فهرست مطالب raziyeh beykmirza

The purpose of this integrative literature review was to find, critically evaluate, and describe publications about barriers against nurse participation and collaboration in multidisciplinary ward rounds. Although multidisciplinary ward rounds are the right place for doctors and nurses to communicate, nurses’ attendance in these rounds is missed. The nurses' absence at the multidisciplinary ward rounding has apparent negative effects on the patients, their relatives, other team members, and patients’ care.

A systematic approach to searching, screening, and analyzing the literature was applied. The original and review papers were used. This study was an integrative review based on Whittemore and Knafl’s framework. Web of Science, PubMed, Scopus, Cochrane, Magiran, and SID were searched by time limitation for ten years (2009-2019). The search was conducted between February 2019–March 2019. The language was limited to English and Persian.

After duplicate removal, title, and abstract review, 63 papers remained. After full-text control, finally, 7 papers chased for this review. Barriers for rounding were divided into 4 main categories: time limitation, reluctance to participate, ineffective communication, and infrastructure & administration. Nurse time limitation, feeling not being valued by MDs, lack of standard and structure, and nurse unawareness from time of round are the most repeated barriers. 

Barriers may need to be removed until nurse participation in multidisciplinary ward rounds improves. Some study needs to take place about this issue in Iran to identify the situation, facilitators, and barriers specific to our country. Based on them, a relevant intervention can be chased.

Effective communication with the patients and engaging patients in decision-making and care planning are necessary to improve health outcomes and satisfaction with the treatment. Communicating effectively can help prevent and manage complications following the treatment of cancer. Therefore, this study aimed to describe and explain cancer patients’ communication facilitators' experiences between patients and nurses.

This is a qualitative conventional content analysis study. The study was conducted on 22 cancer patients who were selected based on a purposeful sampling approach. Semi-structured interviews were performed to collect the data. The data were then analyzed using conventional content analysis. Also, the Lincoln and Guba criteria were used to measure the trustworthiness of the data.

The researchers have identified the main theme as “humanitarian care”. Besides, five categories of “good-naturedness”, “empathy”, “patience”, “confidentiality”, and “honesty” were also extracted from 18 subcategories.

Effective nurse-patient communication facilitates patients’ healing, enhances clinical outcomes and improves patients’ response to treatment. Hence, these ethical features need to be reinforced among nurses.

Proper recording of the nursing report indicates the nurse’s optimal clinical performance and compliance with the standards. Nanda Nursing Diagnosis is one of the most important and widely used international standard terms for recording nursing care. The aim of this study was to determine the degree of compliance and frequency of nursing diagnoses registered in the pediatric oncology department with the statements of nursing diagnoses of the Nanda classification system.

In this descriptive study, the nursing reports recorded in the files of children hospitalized in the pediatric oncology wards of two hospitals affiliated to Shahid Beheshti University of Medical Sciences in the first quarter of 2016, were reviewed. Sampling was done by the census method for 3 consecutive months. Overall, 86 files and 3701 nursing reports were reviewed. Nurseschr('39') documentation was analyzed through the manifest content analysis. The obtained expressions were adapted to the nursing diagnoses of the Nanda classification system and the degree of adaptation and frequency of nursing diagnoses were determined.

The overall compliance between the diagnoses extracted from the nursing reports and the Nanda nursing diagnoses was 14.7%. The most frequent nursing diagnoses were diagnoses related to safety/protection classification with a frequency of 47.95%, followed by diagnoses related to nutrition classification with a frequency of 24.42% and finally a frequency of 12.8% for nursing diagnoses related to comfort classification.

The findings of the present study indicated the low levels of compliance with the Nanda nursing diagnoses and nursing process in the nursing reports. Therefore, practical training is suggested to increase nurseschr('39') knowledge and motivation to apply Nanda nursing diagnoses.

The validity of the findings of the Systematic Review (SR) depends on the methodological quality of the individual studies in which they are included.  Therefore, evaluating the validity of the included studies is an integral component of a systematic review (1).  Bias or systematic error either exaggerates or underestimates the 'true' effect of an intervention or exposure. Typically, four sources for systematic error, including Selection bias, Performance bias, Attrition bias, and Detection bias, are considered in this assessment.

Stoma in children causes physiological and psychological changes and reduces self-esteem and quality of life. The aim of study is to determine the effectiveness of self-care skills training on self-esteem and quality of life in 8-12 year old children with stoma.
Methods & Materials: This study is a non-randomized clinical trial with pretest and posttest design, performed in selected hospitals (Mofid, Hazrat Ali Asghar and Medical Center) in Tehran in 2016-17. A total of 36 children aged 12-8 years with stoma, were selected using the convenience sampling method and divided into two groups of intervention (n=18) and control (n=18). Self-care skills training was performed in six sessions of 45 minutes for the intervention group. The control group received routine care. The Cooper Smith questionnaire and the Kindle quality of life questionnaire were used in this study. Data were analyzed by descriptive and inferential statistics using the SPSS software version 16. The repeated measures analysis of variance showed a significant difference in the quality of life score means over time (P<0.005) and between the two groups of intervention and control (P<0.015). Also, there was a significant difference in the self-esteem score means over time (P=0.004) and between the intervention and control groups (P=0.004). Self-care skills training for 8-12 year-old children with stoma, has increased their self-esteem and quality of life. Therefore, nurses can use self-care skills training for similar patients. Clinical trial registry: IRCT20160802029166N2

one of the dimensions of family-oriented care is enhancing the adequacy and empowerment of the family, and respecting their autonomy and decision-making in child care and treatment. The studies indicate that providing support and information for the parents in the hospital environment during child care, notifying parents about the treatment plan, educating them and using their participation are the most important needs of the parents. This requires the supportive educational relationship of personnel, especially nurses with parents (3). However, there are many situations in nursing care that, if nurses are unaware or negligent, this patient’s fundamental right will be violated. In this article, we will examine these factors and the findings of the studies conducted in this area.
The study of Beykmirza et al (2017) revealed that among the nursing ethical codes, the domain of respect for autonomy and decision making from the perspective of mothers with a child with cancer was at the most unfavorable level of performance. In this study, nurses also acknowledged that they presented poor performance in this domain (4). These findings support the results of other studies on the contentment of parents of children with cancer with giving them the right to make decisions (5, 6). The findings from these studies may indicate the nurses’ lack of knowledge about patient rights and the need for values-based practice. The health system in Iran is mainly far from the concept of patient and family orientation and giving decision-making rights on the basis of sufficient information. This is due to several reasons, such as lack of sufficient information from health care professionals, including doctors and nurses, about patient rights, having a stereotypical view about the lack of preparedness and competency of families to obtain information, the lack of a caring communication between the patient’s family and caregivers along with empathy and attempt for empowerment, the high workload of professionals and in turn, assigning less time to the functions that include the non-physical aspects of patient and his or her family, as well as the lack of familiarity with professional ethics.
It seems that most nurses’ beliefs is that if they give the families of children with cancer the right to autonomy in treatment, health and nursing interventions, they may face the families’ irrational decisions. So, respecting this right is overlooked (7, 8). From their point of views, for example, if the families are familiar with the side effects of drugs, even if that drug is helpful to the physician, they may refrain from continuing treatment with that medication. Perhaps this is also the reason for the weakness in nurses’ performance in the area of patient education. A study by Bartholdson et al. (2015) in Sweden showed the most ethical issues in pediatric cancer care were due to the violation of the patient’s right to autonomy, limitation in reflecting facts, how to decide on the process of treatment and palliative care. Given the different perspectives and cultures, the degree of collaboration between the treatment team, the child with cancer and her/his family is challenged (9).
The results of the study of Rahmani et al. indicated that most patients believed that nurses were at a poor level in respecting their autonomy in terms of providing information to them and their participation in the therapeutic decision-making process. In addition, Sadeghi’s study (2009), entitled "respecting autonomy during nursing care from the perspectives of adolescents admitted to children’s hospitals affiliated to Tehran University of Medical Sciences in 2008 showed that 66.7 percent of adolescents believed that their autonomy was slightly respected, and only 4 percent of them stated that their autonomy was fully respected. In the similar studies, the lack of sufficient time, insufficient personnel, and lack of readiness and experience of nurses to provide illness-related information and to give the right to autonomy and decision making to the family, were suggested as three important factors in nurses’ neglect in this regard (10, 11).