White lie during patient care: a qualitative study of nurses' perspectives.

BACKGROUND: Keeping the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient's rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients; that is why the healthcare staff tell "white lie" instead. This study aimed to explore the nurses' experience of white lies during patient care. METHODS: This qualitative study was conducted from June to December 2018. Eighteen hospital nurses were recruited with maximum variation from ten state-run educational hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data were classified and analyzed by content analysis approach. RESULTS: The data analysis in this study resulted in four main categories and 11 subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses' limited professional competences. CONCLUSION: Results of the present study showed that, white lie told by nurses during patient care may be due to a wide range of patient, nurse and/or organizational related factors. Communication was the main factor that influenced information rendering. Nurses' communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so that they can make accurate decisions regarding their health care.

Medication error reporting in Tehran: a survey.

AIM: The purpose of this study was to evaluate nurses' reporting of medication errors. BACKGROUND: Improvement in medication error reporting is one of the major challenges in today's health care environments. METHODS: This was a descriptive survey of nurses working in medical, surgery, orthopaedic, gynaecology and obstetric wards in hospitals affiliated to Iran University of Medical Sciences, using stratified multistage sampling. Data were collected between November 2008 and May 2009 using a researcher-designed questionnaire. Data were described and explored using Kruskal-Wallis, one-way analysis of variance and Mann-Whitney's test. RESULTS: The response rate was 93% (n = 286).The mean number of medication errors 'reported' per nurse during 3 months was 1.33 [standard deviation (SD) = 4.18, median = 0, interquartile range (IQR) = 0-0, range = 70-0]. The mean number of errors made was 19.5 (SD = 30.27, median = 10, IQR = 1-25, range = 181-0). None of the individual and organisational characteristics reported were significantly related to reporting of medication errors. Failure to record vital signs (e.g. pulse, blood pressure etc.) before and after administering certain medicines was the most frequently reported medication error. CONCLUSION: More errors were made than were reported and this requires further investigation. IMPLICATIONS FOR NURSING MANAGEMENT: The reporting of medication errors is a problem in health care systems worldwide, including Iran. Considering the significant difference between the nurses' actual and reported medication errors, managers should monitor medication errors. Educational initiatives are needed to improve understanding of the importance of medication administration.

The effect of aromatherapy massage on the psychological symptoms of postmenopausal Iranian women.

BACKGROUND: Menopausal symptoms experienced by women vary widely, and while many women transition through menopause with manageable symptoms, others experience severe symptoms, which may impair their quality of life. OBJECTIVES: A randomized clinical trial was conducted to determine the effect of aromatherapy massage on psychological symptoms during menopause. METHODS: The study population comprised 90 women. Each subject in the aromatherapy massage group received 30 min aromatherapy sessions with aroma oil, twice a week, for four weeks; each subject in the massage therapy group received the same treatment with odorless oil, while no treatment was provided to subjects in the control group. The outcome measures were psychological symptoms, as obtained through the psychological subscale of the Menopause Rating Scale. RESULTS: A total of 87 women were evaluated. A statistically significant difference was found between the participants' pre- and post-application psychological score in intervention groups, whereas the score in the control group did not differ significantly. Aromatherapy massage decreased the psychological score MD: -3.49 (95% Confidence Interval of Difference: -4.52 to -2.47). Massage therapy also decreased the psychological score MD: -1.20 (95% Confidence Interval of Difference: -2.19 to -0.08). To distinguish the effect of aromatherapy from massage separately, we compared the reduction in the psychological score. Aromatherapy massage decreased the psychological score more than massage therapy MD: -2.29 (95% Confidence Interval of Difference: -3.01 to -0.47). CONCLUSION: Both aromatherapy massage and massage were effective in reducing psychological symptoms, but, the effect of aromatherapy massage was higher than massage.

Living with breast cancer: Iranian women's lived experiences.

BACKGROUND: Breast cancer is the most common form of cancer among women. Women with breast cancer encounter many psychosocial stresses as well as physical problems. AIM: To capture the meaning of living with breast cancer from the unique perspective and through the lived experiences of Iranian women with breast cancer that were explained with their own words. METHODS: A phenomenological approach was used to explore the meaning of living with breast cancer for Iranian women. The patients' feelings and lived experiences with breast cancer were investigated using semi-structured interviews with probing questions with 13 women between 34 and 67 years old. FINDINGS: The participants explained their experiences of living with breast cancer as losing something important, lack of confidence, living with fear, emotional dizziness and the need to be supported with the negative aspects of breast cancer and helped to explore new aspects of life as positive aspects of this event. CONCLUSION AND IMPLICATIONS: Understanding the phenomenon of 'living with breast cancer' seems to be crucial for nurses to help women with breast cancer to find themselves in confronting the consequences of the changes associated with the illness.

The relationship between incidence and report of medication errors and working conditions.

BACKGROUND: Medication errors are considered to be a serious threat to patients' safety. Efforts to detect and prevent these errors have increased considerably in recent years. AIM: To determine the incidence and reporting rate of medication errors as reported by Iranian nurses and their relationship with work conditions in hospitals under the authority of Iran University of Medical Sciences. METHODS: This descriptive-analytical study was carried out in six hospitals. Through a stratified multiple stage sampling, 300 nurses were selected. A researcher-constructed, three-part, self-report questionnaire was used to collect data regarding the nurses' medication errors, medication error reports and their perceived working conditions during the previous 3 months. The data were processed using descriptive statistics and Kruskal-Wallis one-way analysis of variance. FINDINGS: The mean of medication errors that nurses recalled was 19.5, and the mean of error reporting was 1.3 cases during the previous 3 months. The relationship between error incidence and work conditions as perceived by nurses was statistically significant (df = 3, P ≤ 0.0001); however, there was no significant relationship between reporting the occurred error and nurses' perceived work conditions (df = 3, P ≤ 0.255). CONCLUSION AND IMPLICATIONS: The establishment of an efficient reporting system, documentation of errors and removal of obstacles to reporting may result in reduced frequency of medication errors. Considering the relationship between medication error incidence and working conditions, it seems that creating a work condition in which nurses feel more comfortable and decreasing work tensions may pave the way to preventing nursing errors.

Caring relationship: the core component of patients' rights practice as experienced by patients and their companions.

The aim of this article is to describe how Iranian patients and their companions explain their lived experiences with caring relationships in a central teaching hospital in Tehran, Iran. Despite a large number of theoretical articles on this topic, the meaning of caring is still ambiguous, particularly in specific cultures. In Iran, there is not enough qualitative evidence on this topic to indicate what patients actually mean when they refer to caring relationship. This article explores how Iranian patients and their companions perceive and describe caring relationships as an element of patients' rights practice. This is part of a phenomenological research on patients' rights practice in Iran conducted during 2003-2006. Semi-structured interviews were conducted with 16 patients/companions, and van Mannen's approach was used for thematic analysis. The ethics committee of Tehran University of Medical Sciences approved the study. Patient-centered care, compassion, effective communication, support/advocacy, informed participation and meeting patients' basic needs were found to be the key elements in defining caring relationships. These themes were all described as elements of patients' rights practice issues. The results indicated that it is necessary for care givers/nurses to understand the person who will receive care in order to provide zealous and authentic care, because feeling "to be cared for" is even more important than providing the "care" itself.

Factors affecting patients' rights practice: the lived experiences of Iranian nurses and physicians.

BACKGROUND: The Iranian Ministry of Health and Medical Education published a 'Patient's Bill of Rights' in 2001. AIM: To gain insight into the perception and practice of patients' rights in Iran. This paper reports on Iranian nurses' and physicians' perceptions and lived experiences of respecting patients' rights. METHODS: A purposeful sample of eight nurses and five physicians working in a central teaching hospital in Tehran were interviewed during 2005-2006 for a qualitative study. Data were analysed using thematic analysis. FINDINGS: The emerging themes were categorized as 'barriers to patients' rights practice' and 'facilitators of patients' rights practice'. Under these themes three subgroups were discussed: awareness, resources and accountability. CONCLUSION: Healthcare professionals' lived experiences are an important source of data if managers and policy makers are to make changes and legislate for protecting and promoting patients' rights.