مجله پژوهش پرستاری ایران
پیاپی 73 (مهر و آبان 1400)

Diabetes is the most common glandular disease in the world. The peak prevalence of type one is diagnosed during adolescence. Therefore, the issue of diabetes control in adolescence is very important. This study was designed to determine the relationship between family function and adolescent self-care behaviours in adolescents with type 1 diabetes.

In this cross-sectional study, the study population included all adolescents with type 1 diabetes referred to specialized diabetes clinics of Ahvaz Jundishapur University of Medical Sciences and their families. 62 families and their sick children were selected as the research sample by available sampling method and after obtaining informed consent, were studied. Data collection tools included demographic information form, Family Assessment Device and self-care of adolescents with diabetes questionnaire. Data were analyzed using independent t-test and Pearson correlation coefficient and SPSS software version 22.

Among the adolescents studied, 46.7% (29 people) were boys and 53.2% (33 people) were girls. All studied families reported the overall functioning of their families as unhealthy. Most of the adolescents in the study reported poor self-care (51.6%). 96.8% (n = 60) of the adolescents had HbAӏC blood levels higher than 9%. The results showed that there was a significant relationship between family functioning and self-care behaviours in adolescents (p = 0.014).

Based on the results obtained, it can be concluded that the performance of families with adolescents with type 1 diabetes is an important and influential variable on the child's self-care behaviours and blood sugar control. Therefore, helping families to increase their efficiency can play an important role in controlling diabetes.

Burnout is one of the occupational hazards that has been considered in recent years and as the main characteristic of job stress, it will have several adverse effects on the individual and the organization in which she works.

In terms of data collection, this research is among the descriptive researches of correlation and structural equation modeling (sem) and in terms of method, it is among the quantitative researches. The population of the present study consisted of all nurses of Imam Khomeini Hospital complex, their number was 1950 people. The sample size was calculated in each group of 300 people, of which a total of 600 people were randomly selected for each group of 300 people using stepwise cluster sampling method. In the present study, the Maslach burnout questionnaire (1993), the Lutans psychological capital questionnaire (2007), the Scorron and Freelander self-differentiation questionnaire (1998) and the Carroll Perception Questionnaire based on the Carol model (2001) were used. It was done using PLS and SPSS software.

Findings showed that the values ​​of descriptive statistics and central indicators such as mean, standard deviation, skewness and elongation, the higher the mean values ​​of variables with positive semantic load, show that the evaluation of the variable is in a more favorable and satisfactory situation. The higher the mean values ​​of the variables with negative semantic load, the more the evaluation of the variable is in an unfavorable situation. The results also showed that this effectiveness was significant at 95% confidence level (absolute value of t-statistic is greater than 1.96), so with 95% probability the researcher's claim was confirmed and showed that psychological capital and self-differentiation as Directly and mediated by the perception of social responsibility, it affects the burnout of nurses.

According to the research results, it is possible to reduce and improve burnout by interventions such as self-differentiation training, psychological capital, social responsibility perception, emotion management and emotion regulation for nurses.

Self care is a key factor in the health of menopausal women and a strategy for adapting with the events and stresses of menopause. So far, many studies have examined the effect of strategies on increasing self care capacity in menopausal women.

In this narrative review study, to achieve the desired persian and english studies searching the databases of Magiran, Sid, , Pubmed, scopuse, web of science, Embase, The Cochrane Central Register of Controlled Trials (CENTRAL) Google scholar search engine  were performed between 2000-2021. The checklist of original research articles was used.

After reviewing the articles, 12 eligible articles were reviewed. Findings from review of articles showed that using of The teach back method, Orem self care model, self care education, self directed learning, support group learning, Mindfulness-Based Art Therapy, Online program, Interventional strategy, integrative health-care model and personal counseling that place into two categories: “Perception Based Self care Strategies” and “Action-Based Self-care Strategies” which can help improve the self-care capacity of postmenopausal women.

Based on the results of reviewed researches, perception based Self-care Strategies and action-Based Self-care Strategies can be used as effective strategies to improve self care in menopausal women. Therefore, it is recommended that these methods be considered in postmenopausal women's health promotion programs.

The aim of this study was to evaluate the effectiveness of group therapy based on acceptance and commitment on disease perception and rumination in nurses with rectal cancer.

The statistical population of the present study included all 380 nurses with rectal cancer in Mashhad in the first six months of 2018. Using purposive sampling method, 30 patient nurses were selected as the study sample. These 30 people were randomly assigned to two groups of 15 people (experimental and control). The experimental group received treatment based on acceptance and commitment and the control group was on the waiting list for comparison with the experimental group. The research instruments included a short disease perception questionnaire and a rumination questionnaire. Data were analyzed in two descriptive and inferential sections using SPSS software version 20.

The results of statistical analysis showed that group therapy based on acceptance and commitment had a significant effect on reducing disease conflict (p-value = 0.39 = difference = means) and rumination (p-value 0.001). = 06/58 = difference in means) in nurses with cancer.

Therefore, based on the results and the effect of acceptance and commitment-based therapy on nurseschr('39') rumination, it is suggested that acceptance and commitment-based therapy training for nurses with rectal cancer reduce their perception of disease and rumination.

Background:

 Missed care means elimination or delay of any aspect of patient care (whether part of care or the whole care). Incidence of missed care as a common threat to the quality of care and patient safety leads to many health outcomes for patients in emergency departments. This study was conducted to investigate the causes of missed nursing care in emergency departments of selected hospitals affiliated to Tehran University of Medical Sciences.

Methods  :

This cross-sectional and descriptive study was conducted on 146 nurses working in emergency departments of selected hospitals affiliated to Tehran University of Medical Sciences. The samples were selected by census method. Iinclusion criteria included having a bachelorchr('39')s degree in nursing and at least 6 months of experience in the emergency department and consent to participate in the study. The method of data collection was self-report and the data collection tool was two demographic information questionnaires and Kalish Missing Nursing Care Questionnaire. The validity of the instrument was calculated by content validity method and its reliability was calculated by Cronbachchr('39')s alpha method with a coefficient of 0.743. Data analysis was carried out by SPSS-16 software using descriptive statistics.

In general, the overall mean score of causes of missed care was 0.44 ± 2.90. The reasons for missed care in the areas of human resources with the mean score of 3.26, material resources with the mean score of 2.82 and communication with the mean score of 2.73 had the highest and lowest mean, respectively.

The results of this study showed that causes of missed care are rooted in three areas of human resources, material resources and communication. Therefore, nursing managers are recommended to consider the root causes of missed nursing care in each area of human resources, material resources and communication.

Understanding the severity of depression, stress and anxiety is essential to ensure adherence to treatment and achieve appropriate treatment outcomes in patients with hypertension; therefore, the aim of this study was to determine the effectiveness of rational-emotional-behavioral therapy on depression and anxiety in patients with hypertension.

The present study was a quasi-experimental pretest-posttest with a control group. From the statistical population that includes all people with hypertension referred to Dr. Mahmoudi Rad clinic in the first six months of 2020 in Birjand, 24 eligible people were selected by convenience sampling method and randomly divided into two groups (12 people tested And 12 controls were placed. The experimental group participated in eight sessions of Dryden and Newman (2013) rational-emotional-behavioral therapy, but the control group was on the waiting list. Data collection tools were Beck Depression Inventory - Second Edition Beck et al. (2000) and Beck et al. (1988) Anxiety Inventory. Data were analyzed using SPSS software version 24 and analysis of variance with repeated measures between groups at the significance level of α = 0.05.

The results showed that rational-emotional-behavioral was effective in reducing depression (p <0.01) and anxiety (p <0.01) in patients with hypertension and these results continued in the follow-up period (p <0.01).

Considering the effectiveness of rational-emotional-behavioral therapy, the results of this study can be used for psychiatric nursing processes as well as prevention of psychological problems in patients with hypertension for health system managers, for proper treatment planning, promotion of mental health services and related policies. It should be used in the community and they should pay more attention to non-drug therapies.

High prevalence of cardiovascular diseases has increased treatment costs. Strategic purchasing of health services provides a fair access to health services, financial risk protection, and effective management of the underlying risk factors for cardiovascular diseases. This study aims to identify the factors affecting the strategic purchasing of cardiovascular health services in Iran.

This qualitative study was conducted in 2020. In the first stage, a literature review and, in the second stage, the semi-structured interview tools were used for the data collection. The study population consisted of managers and policy-makers of the basic health insurance organizations, Ministry of Health, hospital administrators, faculty specialists, and cardiologists. The research sample was selected by targeted sampling method. The sample size of the research continued until theoretical saturation (12 people). Data were analyzed by content analysis method using MAXQDA.

Factors of Stewardship and policy-making, insurance, financial, structural, effective social factors for health, providers, patient-related factors, and political behavior of stakeholders influence the strategic purchasing of cardiovascular health services.

Due to the limited resources of the health system and the unlimited requirements of society, a strategic approach toward preventive interventions and the social determinants of health in terms of developing a basic insurance benefit packages can reduce the costs and quality of cardiovascular health care. Strategic purchasing requires the involvement and comprehensive support of stakeholders and key players in the health system.

The learning process is present throughout nurses' working lives, and work-based learning is one of the best ways to ensure professional competence during their working lives. Awareness of the value and importance of this learning method is very important in the strategic goals of health care organizations to succeed. The aim of this study was to investigate the implementation barriers of work-based learning practices in clinical settings.

This descriptive-analytical study was performed in February 2016 in two hospitals affiliated to Shahid Beheshti University of Medical Sciences. Using available sampling and Morgan table, 220 clinical nurses, nursing managers (matron, supervisor, head nurse) were selected as the research sample. The opinions of nurses and nursing managers were examined in clinical education environment using a researcher-made questionnaire that was validated. After data collection, data analysis was performed using Spss software. Data using descriptive statistics (frequency and percentage) and inferential tests (exploratory factor analysis, Kaiser-Meyer-Olkin sampling adequacy test, Bartlett sphericity test, Cronbach's alpha coefficient, one-group comparison test, independent means test and test Nonparametric statistics within Friedman's case were analyzed.

According to nursing managers and nurses, individual, organizational and managerial factors were serious barriers to work-based learning in health centers. The difference between the opinions of nursing managers and nurses was statistically significant only in managerial barriers (P <0.01) and the difference between the views of nursing managers and nurses in individual and organizational barriers was not statistically significant (P >0.05). Compared to nursing managers, nurses considered managerial barriers to be more involved in work-based learning. According to nursing managers, organizational barriers were the most limiting factor for work-based learning methods in clinical environments.

Using work-based learning method is one of the active and interactive learning ways that leads to professional development in many fields, including nursing. Therefore, it is important to identify the factors that affect the implementation or non-implementation of this learning approach. Therefore, it is necessary for health care organizations and executives, especially in the clinical field, to consider the need to do work and improve the quality of nursing services in clinical environment and hospitals to identify other factors that hinder on-the-job learning and as far as possible Familiarize employees more and implement new and active training methods and, if necessary, integrate it with other learning methods.

Transmitting bad news is one of the difficult tasks of the care team. This situation is as stressful and costly for the healthcare team as it is tedious and expensive for the clients. Therefore, the present study was conducted to investigate the factors affecting the skill of presenting bad news to the patient and companions.

This study was a narrative review. In the present study, Persian studies were searched in Persian language databases such as Elm Net, Noormag, SID, Magiran, With The Keywords Bad News, Diagnosis Disclosure, Truth-Telling, Patient, Treatment Staff from 1385 to 1399. To search for studies in English, the keywords, breaking bad news, diagnosis disclosure, truth-telling, patient, medical staff in the database, Research gate, Elsevier, Science DirectPubmed, Scopus between 2009-2020 were used. The Google Scholar database was also searched in Persian and English. Inclusion criteria included complete Persian and English articles. Exclusion criteria included not having access to the full article. Review articles were also excluded from the study. After searching the databases, 208 articles were included in the study. The researchers examined 27 articles by applying inclusion and exclusion criteria and eliminating duplicates.

The findings showed that individual factors, communication factors and supportive factors are the factors affecting the bad news. Training in this area is insufficient. Therefore, according to the findings of the study, the role-playing method and multimedia tools can be used, the spikes protocol also plays an important role in improving communication skills.

According to the findings of the study, it is recommended that health policy makers and hospital managers by providing appropriate instructions to the cultural and social conditions of the country and also by holding bad news presentation skill classes, taking into account the mentioned effective factors. Try to improve bad news presentation skills.

Anxiety in patients under Coronary angiography leads to changes in cardiopulmonary parameters. The current study aimed to compare the effect of virtual reality and rhythmic breathing on physiological parameters of patients undergoing coronary angiography.

In this clinical trial study, 90 patients admitted to the cardiac care ward were studied in 2019-2020. They were selected by convenience sampling and randomly allocated into three groups: virtual reality, rhythmic breathing and control. Virtual reality and rhythmic breathing groups received intervention and control group received routine care. Systolic and diastolic blood pressure, heart rate; respiration rate and arterial oxygen saturation were measured before, half and one hour after the intervention in three groups. Data were analyzed by SPSS-16 using repeated measures analysis of variance and Chi-square.   

The results showed that the pattern of changes of the mean of respiration and heart rate was significantly difference in three times of measures in the three groups (p = 0.001). In the case of systolic and diastolic blood pressure and arterial oxygen saturation, the pattern of changes did not show a significant difference in the three groups (p >0.05).

The use of these methods can lead to modification of some physiological parameters, so the nurses can use these methods as non-invasive, without side effects, cheap and applicable to improve patients’ physiological parameters.