Effects of Auriculotherapy on Gestational Hypertension: Randomized Controlled Trial Study.

Background: This study aims to observe how auriculotherapy acts as a nonpharmacological treatment for pregnant women's gestational hypertension. Materials and Methods: This study was a randomized controlled trial. Eighty patients were with gestational hypertension recruited and divided into control (n = 40) and intervention (n = 40) groups. The control group just received the usual perinatal care. The intervention group received one month of auriculotherapy in addition to the usual care. Blood pressure was measured before and 15 minutes after rest in both groups twice a week. The data were analyzed using descriptive statistics and inferential tests. Results: The mean systolic blood pressure, based on the Mann-Whitney test, was not statistically significant between the two groups before the intervention and in the first two weeks after the intervention (p >0.05); however, after the third week of intervention, the mean systolic blood pressure in the intervention group was significantly lower than that in the control group (p <0.001). As per the Mann-Whitney test, the mean diastolic blood pressure was not statistically significant between the two groups before the intervention and the first week after the intervention (p <0.05). However, after the second week of intervention, the mean diastolic blood pressure in the intervention group was significantly lower than that in the control group, and this decrease was highest in the fourth week of the intervention (p <0.001). Conclusions: This study demonstrated that auriculotherapy would reduce blood pressure in pregnant women suffering from hypertension.

ChitoHeal gel use on the nasal site for prevention of N95 masks caused pressure injuries: A randomised clinical trial.

Prolonged use of personal protective equipment can cause pressure injuries on the skin. The current study was conducted with the aim of investigating the effect of ChitoHeal gel on the nasal site on the prevention of N 95 masks that caused pressure injuries in nurses working in intensive care units. This is a randomised controlled clinical trial that was conducted in 2022. The study sample consisted of 92 nurses working in the intensive care units. A randomised block method was used to allocate the nurses to two equal groups of intervention and control. However, in the intervention group, ChitoHeal gel was applied on nurses' nose bridge. To perform this, the researcher referred to the department during the morning and evening shifts and applied the gel on nurses' nose bridge at the beginning of each shift. Then, the N95 mask was installed on the face by the nurse. Before and at the end of each work shift, the skin in both groups was assessed for any signs of pressure injuries. No significant differences were observed between the two intervention and control groups in terms of demographic variables. The frequency distribution of mask-caused pressure injuries on nurses' nose bridge in the two groups was analysed using the Chi-square test (Fisher's exact test). The results showed that after the intervention, it was 0 in the intervention group. However, 4 nurses (8.6%) in the control group developed pressure injuries, and this difference between the two groups was statistically significant (P > .05). The result of the current study showed that the use of ChitoHeal gel is effective in preventing N95 mask-related pressure injuries. Considering the cheapness and rational global availability of this gel, it seems that its use is an effective strategy in order to prevent N95 mask-related pressure injuries. Given the lack of studies in this regard, similar studies are strongly recommended to be conducted.

Development and Testing of the Psychometric Properties of the Attitude Towards Medical Device-related Pressure Ulcers/Injuries Questionnaire.

BACKGROUND: Medical device-related pressure ulcers/injuries (MDRPU/Is) are a serious concern in health care. PURPOSE: To develop and assess the psychometric testing of a questionnaire to measure nursing students' attitudes about the care and prevention of MDRPU/Is. METHODS: Based on a review of the literature, a 26-item questionnaire was developed; face validity was assessed by ten (10) nursing students. The modified Lawshe's model was used, and both the content validity index (CVI) and content validity ratio were calculated. Items with a CVI more than 0.63 were retained. The minimum optimal CVI for the new instrument was 79%. Qualitative assessments were performed by 10 experienced faculty members. One-hundred-and-eighty seven (187) nursing students participated in the construct validity testing of the 11-item questionnaire. The Kaiser-Meyer-Olkin test of sampling adequacy and Bartlett's test of sphericity were performed. Following analysis of the main components and the varimax rotation, the factor analysis was determined. Internal consistency (Cronbach's alpha) and test-retest were determined using Pearson's correlation and intraclass correlation coefficient to evaluate reliability. RESULTS: During the face validity phase of the initial 26 items, 7 items had impact scores less than 1.5. After calculating the CVI and content validity ratio for all items, 8 items did not achieve the desirable score. After performing exploratory factor analysis on the remaining 11 items, the Kaiser-Meyer-Olkin test value was 0.789, and Bartlett's test of sphericity was 0.0001, which was statistically significant. Internal consistency of items (Cronbach's alpha of 0.77) showed that all items had a high correlation. The reliability of test-retest was significant using an intraclass correlation coefficient of 0.75 and Pearson's correlation coefficient of 0.86 at P < .005. CONCLUSION: In this sample of nursing students, the Attitude Towards Medical-device Related Pressure Ulcers/Injuries Questionnaire was valid and reliable. Studies including licensed clinicians are needed to confirm these results.

Quality of life of family caregivers of patients with a stoma: a cross-sectional study from Iran.

AIM: The family plays a key role in supporting and caring for patients who have a gastrointestinal stoma because of cancer. This study investigated the quality of life of family members caring for such patients. METHODS: A descriptive study was conducted in 2020 in Iran. The study sample consisted of 250 family members caring for cancer patients with an intestinal stoma. The Caregiver Quality of Life Index-Cancer scale was used to measure quality of life. This scale has 35 questions, which are categorised into four subscales: mental/emotional burden; lifestyle disruption; positive adaptation; and financial concerns. The highest possible total score is 140 (35 in each subscale), and a high score indicates a poor quality of life. RESULTS: A total of 250 carers took part in the study. Of these, 143 (57.2%) were men and the average age was 35.1 years. Mean scores of mental/emotional burden, lifestyle disruption, positive adaptation, and financial concerns were 28.4±41, 17.3±3.2, 19.8±28, and 8.6±1.2 respectively. No significant relationship was found between participants' quality of life and demographic variables. CONCLUSION: Carers' quality of life is relatively poor. Carers' quality of life need to be improved and support programmes, devised and delivered by nurses, could have a role in this.

Relationship Between Practice and Attitude Regarding Pressure Injury Among Intensive Care Nurses in Iran: A Descriptive, Correlational Study.

Nursing practice can be influenced by attitude. PURPOSE: A study was conducted to evaluate the relationship between critical care nurses' practice, demographics, and attitude regarding pressure injury. METHODS: The descriptive-correlational study was conducted from March 14 to June 21, 2019, among nurses working in 3 intensive care units affiliated with Qazvin University of Medical Sciences in Iran. Using convenience sampling methods, nurses with at least a bachelor's degree in nursing who are involved in pressure injury care were invited to participate. Demographic information (age, sex, work experience in intensive care unit, education level) and pressure injury education information were collected from participants. Each nurse was observed 3 times by a researcher during his or her full work shift and evaluated using the Quality of Nursing Care Related to Pressure Injury checklist, which consists of 85 items categorized in 6 groups: 1) pressure injury risk factor evaluation (23 items), 2) change of patient position (12 items), 3) patient nutrition (16 items), 4) skin examination (25 items), 5) skin care in high-risk patients (5 items), and 6) use of accessories for pressure injury prevention (4 items). Each item offers 3 response options (ie, applied, not applied, applied but not correct). Correct responses on 70%, 69% to 50%, and less than 50% of items indicate good, relatively good, and poor practice, respectively. The Attitude Towards Pressure Ulcer Questionnaire, used to assess nurses' attitudes regarding pressure injury prevention, is a paper-and-pencil questionnaire that is completed by the nurse participants and consists of 11 items, with answers based on a 5-response Likert scale that ranges from 1 (totally agree) to 5 (totally disagree). The total score ranges from 11 to 55. A higher score indicates a more positive attitude. Descriptive statistics including mean and standard deviation were used to describe demographic information, and analytical tests including Pearson correlation test were used to determine the correlation between numerical variables. An independent t test was used to evaluate the differences in mean scores of numerical variables between the 2 groups. Significance level was considered as P < .05. RESULTS: The mean quality-of-nursing checklist score was 71.4 ± 13.5, inferring nurses provided good care. The highest and lowest mean scores were related to skin examination (22.8 ± 3.7) and skin care in high-risk patients (4.3 ± 0.8). The mean overall score of nurses' attitudes toward pressure injury was 27.26 ± 5.1, indicating a positive attitude toward providing pressure injury care and prevention. There was a significant and positive relationship between mean years of practice and the mean attitude score (r = 0.195; P = .041) as well as a significant relationship between quality of practice and attitude score (r = 0.195; P = .041) Conclusion: Ninety percent (90%) of critical care nurses demonstrated a good practice and a relatively positive attitude toward pressure injury. Additionally, the findings suggest that nurses with more years of experience and a more positive attitude have better quality of practice. The results of the present study could be useful for improving pressure injury care in the hospital setting and for educating nurses and nursing students. Further research that includes nurses in other wards is warranted.

Incidence and risk factors for medical device-related pressure ulcers: The first report in this regard in Iran.

Few studies, especially among developing countries such as Iran, have been conducted on the incidence and risk factors for medical device-related pressure ulcers (MDRPUs). Given the importance of this issue and the lack of previous studies, the present study aimed to investigate the incidence and risk factors for MDRPUs in Iran. The present descriptive-analytical study was conducted at three hospitals in Qazvin, Iran, from June 1, 2019, to September 1, 2019. Data collection took approximately 3 months from July to September 2019. Sampling was carried out through a convenience sampling method, and the samples consisted of 404 patients. For data collection, a checklist for demographic variables, a checklist for patient-connected medical devices, Braden Scale, Glasgow Coma Scale, National Pressure Ulcer Advisory Panel Pressure Grading Scale, and Nutrition Risk Screening 2002 were used. Of the 404 patients studied, 20.54% (n = 83) developed some degree of MDRPUs. From those, 61 (70.11%) were in stage I, 17 (19.5%) were in stage II, and 9 (10.34%) were in stage III. Among the nine medical devices that caused pressure ulcers, the most commonly reported ones were nasal oxygen tubes (31 cases), oxygen face masks (23 cases), and endotracheal tubes (17 cases). The mean score of Braden Scale (P = .004), the mean score of NRS 2002 (P = .037), older age (P = .007), male gender (P = .002), the average length of stay in hospitals (P = .001), and having pressure ulcers in body (P = .025) significantly increased the possibility of occurring MDRPUs. In the present study, the incidence of MDRPUs was high. Taking the necessary measures into consideration in order to prevent the MDRPUs is essential in Iranian hospitals. Further studies in this regard are strongly recommended.

Parenteral Nutrition Administration by Critical Care Nurses in Iran: A Performance Evaluation.

In Iran, nurses are responsible for administering parenteral nutrition (PN) to hospitalized patients in intensive care units (ICUs). However, little information is available among nurses in Iran regarding best practices in PN administration. This study evaluates the performance of critical care nurses in Iran in the administration of PN. The performance of 50 nurses in the administration of PN in the ICU was observed 3 times during a 5-month period for a total of 150 observations. A researcher-developed checklist, "Critical Care Nurses' Performance in Parenteral Nutrition Administration," was used for data collection. The total score in this checklist ranged from 0 to 52. Based on the procedural steps in the checklist and whether the steps were performed appropriately, nurses' performance was scored as poor, moderate, or good. The mean score of nurses' performances in PN administration skills was 24.6 ± 2.5. This study found that 46 nurses had moderate skill levels in PN administration, and 3 demonstrated poor skills. Overall, the results indicated that critical care nurses in Iran have poor to moderate PN administration skills.

Hopelessness, Perceived Social Support and their Relationship in Iranian Patients with Cancer.

OBJECTIVE: Cancer is considered a global health problem and its prevalence has been growing in recent years. The present study was conducted to investigate the role of hopelessness and perceived social support for Iranian patients with cancer. METHODS: Convenience sampling was used to select the study sample comprising 100 patients with cancer presenting to the Education and Treatment Center of Valiasr in Zanjan, Iran. A demographic questionnaire, the Beck Hopelessness Scale, and the Social Support from Family and Friends Scale were used to collect the data. Collected data were analyzed using SPSS-16. RESULTS: Of the 98 study patients, 52 (53.1%) were female and the remainder were male. Lung cancer constituted the most prevalent type of cancer (25.5%). The mean hopelessness score was 5.93 ± 4.71. The mean scores for social support provided by family and friends were 10.89 ± 5.61 and 14.94 ± 4.16, respectively. Significantly negative correlations were observed between the mean scores of hopelessness and social support provided by family (P = 0.007; r = -0.270) and friends (P = 0.001; r = -0.327). CONCLUSION: According to the findings of the present study, Iranian patients with cancer have relatively mild levels of hopelessness and moderate levels of social support. Perceived social support was also found to affect the patients' hopefulness. Given the lack of studies on this subject, it is recommended that further studies are performed.

The assessment of safe nursing care: development and psychometric evaluation.

AIM: To develop an instrument for the assessment of safe nursing care (ASNC) within the Iranian context and psychometrically evaluate its reliability and validity. BACKGROUND: There is a need for a valid and reliable instrument to assess how nurses employ the components of safe nursing care in clinical practice in non-Western countries. METHOD: This methodological study was conducted in two phases: (1) a qualitative phase of instrument development, and (2) a quantitative phase of psychometric evaluation of the assessment of safe nursing care (ASNC). The instrument's content validity was assessed by experts in the field of safe nursing care. The reliability of this instrument was examined using internal consistency reliability and intra-rater reliability analysis. Exploratory factor analysis was then conducted to establish the instrument's initial construct validity. RESULTS: The instrument developed was a questionnaire with 32 items. The Cronbach's alpha of the scale was 0.92, and Intra-class Correlation Coefficient for intra-rater reliability was 0.78. Exploratory factor analysis resulted in a four-factor solution: (1) evaluation of nursing skills, (2) assessing the patient's psychological needs, (3) assessing the patient's physical need, and (4) Assessing nurses' teamwork. The four factors accounted for 63.54% of the observed variance. CONCLUSION: The ASNC can be applied to a wide variety of settings because of the broad range of methods utilised to generate items and domains, its comprehensive consideration of the principles of safe care, and its initial reliability and validity. IMPLICATIONS FOR NURSING MANAGEMENT: The ASNC can help nurse managers assess whether clinical nurses are prepared to apply their safe care skills in clinical practice. It can also be used by clinical nurses to assess their own and peers' practice to detect potential areas for improvement in nursing care and help nurse managers with planning appropriate quality improvement programmes.

Iranian nurses perspectives on assessment of safe care: an exploratory study.

AIM: To explore the perspectives and experiences of nurse instructors and clinical nurses regarding the assessment of safe nursing care and its components in clinical practice. BACKGROUND: Safe nursing care is a key aspect of risk management in the healthcare system. The assessment of safe nursing care and identification of its components are primary steps to establish patient safety and risk management and enhance the quality of care in clinical practice. METHODS: This was an interview study, with qualitative content analysis. Semi-structured interviews were conducted with 16 nurse instructors and clinical nurses including nurse managers chosen by purposive sampling based on theoretical saturation. Data collection and analysis were carried out simultaneously until data saturation was reached. RESULTS: Data analysis led to the extraction of four main themes: holistic assessment of safe nursing care; team working and assessment of safe nursing care; ethical issues; and challenges of safe nursing care assessment. CONCLUSION: Identifying these four components in the assessment of safe nursing care offers a contribution to the understanding of the elements of safe care assessment and the potential for improved patient safety. IMPLICATIONS FOR NURSING MANAGEMENT: Safe care management requires the accurate and reliable assessment of safe nursing care and the need for strategies for reporting actual or potential unsafe care and errors to ensure patient safety.

The effects of self-care training on quality of life in patients with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a chronic and progressive disease of the central nervous system with debilitating symptoms and complications. Therefore, education and appropriate interventions, including self-care education, are necessary to increase the quality of life in these patients. The purpose of this study was to determine the influence of self-care education on quality of life in MS patients affiliated to Iranian MS Association. MATERIALS AND METHODS: This quasi-experimental study assessed a single group of MS patients before and after training. Totally, 50 MS patients were selected non-randomly from the patients referring to Iranian MS Association. A two-part questionnaire was used to collect data. The first part included demographic information and the second part consisted of a quality of life questionnaire (MSQOL-54) including 54 items in 3 sections and 14 subgroups. The scores ranges from zero to a hundred in each subgroup. The reliability of the questionnaire has been confirmed (Cronbach's alpha = 0.96). The questionnaires were filled out by the patients before training. After at least six 50-minute training sessions during three months, the same questionnaire was again completed by the participants. Statistical analyses, including absolute and relative frequency tables and mean and standard deviation for descriptive analysis, and t-test and Pearson correlation for descriptive analysis, were performed by SPSS. FINDINGS: The mean values of quality of life in physical health, pain, fatigue, health conception, changes in health status, sexual activities, as well as overall quality of life scores differed significantly after training. Moreover, except for cognitive activity, there were significant differences in values of mental health before and after training. CONCLUSIONS: Designing and applying the self-care programs based on the educational needs of MS patients has a positive effect on physical and psychological aspects of their quality of life.