نشریه پرستاری ایران
پیاپی 139 (دی 1401)

All health systems in the world are facing the lack of financial resources for meeting the health needs of people. Policymakers in the health sector use economic and political methods to solve this problem and implement appropriate strategies for prioritizing and allocating limited resources to meet unlimited health needs [1]. In this regard, it is important to conduct studies for economic evaluation of health to provide evidence to decision-makers. These comparative studies of the costs and consequences of different health technologies and strategies [2] can help policymakers to choose the most cost-effective interventions to create the greatest health outcomes. As universal health coverage (UHC) becomes one of the priorities of countries to achieve sustainable development goals, the access of all people to the needed services at a reasonable price should be considered by governments. The COVID-19 pandemic showed that only a robust health system with sufficient finance cannot guarantee people’s health in the long term, and we need to find cost-effective methods to provide health services [3].

Background & Aims:

 Breast cancer is one of the common diseases in women that endangers their physical and mental health. Rumination is one of the psychological problems in these women. The present study aims to determine the effect of an educational program based on hope therapy on the rumination of women with breast cancer.

This is a quasi-experimental study. The study population consist of all women with breast cancer referred to the chemotherapy departments of hospitals affiliated to Zahedan University of Medical Sciences. The sampling was done using a continuous method. Then, the samples were divided into intervention (n=50) and control (n=50) groups randomly by lottery method. The intervention was conducted at eight group sessions, twice a week. The data collection tools were a demographic form and the Ruminative Response Scale (RRS). The data were analyzed in SPSS software, verion 16.

The mean score of rumination before the intervention was not significantly different between the two groups (P=0.29). After the intervention, the difference between the two groups was significant (P=0.0001). The paired t-test results showed a significant difference in the mean score of rumination before and after the intervention in the intervention group (P=0.003), but there was no significant difference in the control group (P=0.89).

 Education based on hope therapy can positively affect the rumination of women with breast cancer. By an hope therapy-based intervention, the disturbing thoughts, which are mostly related to disease and despair, can be reduced in women with breast cancer experiencing rumination.

Cardiovascular diseases are responsible for 30% of all deaths worldwide. The present study aims to evaluate the effect of education through online social media (WhatsApp) on the anxiety and satisfaction of candidates for coronary angiography.

In this study, participants were candidates for elective coronary angiography referred to Imam Khomeini Hospital in Ahvaz, Iran from May to July 2021. They were assigned to the intervention (n=43) and control (n=43) groups. Data were collected using a demographic form, the Beck anxiety inventory (BAI) and the visual analog scale (VAS) for measuring satisfaction. Data analysis was performed in SPSS software, version 16 using independent t-test, paired t-test, chi-square test, and Fisher's exact test.

Both groups were homogeneous in terms of demographic characteristics at baseline, and there was no significant difference in BAI scores between the intervention and control groups before the intervention (P=0.229). The results of independent t-test showed a significant difference in the mean BAI score before and after intervention in two groups (P<0.001), indicating the effect of intervention on reducing anxiety. The results of independent t-test showed that the satisfaction in the intervention group was significantly higher than in the control group (P<0.001). The results of the paired t-test showed that in both intervention (P<0.001) and control (P=0.005) groups, the BAI score decreased significantly after the intervention compared to the pre-intervention phase. The effect size of education on anxiety was 0.9 and the effect size on satisfaction was 1.88, which shows the high effect of the educational intervention.

The use of mobile social networks for education is effective in reducing anxiety and improving satisfaction in patients undergoing coronary angiography. Therefore, this interventional method can be used by nurses as an effective method in medical centers.

The most important factors for the development of any society are human resources. The intensive care units (ICUs) are the most important departments in the hospitals. Considering the importance of time management for patient care, lack of human resources in this profession, and the fact that nurses spend a lot of time on indirect and non-nursing works, this study aims to investigate the time and type of indirect patient care provided by nurses in the ICU of a hospital in Iran during the COVID-19 pandemic.

This is a descriptive, cross-sectional, and observational study that was conducted for 6 months. Participants were 42 nurses working in the ICU of Hafte Tir Hospital in Rey, Iran who were randomly selected from different shifts. Their activities were observed and their spent time was recorded by the researcher using the stopwatch mobile application. The data collection tool was the Persian version of the International Classification for Nursing Practice (ICNP) checklist with acceptable face and content validity according to opinions of a panel of experts (5 faculty members and 10 nurses). descriptive statistics (frequency, mean, standard deviation, minimum, and maximum) were used for data analysis by SPSS software, version 22. 

Most of nurses (60%) were in the age group of 30-39 years and 72% of them had a work experience of 11-20 years. Most of the nurses were female (85%) and married (80%). In each shift, nurses spent an average time of 247 minutes providing indirect care. The longest time in indirect care was related to writing nursing reports (34.9 ± 10.5 min per shift) and the shortest time were related to removing personal protective equipment (6.11±3.19 min per shift), consulting with a colleague, and wearing personal protective equipment (both with 7±3.55 min per shift).

Although patients need direct care and continuous presence of the nurse more during the COVID-19 pandemic and there are advanced equipment. To provide proper nursing care, it is important to increase the number of nurses and reduce their non-nursing activities.

Interpersonal cognitive distortion (ICD) is one of the psychological problems in old age that causes a person not to have a correct and logical understanding of relations. Its continuation can lead to anxiety and depression. This study aims to determine the ICDs among the community-dwelling elderly in Tehran, Iran.

In this descriptive-correlational study, participants were 200 older people dwelling in the urban parks in Tehran, Iran who were selected using a cluster sampling method from December 2020 to October 2021. Data collection tools included a demographic form, abbreviated mental test score (AMTS), and interpersonal cognitive distortion scale (ICDS). The collected data were analyzed in SPSS software, version 16 software using descriptive statistics (Mean±SD, No. (%)) and inferential statistics (Pearson correlation test, independent t-test, analysis of variance).

The mean total score of ICD was 52.53±8.29 out of 95, which indicates the moderate level of ICD among the elderly. In terms of the dimensions of ICDS, the unrealistic relationship expectations had the highest mean score (2.91±0.57), while the dimension of interpersonal rejection had the lowest score (2.64±0.52). There was a significant relationship between the age of the elderly and their ICD (P=0.03).

Considering the existence of a significant relationship between ageing and cognitive distortions, The nurses working in healthcare centers in Mashhad should take it into account in interventions for the elderly.

Although COVID-19 can affect people in different age groups, the conditions and severity of symptoms are worse in people with diabetes. This aims to determine the knowledge, attitude and practice (KAP) regarding COVID-19 in people with diabetes in Tehran, Iran.

This is a descriptive cross-sectional study on 384 patients with type 1 and type 2 diabetes referred to Firozgar and Hazrat Rasool-e Akram hospitals affiliated to Iran University of Medical Sciences from December 2021 to June 2022. They were selected using a continuous sampling method. The instruments were a demographic form and the KAP questionnaire designed by Honarvar et al. (2020). Data analysis was done in SPSS v.16 using descriptive and inferential statistics.

The mean age of the participants was 40.11±15.20 years. It was reported that 94.8% had moderate and sufficient knowledge of COVID-19. The mean attitude score was 30.90±4.89 which is a moderate-to-high level. Only 1.3% had poor practice regarding COVID-19. A statistically significant relationship was observed between the average knowledge of patients and their marital status (P=0.006), employment status, and duration of disease (P<0.001). In addition, there was a statistically significant relationship between the attitude of patients and their educational level (P=0.015) and duration of disease (P=0.027). Their practice level had a significant relationship with gender (P=0.010), marital status (P=0.001), and type of diabetes (P<0.001).

The KAP of people with diabetes in Tehran regarding COVID-19 is at a favorable level. This indicates the success of the measures taken to educate this category of patients by health centers and media, and reveals the necessity of increasing the health literacy of people in pandemics.

Considering the benefits that a welcoming environment can have for the patients and their families, and specifically for people with mental disorders, this study aims to launch a welcoming program in the Iran psychiatric Hospital and assess its effectiveness in improving the quality of and satisfaction with the services for patients with mental disorders.

The welcoming unit of the hospital was officially launched and began to operate since September 2017. In the welcoming program, the nurse first introduced herself to the patients and their families, and if needed, made them familiar with the hospital and its goals and environment, how to reach psychiatrists, and regulations during hospitalization. This program continued by acquainting patients with their rights, the hospital's rules, treatment team, welfare amenities, inpatient wards, electroconvulsive therapy unit, clinics, support center, and by handling complaints and criticisms. For internal evaluation, a survey form with 5 open-ended questions was designed without including demographic characteristics and distributed among the hospital departments. The responses were collected and analyzed using the content analysis method.

The results of internal evaluation showed that 92% of the patients and their families were satisfied with the welcoming program and perceived it as very good and excellent. Half of the patients and their families (50%) believed that some nurses were caring and some were careless and did not take care of problems well. They perceived that psychiatrists and psychologists did not spend much time with the patient, and their visits were done very late.

Based on the perceptions of the patients and their families about the welcoming program, it seems that they are satisfied with the program in overall. The result can motivate other psychiatric and non-psychiatric centers in Iran for the implementation of a welcoming program.

Resilience is defined as a person’s ability to maintain psychological balance and recover from challenging conditions. Due to the very important role of family caregivers in the treatment of older patients with COVID-19, attention to their health and well-being has been increased. This study aims to determine the resilience level of the family caregivers of older people during COVID-19 pandemic in Mashahd, Iran.

This descriptive-analytical study was conducted on 120 family caregivers of older people who referred to urban health centers in Mashhad, Iran. Sampling was done in using cluster random sampling method from April to June 2022. The instrument was a two-part questionnaire included demographic form (surveying age of the elderly and caregiver, gender of caregiver, educational level of caregiver, employment status of caregiver, marital status of caregiver, and the relation of caregiver with the elderly) and the Connor-Davidson resilience scale. Data analysis was done in SPSS v.23 software using descriptive and inferential statistics.

The mean age of family caregivers and elderly were 39.94±1.32 and 74.44±3.17 years, respectively. The age of caregivers ranged 20-74 years and the age of the elderly ranged 60-89 years. The mean resilience score of caregivers was 49.40±13.07, which is low. There was a significant relationship between resilience score and educational level (P<0.05), marital status (P<0.001) and employment status of family caregivers (P<0.05). The correlation between resilience and caregiver’s age (r=0.17) and elderly’s age (r=0.13) was positive, but weak.

Family caregivers of the elderly in Mashhad city have low resilience. Their educational level, employment status, and marital status are related to their resilience level. Attention to these factors can help health care providers to develop plans for increasing their resilience and improving the quality of life of the elderly.