Qualitative Study.

INTRODUCTION: Communication is one of the key principles in Family-Centered Care (FCC). Studies have shown some drawbacks in communication between families and nurses. Therefore, the present study aimed to recognize the obstacles against nurse-family communication in FCC in Neonatal Intensive Care Unit (NICU). METHODS: This qualitative study was conducted on 8 staff nurses in 2 NICUs affiliated to Shiraz University of Medical Sciences selected through purposive sampling. The data were collected using 8 deep semi-structured interviews and 3 observations. Then, they were analyzed through inductive content analysis. RESULTS: Data analysis resulted in identification of 3 main categories and 7 subcategories. The first category was organizational factors with 2 subcategories of educational domain (inadequate education, lack of a system for nursing student selection, and poor professionalization) and clinical domain (difficult working conditions, lack of an efficient system for ongoing education and evaluation, and authoritarian management). The second category was familial factors with socio-cultural, psychological, and economic subcategories. The last category was the factors related to nurses with socio-cultural and psycho-physical subcategories. CONCLUSION: Identification of the obstacles against nurse-family communication helps managers of healthcare systems to plan and eliminate the challenges of effective communication. Besides, elimination of these factors leads to appropriate strategies in NICUs for effective application of FCC.

The Impact of Multimedia Education on Knowledge and Self-efficacy among Parents of Children with Asthma: A Randomized Clinical Trial.

INTRODUCTION: Asthma is one of the most common chronic disease among children, and is considered as a global health problem. According to the guidelines of childhood Asthma, parental education in order to improve their knowledge and self-efficacy should be considered in clinical care. Therefore, this study was performed with the purpose of investigating the influence of multimedia education on knowledge and self-efficacy of the parents of children with Asthma. METHODS: This study is a clinical trial which was carried out on 50 parents of children with Asthma. Data collection instrument included the demographic questionnaires, assessing knowledge and self-efficacy of the parents of children with Asthma. Reliability and validity of the instruments were assessed and the multimedia education was carried out for the experimental group. Data analysis was done using SPSS 13 and descriptive inferential statistical tests (independent t-test and Mann-Whitney). RESULTS: History of Asthma was present in majority 52% of the families of the children and 54% reported smoking in their home. The average scores of knowledge and self-efficacy of the study samples in the experimental group showed an increase after multimedia education methods, so that there was a statistically significant difference between the experimental and control groups. CONCLUSION: The results obtained in this study also demonstrate that educating parents through multimedia technology increase their knowledge and self-efficacy in their care of children.

The relationship of general health, hardiness and spiritual intelligence relationship in Iranian nurses.

OBJECTIVE: Nursing is one of the stressful jobs that affect nurse's well-being. The aim of this study was to assess the relationship between spiritual intelligence, hardiness and well-being among Iranian nurses. METHODS: Samples of this cross- sectional study selected by Randomized stratified sampling, 125 nurses who have been working in different wards of Bushehr university hospitals. Data were collected using spiritual intelligence, hardiness, well-being and demographic characteristics questionnaires. Correlation, t-test, ANOVA, Tukey and regression analysis were applied. RESULTS: The results revealed a significant relationship between spiritual intelligence and hardiness, spiritual intelligence and well-being, Hardiness and well-being. It also showed that among the demographic characteristics (age, gender, working ward, marital status, job experiences, and education) working ward significantly correlated with spiritual intelligence. CONCLUSION: Improvement of spiritual intelligence and reinforcement of hardiness could help increase the well-being of nurses.

Clinical decision-making in senior nursing students in Iran.

Clinical decision-making is the basis for professional nursing practice. This can be taught and learned through appropriate teaching and clinical experiences. Unfortunately, it has been observed that many graduates are unable to demonstrate suitable clinical decision-making skills. Research and study on the process of decision-making and factors influencing it assists educators to find the appropriate educational and clinical strategies to teach nursing students. To explore the experience of nursing students and their view points regarding the factors influencing their development of clinical decision-making skills. An exploratory qualitative approach utilizing grounded theory methods was used; focus group interviews were undertaken with 32 fourth year nursing students and data were analysed using constant comparative analysis. Four main themes emerged from the data: clinical instructor incompetency, low self-efficacy, unconducive clinical learning climate and experiencing stress. The data indicated that students could not make clinical decisions independently. The findings of this study support the need to reform aspects of the curriculum in Iran in order to increase theory-practice integration and prepare a conductive clinical learning climate that enhances learning clinical decision-making with less stress.