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Nursing and Midwifery Research - Volume:26 Issue: 5, Sep-Oct 2021

Iranian Journal Of Nursing and Midwifery Research
Volume:26 Issue: 5, Sep-Oct 2021

  • تاریخ انتشار: 1400/07/28
  • تعداد عناوین: 15
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  • Brian Barasa Masaba, Jonathan Taiswa, Rose Maureen Mmusi Phetoe Pages 373-379
    Background

    Caring for children with Autism Spectrum Disorder (ASD) is demanding,especially where access to services and support are inadequate. The present study aimed tosystematically review the challenges associated with the caregivers whose children have autism.

    Materials and Methods

    A systematic review design was utilized. The searches were conductedfrom February 2019 to January 2020. A qualitative analysis that was based on meta‑aggregationapproach and thematic analysis was used. Thereafter, data was presented into themes. The quality ofall included studies was assessed using the Critical Appraisal Skills Program (CASP).

    Results

    Thesearch generated 909 articles of which only 9 met the inclusion criteria.The main findings werediscussed under the following three thematic domains: 1) Stigma, 2) Financial burden, and3) Caregiving burden.

    Conclusions

    Evidence from the data reviewed showed financial burden facedby the caregivers whose children are diagnosed with ASD. This was manifested through both directand indirect cost of treatment. Another key finding was that majority of the caregivers faced stigmafrom the community. This implies the low level of awareness of the ASD within the community. Thepresent study calls for more programs on the present research problem within the community so asto increase awareness. Furthermore, the current advocacy of Universal Health Coverage programs inthe country should incorporate ASD children.

    Keywords: Autistic disorder, caregivers, child, Kenya
  • Imane Bagheri, Narges Hashemi, Masoud Bahrami Pages 380-391
    Background

    Palliative research studies seem to be limited and disperse in Iran. The present studywas therefore conducted to review and categorize the Palliative Care (PC) studies performed inIran in terms of the research type, the type/focus of PC, the measured outcomes in interventionalpalliative studies and their related results, the disease type, and their geographical distribution.

    Materials and Methods

    This narrative review was conducted in 2021 in which both Iranian andinternational databases including PubMed, Scopus, Web of science, CINAHL, ProQuest, Magiran,SID, Noormags, ISC were searched. The inclusion criteria were original articles conducted inIran and results published in Persian or English journals ab initio in which PC was assessed as avariable (dependent or independent) or the main concept.

    Results

    A total of 1096 articles wereidentified from which only 44 articles were reviewed. The research studies were mainly focused oncancer and majority conducted in Tehran. Majority of studies were quantitative‑interventional leadingto a variety of positive changes in dependent variables, including reduce in pain severity, changein life pattern, a good response to therapy, increase life expectancy, improve in dysphagia, improvequality of life, reduce patients’ metastasis, and increase in nurses’self‑efficacy.

    Conclusions

    The PCstudies distributed across different fields and cities in Iran resulted to a number of positive outcomesfor patients. More focused and robust research studies with different patients need to be conducted inthis emerging field in Iran. 

    Keywords: Palliative care, review, nursing, Iran, neoplasm, terminal care, supportive care
  • Apinya Koontalay, Wanich Suksatan, Aumpornpun Teranuch Pages 392-398
    Background

    Critically ill patients face challenges in hypercatabolism due to crisis states, as itmay lead to malnutrition. An early Enteral Nutrition (EN) within 24–48 h is recommended to usein order to improve clinical outcomes. This systematic scoping review is examined recently withthe evidence of the early EN protocol led by nurses to drive and achieve the daily calorie targetand improve clinical outcomes.

    Materials and Methods

    The database of CINAHL, MEDLINE viaPubMed and Scopus, Web of Science, and Embase through Ovid from January 2019 to September2020, comprised of 221 articles which four articles are chosen and entered into the final analysis.

    Results

    The findings show the benefits of the early EN to guide nurses to start the EN as soon aspossible after admitted to the Intensive Care Unit or when hemodynamic is stable in order to achievea daily calorie target regarding the reduced hospitalization, duration of mechanical ventilation,morbidity, and mortality.

    Conclusions

    The synthesized results show the early EN led by a nurse toaddress the specific needs and the vital role of nutritional support, and also drive the enteral feedingfor critically ill patients to reach the calorie target goals in short times to enhance clinical outcomes.

    Keywords: Critical illness, enteral nutrition, nurses
  • Seyedeh Atefeh Koohpayeh, Fatemeh Estebsari, Fatemeh Lashani, Abdollsamad Homayouni, Malihe Nasiri Pages 399-405
    Background

    Health literacy (HL) is considered a cancer‑preventive strategy. In addition, successin early diagnosis of cancer largely depends on individuals’ knowledge, attitude, and performanceregarding cancer warning signs. The aim of the present study was to investigate the potentialrelationship between HL and Knowledge, Attitude, and Performance (KAP) regarding cancerwarning signs.

    Materials and Methods

    This descriptive‑correlational study was conducted on 280adults who were referred to 3 health centers in Tehran, Iran, from January to March 2020. Data werecollected using the Health Literacy Instrument for Adults (HELIA) and the researcher‑made KAPregarding cancer warning signs questionnaire. Data were analyzed using the Pearson correlation testand linear regression in an adjusted model in the statistical package for social sciences software.

    Results

    Total HL score was positively and significantly correlated with knowledge (r = 0.35;p </em>< 0.001), attitude (r = 0.17, p </em>= 0.003), and performance (r = 0.46, p </em>< 0.001). Moreover, aftercontrolling for potential confounders, a significant and positive relationship was found betweenHL and knowledge (â = 0.48; t275 = 4.45; p </em>< 0.001), attitude (â =0.17; t265 = 4.64; p </em>< 0.001), andperformance (â = 0.62; t265 = 8.23; p </em>< 0.001).

    Conclusions

    It seems that adults’ KAP regardingcancer warning signs can be promoted by increasing their HL. Therefore, greater attention shouldbe paid to individuals’ HL at community health centers when designing and performing programs toimprove their KAP regarding cancer warning signs.

    Keywords: Attitude, health literacy, Iran, knowledge, neoplasms, Psychomotor performance
  • Neda Khalili, Masoud Bahrami, Elaheh Ashouri Pages 406-410
    Background

    Emotional disorders and depression make cancer patients reluctant about adherenceto their treatment. The present study was conducted to determine the relationship  betweenself‑compassion and adherence to treatment in cancer patients.

    Materials and Methods

    Thiscross‑sectional study was conducted on 214 patients with cancer in 2019. They were inpatientsaged over 18 years. Two months had passed since their cancer was diagnosed, and they hadundergone a course of chemotherapy. Data were collected using a personal details form, Neff’sSelf‑Compassion Scale and the Modanloo Adherence to Treatment Questionnaire and were thenanalyzed using the mean, frequency, Pearson’s correlation coefficient and linear regression analysis.

    Results

    The mean(SD) total score of self‑compassion was 80.07 (15.68), and the mean (SD) totalscore of adherence to treatment was 134.44 (38.37). Pearson’s correlation coefficient showed adirect relationship between the total score of self‑compassion and the total score of adherence totreatment (p </em>< 0.05). The linear regression analysis showed that the score of suffering as a commonhumanity (â = 0.47, p </em>≤ 0.001) and the variable of education (â = 0.27, p </em>≤ 0.001) were significantpredictors of the total score of adherence to treatment (R2 = 0.33).

    Conclusions

    According to theresults, suffering as a common humanity and education were significant predictors of adherence totreatment. Oncology nurses are therefore recommended to get further educated about self‑compassion,so that they take this concept more seriously in providing patient care. Nurses should also educatethe patients with low levels of education about the consequences of not adhering to their treatment.

    Keywords: Compassion, neoplasms, patients, treatment adherence, compliance
  • Zahra Bagheri, Zahra Boroumandfar, Maryam Shirazi Pages 411-416
    Background

    Knowing about sexual issues and substance abuse is crucial for girls in preventing high‑risk behaviors in the medical, social, cultural, and evolutional levels. The aim of this study was to determine the self‑care needs of adolescent girls in the domains of knowledge, attitude, and performance with regard to drug use and risky sexual behaviors.

    Materials and Methods

    This cross‑sectional study was conducted in the secondary schools located in the third district of Isfahan. Data were collected from 384 female students by systematic random sampling on 2019, and using a four‑part questionnaire including demographic characteristics and self‑care needs (knowledge, attitude and performance), drug addiction and unsafe sexual behaviors were measured and then were analyzed using descriptive and inferential statistics.

    Results

    According to the adolescents, “familiarity with infectious diseases caused by drug addiction”, “alcohol consumption, drugs and smoking as a way of forgetting problems” and “learning the skills of excitement control,” were their first self‑care priorities in terms of awareness, attitude, and performance, respectively. Additionally, “understanding the social and mental effects of relationships with the other sex”, “separating the children’s bedrooms from that of parents” and “ways of caring for personal hygiene in menstruation period and travel time” were considered as their first self‑care priorities in terms of knowledge, attitude, and performance with regard to sexual behaviors, respectively.

    Conclusions

    Based on the results, more effective interventions to protect the adolescents from being involved in substance use and sexual harmful behaviors are recommended through the training of self‑care needs in adolescents.

    Keywords: Adolescent, dangerous behavior, self care, substance-related disorders, unsafe sex
  • AliAkbar Khasseh, MohammadReza Amiri, Amir Sadeghi Pages 417-424
    Background

    Nursing is one of the most important areas of medical sciences whose developmentsincluding its scientific publications can influence health care. Therefore, the aim of this study was toinvestigate nursing articles published from 2013 to 2018, and to provide a comprehensive view ofcommon topical clusters in this research area.

    Materials and Methods

    In this practical research,bibliometrics method and co‑word analysis technique are used. The study population includedall the articles in nursing area indexed in Web of Science from 2013 to 2018. The bibliometricssoftware, including BibExcel, UCINET, and SPSS was used to analyze the data.

    Results

    Resultsindicated that the most frequently used nursing words in nursing research articles were “Qualityof life,” “Aged,” “Education,” and “Nursing.” Moreover, the pairs such as “Anxiety-Depression”,“Education, Nursing-Students, Nursing” and “Depression‑‑Quality of life” were the most frequentco‑occurrences. The use of hierarchical clustering led to the formation of seven topical clusters inNursing: “Nursing care for the Aged,” “Self‑care,” “Physical, emotional, and social support, “Motherand child health,” “Preventing nursing care,” “Nursing profession Research,” and “Quality of nursingcare.”

    Conclusions

    The growth of nursing scientific productions is an indicative of the importanceof this subject area in healthcare services; however, there is no balanced growth in various subjects. 

    Keywords: Bibliometrics, nursing research, publishing
  • Maasumeh Elahi, Parisa Mansouri, Zahra Khademian Pages 425-429
    Background

    Caring is the essence of nursing, and nurses who are dissatisfied with their job arenot able to perform optimal patient care. This study was conducted with the aim to determine theeffect of education based on human care theory on nurses’ caring behaviors and job involvement.

    Materials and Methods

    In this clinical trial, a total of 110 intensive care unit nurses from NemazeeHospital, Shiraz, Iran, were randomly allocated to control and intervention groups. The interventiongroup received a 6‑h workshop based on Watson’s human care theory using a collaborative androle‑playing approach and 1‑month follow‑up period through presenting weekly preplanned careand caregiving scenarios. The control group received routine hospital trainings. The data collectiontools used were included in a demographic information form, and the Larson Caring AssessmentQuestionnaire, and Kanungo Job Involvement Questionnaire. Data were analyzed using Chi‑squaretest, and independent and paired t</em>‑test in SPSS software.

    Results

    Majority of the participants weremarried women and had Bachelor of Science degree in Nursing. The participants’ age ranged from 21to 52 years. After the education, caring behaviors and job involvement scores significantly increasedin the intervention group compared to the control group (p </em>< 0.001).

    Conclusions

    The findingssuggest that a care workshop can be effective in improving care behaviors and job involvement.Therefore, we recommend more extensive research to determine the effectiveness of long‑termintervention on nursing care behaviors.

    Keywords: Education, intensive care units, nursing care, nursing theory
  • Nazila Vosoghi, Masoud Fallahi Khoshknab, Mohammadali Hosseini, Fazlollah Ahmadi Pages 430-436
    Background

    Violence against children is a serious global phenomenon. The severity of the injuriescaused due to violence toward a child is sometimes so great that it sends them to the hospital.Nurses have the first contact with Child Violence Victims (CVVs). These nurses experience differentchallenges. This study was aimed at exploring nurses’ experiences of challenges in care provisionto CVVs.

    Materials and Methods

    This conventional content analysis and qualitative study wasconducted in 2018–2019. Using a purposive sampling method, 17 nurses with experience in caredelivery to CVVs were recruited from among those working in Children’s Medical Center, Tehran,Iran, and Bu‑Ali Subspecialty Hospital, Ardabil, Iran. In‑depth semi‑structured interviews wereconducted to collect the required data. Data were analyzed through the conventional content analysismethod.

    Results

    During data analysis, the 3 main categories of role conflict, lack of continuity ofcare, and emotional resentment and 9 subcategories were identified. Nurses experience challenges incare provision to CVVs. They do not have enough knowledge about CVVs, are unable to maintainthe continuity of care, and experience role conflicts and emotional resentment.

    Conclusions

    Nursesexperience some difficulties and challenges in the process of care delivery to CVVs. They tried toovercome emotional resentment, different conflicts, and concerns about the lack of continuity ofcare without adequate support and resources. Thus, planning to support nurses in this regard seemsessential.

    Keywords: Iran, nursing, qualitative research, violence
  • Parinaz Noormohamadi, Atefeh Ahmadi, Yunes Jahani, Katayoun Alidousti Pages 437-442
    Background

    Violence against women is a health problem that poses an additional threat to themother and fetus during pregnancy. Therefore, the present study was conducted to investigatethe effect of Gestalt counseling on self‑esteem and Intimate Partner Violence (IPV) in pregnantwomen.

    Materials and Methods

    This clinical trial was carried out on 60 pregnant women whowere referred to health‑care centers in Kerman, Iran, in 2018. Simple random sampling wasperformed through lottery. The intervention group (n </em>= 30) received counseling in eight weeklysessions of 45 min using the Gestalt approach. The control group was placed on a waiting list.There was no blinding during the study. Data were collected using a demographic questionnaire,the Domestic Violence Questionnaire designed by Mohseni Tabrizi, and the Rosenberg Self‑EsteemScale before and after counseling.

    Results

    Differences between the groups in terms of meanscore of violence (intervention: t</em>34 = 1.81, p </em>= 0.08; control: t</em>34 = 1.41, p </em>= 0.16) and self‑esteem(intervention: t</em>34 = 1.87, p </em>= 0.07; control: t</em>34 = 1, p </em>= 0.32) in the pretest and posttest werenot significant. Analysis of covariance results showed a significant difference between theintervention 21.79 (10.62) and control groups 21.79 (10.62) in terms of mean (SD) violence(F</em>1,67 = 1.97, p </em>= 0.049) after the counseling sessions. It also showed a significant difference betweenthe intervention 74.47 (14.61) and control groups 66.28 (15.14) in terms of self‑esteem after theintervention (F</em>1,67 = 5.02, p </em>= 0.01).

    Conclusions

    Considering the impact of the Gestalt approachon IPV and self‑esteem, it is recommended that health‑care providers be educated about using theGestalt approach and apply it in communication with women. 

    Keywords: Gestalt therapy, intimate partner violence, Iran, pregnancy
  • Jamal Hame Morad, Hossein Namdar Areshtanab, Hossein Ebrahimi, Mohammad Arshadi Bostanabad Pages 443-448
    Background

    Nowadays, virtual social networks are among the most essential communication tools in the exchange of science, knowledge, and technology and are very popular among different peoples of the society, especially nursing students. They can also influence academic success. The present study was aimed to investigate the use of social networks among nursing students of Tabriz University of Medical Sciences.

    Materials and Methods

    This study adopts a descriptive cross‑sectional design and employed 406 nursing students in 2018 by means of the convenience sampling method. For data collection, a researcher‑made questionnaire consisting of demographic characteristics and social network usage was used. Descriptive and inferential statistics were used to analyze the data.

    Results

    The mean (SD) of social networking usage was 116.81 (17.20) out of the achievable score range of 38 to 190, where the highest and lowest scores were related to dimensions of content sharing (73.56%) and unconventional issues (51.00%), respectively. There was a significant statistical relationship between total score of social networking usage which included the variables of grade point average (r = ‑0.17, p </em>= 0.000), average daily study hours in non‑exam periods (r = ‑0.10 and p </em>< 0.04), family income (F2,375 = 6.28, p </em>< 0.001), number of siblings (F4,350 = 4.98, p </em>< 0.001), and academic semester (F6,376 = 2.12, p </em>< 0.05).

    Conclusions

    Given the high percentage of students enrolled and the aim of using these networks, proper planning for the management of cyberspace is necessary to take advantage of the benefits of social networks and reduce their disadvantages.

    Keywords: Academic success, students, nursing, social networking
  • Garima Goswami, Suresh K. Sharma, Rakesh Sharma, Ritu Rani Pages 449-454
    Background

    Simulation and skill development facilities are essential for the training and preparation of nursing students, which aids in their clinical readiness and professional development. The aim of the study was to assess simulation and skill training facilities, their utility in selected nursing institutes at Uttarakhand.

    Materials and Methods

    This descriptive cross‑sectional study was conducted in conveniently selected 16 nursing institutes at Uttarakhand (India). Data were collected from Nov. to Dec. 2019, through a face‑to‑face interview using a validated self‑structured questionnaire. Descriptive and inferential statistics were used to analyze the data.

    Results

    There were 16 institutes from four districts that participated in the study. Of these, five (31%) were government, and 11 (69%) were private. All nursing institutes (100%) had a nursing foundation lab, midwifery, and child health nursing lab, while only 44% of institutes had a medical surgical nursing skill lab. Among skill development facilities, the overall average number [mean (SD)] of mannequins was 3.90 (7.10); and high‑fidelity simulators were 2.47 (7.1). In private institutes, the average period [mean (SD)] of laboratory usage was significantly higher than in government institutes [35.82 (6.57) vs 27.40 (5.22); p </em>= 0.025]. The duration of lab usages was significantly associated with the age of the institute (p </em>= 0.04).

    Conclusions

    This study found inadequate simulation and skills training facilities and less utilization of those facilities. There is a great need to find out the key issues that lead to the unavailability and limited use of the required nursing skill development facilities.  

    Keywords: Clinical skills, education, nursing, students, simulation training, skilled nursing facilities
  • Fateme Goudarzi, Fatemeh Jafari Pour, Shirin Hasanvand, Farzad Ebrahimzadeh, Tarja Kvist Pages 455-461
    Background

    It is important to assess the provision of care in a humane framework to achieve patients’ holistic needs in Critical Care Units (CCUs) and to promote health outcomes. The aim of the current study was to determine patients’ satisfaction with humane care in CCUs.

    Materials and Methods

    In the current descriptive–analytical study, data were collected from 225 patients admitted to the CCUs of seven teaching hospitals in Lorestan Province, Iran, in 2017. The Persian version of the Revised Humane Caring Scale (P‑RHCS) was used in this study. Data were analyzed using descriptive statistics and inferential statistics (independent t</em>‑test and one‑way ANOVA).

    Results

    The mean (SD) overall score of the P‑RHCS was 4.61 (0.53), which indicated that patients were highly satisfied with humane care. The patients were most satisfied with “professional performance” [mean (SD) 4.72 (0.60)] and “interdisciplinary collaboration” [mean (SD) 4.72 (0.65)], and the least satisfied with “awareness of and contribution to self‑care” [mean (SD) 4.23 (0.78)]. The findings revealed that patients’ satisfaction with humane care depends on their demographic and clinical characteristics.

    Conclusions

    Generally, patients were satisfied with humane care provided in CCUs; however, it is recommended that nurses’ skills be reinforced, especially regarding information provision and effective communication with patients to improve health outcomes.

    Keywords: Critical care, humanism, nursing care, patient satisfaction
  • Zahra Abedini, Maryam Saeedi, Ashraf Khoramirad, Hamid Sharif Nia Pages 462-466
    Background

    Uncivil student behavior is one of the challenging issues in the nursing schools that disrupts the learning process and teacher‑student interactions. Planning to control student’s incivility requires knowing the condition using valid tools. The purpose of this study was to investigate the validity and reliability of the incivility occurrence’s questionnaire among Iranian students.

    Materials and Methods

    This methodological study was conducted on 358 nursing students and 122 nursing faculty members. The samples were selected from the nursing students of second to fourth year from September to October 2019. McDonald’s omega, Cronbach’s alpha coefficients and composite reliability were calculated. Exploratory and confirmatory factor analysis were used to investigate the construct validity of tool.

    Results

    Content validity index was 0.94 for the whole instrument. In factor analysis, three factors of irresponsible, violent, and unsound behaviors were identified. These factors explained more than 50.52% of the variance. Model fit indices Parsimonious Normed Fit Index) = 0.74, Root Mean Square Error of Approximation = 0.05, Parsimonious Comparative Fit Index = 0.78, Goodness‑of‑Fit Index = 0.92, Comparative Fit Index ( CFI) = 0.92, Adjusted Goodness‑of‑Fit Index) = 0.89, CIMN=2.58) indicated the proportion of factors. Internal consistency was 0.77 to 0.89.

    Conclusions

    This questionnaire is a three‑dimensional tool with appropriate validity and reliability that can be used to evaluate occurrence rate of nursing student incivility in Iran. 

    Keywords: Incivility, Iran, nursing, factor analysis
  • Zahra Borzabadi Farahani, Nazi Nejat Page 467

    Dear editor, The authors are members of the nursing faculty and as nurses’ educators are concerned with the nursing profession and have a responsibility to strive to promote the profession. The World Health Organization had declared 2020 as the International Year of the Nurse. This is a unique opportunity to recognize and showcase the work and contributions of nurses to the health system more broadly. Moreover, by the onset of COVID‑ 19 pandemic, the role of nurses has been thrown into sharp relief. However, they confront with many challenges under the shadow of COVID‑19......