shirmohammad davoodvand

Chronic fatigue and decreased quality of life are complications of COVID-19. This study aimed to determine the impact of the continuous care model implementation on fatigue and quality of life of patients with COVID-19.

This semi-experimental study was conducted with pre-test and post-test design in Shahrekord, Iran, 2022. The study was conducted on 80 patients with COVID-19 who were hospitalized at Hajer hospital in Shahrekord and Seyed al-Shohda hospital in Farsan. They entered the study by convenient sampling and were randomly assigned to intervention and control groups using cards. The continuous care model was implemented in 4 stages for the intervention group for three months. Data were gathered using the demographic data questionnaire, Krupp et al.’s fatigue intensity questionnaire (1989), and St. George’s Quality of Life Questionnaire (SGRQ) (1991), then analyzed with SPSS19 software.

Before the intervention, both groups had no statistically significant difference between fatigue intensity (P=0.65) and quality of life (P=0.47). The fatigue intensity immediately after the intervention and three months later in the intervention group was significantly lower than in the control group (P<0.001). The quality of life immediately after the intervention and three months later in the intervention group was significantly higher than the control group (P<0.001).

Considering the effectiveness of the continuous care model in COVID-19 complications, it is recommended that healthcare professionals train and use it to take care of these patients and in similar cases.

Professional commitment and moral courage affect the quality of nursing care. Assertiveness is a necessary communication skill for nurses. The studies have less focused on the relationship between the mentioned variables. Therefore, this study examined the impact of assertiveness-based empowerment on professional commitment and moral courage.

This quasi-experimental study was conducted on 70 nurses of Shahrekord educational hospitals who entered the study via available sampling and random allocation in intervention and control groups in 2021. Then, the assertiveness-based program was implemented in six 2-hour sessions for the intervention group. In both groups, data were collected before, immediately, and three months after the intervention using the Nurses’ Professional Commitment Standard questionnaire (NPCS) and Sekerka’s moral courage. The data was analyzed using SPSS software version 18. One sample t-test, chi-square, and repeated measurements analysis were used.

Before the study, neither group showed significant differences in demographic data, professional commitment, and moral courage (P > 0.05). However, this difference was significant immediately after the intervention and three months later (P < 0.001).

The empowerment program based on assertiveness improved nurses’ professional commitment and moral courage. Therefore, it is appropriate to use these moral virtues in the professional training of nurses to provide high-quality care to patients.

Clinical environment is a significant component in relation to students' learning. Exposure to the challenges of the clinical learning environment has some consequences for students and can affect their learning. Identifying these consequences will moderate the challenges, and therefore, improve the quality of learning in such environments. The present study aimed to explain the consequences of exposure to clinical learning challenges among operating room students.

This study was conducted based on the qualitative content analysis approach at Shahrekord University of Medical Sciences, Shahrekord, Iran, in 2022. A total of 14 surgical technology students were selected by a purposeful sampling method. The required data were collected using in-depth, semi-structured face-to-face interviews. The data were analyzed using Graneheim and Lundman's approach.

The results of the study revealed two categories (i.e., learning distress and using harmful clinical shortcuts) and four subcategories (i.e., feeling of helplessness in learning, anxiety, incomplete care, and wrong modeling). Under the conditions and challenges in the learning environment, students felt helpless toward learning, experienced anxiety, and suffered from learning distress. It was also found that in the clinical learning atmosphere, when faced with the existing challenges, the students would be likely to facilitate the care process and attempt to do unprincipled care by imitating the wrong personnel examples.

Faced with the learning challenges of the clinical environment, the operating room students suffered from learning stress and resorted to harmful clinical shortcuts. Examining students' anxiety and their disappointment and helplessness toward the conditions and challenges of clinical education, identifying clinical wrong patterns in the care process, as well as modifying the care process provided by the personnel as wrong role models of students can have an effective impact in reducing the existing consequences.

The use of massage as a safe method to control and manage complications after major surgery is recommended.

This study aimed to determine the effect of this method on arterial blood oxygen saturation and temperature changes in patients after abdominal and thoracic surgery.

This quasi-experimental study was conducted on 60 patients undergoing surgery in Shahrekord city in 2019. They were enrolled in the study by convenience sampling and assigned to the intervention and control groups by the blocking method. In the intervention group, a hand and foot massage was performed at 5-minute intervals for 4 sessions on each patient’s limb 3 times a day. The control group received routine care. Data were collected by a demographic questionnaire, pulse-oximetry, and thermometer. They were analyzed using SPSS version 16 and descriptive and inferential statistical tests (t-test, paired t-test, and analysis of variance (ANOVA)).

The mean arterial blood oxygen saturation in the groups after the intervention did not show a significant difference compared to before (P = 0.95), but its mean was significantly higher in the intervention group after the intervention than before (P < 0.001). The mean temperature in the 2 groups after the intervention did not show a significant difference compared to before (P = 0.38), but the changes in the mean were significant in the massage group after the intervention compared to before (P = 0.019).

The hand and foot massage can be used by nurses along with the required medical care to improve arterial blood oxygen saturation and reduce body temperature. Further research in this area is suggested.

 Multiple sclerosis (MS) is one of the most common progressive neurological diseases in young people. Tremor is a common and debilitating symptom in people with MS, significantly affecting their quality of life. This study aimed to evaluate the effect of a self-care program based on a mobile application on tremors in people with MS.

 This semi-experimental study was conducted on 72 patients with MS in Chaharmahal and Bakhtiari province in 2019. Samples were selected by convenience sampling and randomly assigned to intervention and control groups (36 people in each group). For the intervention group, a self-care program in the form of a mobile application was installed on their mobile phones and, for two months, used by patients. The use of the program was measured using self-report checklists and telephone tracking. The control group receives routine intervention only. Data were collected before and two months after the intervention using the Fahn-Tolosa-Marin Tremor Rating Scale and analyzed using SPSS software version 21 and descriptive and inferential statistics (chi-square, independent t test, and paired t test).

 There was no statistically significant difference between the two groups in the mean tremor score before the intervention (P=0.768). However, after the intervention, this difference was significant (P=0.022).

 According to the findings, teaching a self-care program through a mobile application effectively improves the tremor of patients with MS and can be considered an effective intervention method.

Surgery is a main treatment for some illnesses. Postoperative pain (POP) is a major postoperative concern for patients and healthcare providers. The present study aimed at comparing the effects of cold therapy and foot and hand massage on POP among patients with major surgeries.

This quality improvement study was conducted in 2019 on ninety patients who underwent thoracoabdominal surgeries in Kashani teaching hospital, Shahrekord, Iran. Participants were randomly assigned to a control, a cold therapy, and a foot and hand massage group through block randomization with a block size of six. Participants in the control group received routine care services, while participants in the cold therapy group received twenty-minute local cold therapy three times a day for 48 hours and participants in the massage group received twenty-minute hand and foot massage three times a day for 48 hours. POP was assessed before and 48 hours after the study intervention using the McGill Pain Questionnaire. The SPSS software was used to analyze the data through the Kolmogorov-Smirnov, Fisher’s exact, chi-square, Kruskal- Wallis, paired-sample t, and Wilcoxon’s sign-ranked tests as well as the one-way analysis of variance.

There was no significant difference among the groups respecting the pretest mean score of POP (P > 0.05). The mean score of POP significantly decreased in all groups (P < 0.05) and the amount of decrease in the intervention groups was significantly more than the control group (P < 0.05).

Cold therapy and foot and hand massage are effective in significantly reducing POP among patients with major thoracoabdominal surgeries.

Postoperative complications can endanger the patient's life and disrupt the recovery process if not properly managed. Local cold therapy can be a safe non-pharmacologic method to manage these side effects; however, it has not been highly considered.

This study was done to determine the effect of local cold therapy on arterial blood oxygen saturation and temperature changes in patients undergoing surgery.

This quasi-experimental study was performed at Shahrekord University of Medical Sciences in 2019 on 60 patients undergoing thoracic and abdominal surgery selected by convenience sampling, and they were randomly assigned to the intervention and control groups. The intervention (local cold therapy) was performed for 48 hours after full consciousness, three times a day for 20 minutes to the intervention group. Data were collected before and after the intervention using a demographic questionnaire, pulse oximetry device, and thermometer. The data were analyzed based on the independent samples t-test, paired-samples t-test, and chi-square and Fishers’ exact tests by SPSS version 20 software.

The mean arterial blood oxygen saturation percentage (O2Sat%) during the intervention significantly increased in both groups (P < 0.05), but the rate of increase was significantly higher in the local cold group (P < 0.05). The results of within-group research showed that the mean temperature had significant differences in the local cold therapy group (P < 0.05), but the mean body temperature did not show a significant difference between the two groups (P < 0.05).

Local cold therapy can be effectively trained and used by nurses to improve the O2Sat%. It did not affect postoperative body temperature. Further studies must be conducted to investigate the effects of local cold therapy on postoperative body temperature changes.

The aim of the present study was to evaluate the effect of a cardiac rehabilitation program using a mobile application on activity tolerance, fatigue, and dyspnea in patients with acute myocardial infarction in hospitals affiliated to Shahrekord University of Medical Sciences, Iran, in 2018.

In a randomized clinical trial study, 100 patients with acute myocardial infarction were selected in two groups of control (50) and test (50). In test group, the application of cardiac rehabilitation with weekly monitoring, medication reminders, tests, exercise, warning in case of shortness of breath and fatigue and chest pain, increase or decrease in blood pressure and heart rate, family education, risk factors, and reducing smoking was implemented for 8 weeks. For the control group, routine hospital trainings were performed. At the end of the rehabilitation program, data related to patients' physical activity scores, fatigue, and shortness of breath were analyzed at the beginning and end of the intervention, as well as between the two groups.

After the intervention, physical activity in the experimental group with a mean of 3.92 ± 1.23 was significantly higher than the control group with the mean of 2.90 ± 1.28 (P < 0.001). Moreover, fatigue and dyspnea in the experimental group with a mean of 3.57 ± 1.15 and 3.48 ± 2.73, respectively, were significantly less than the control group with the mean of 4.02 ± 1.17 and 4.66 ± 3.48, respectively (P < 0.050).

The implementation of cardiac rehabilitation program via mobile application relieved fatigue and dyspnea, and improved activity tolerance in patients with myocardial infarction.

Anxiety is one of the most common psychological problems after myocardial infarction and can lead to many problems in acute coronary syndrome (ACS). Two possible ways to reduce anxiety are to listen to music and to recite the Holy Quran, the effects of which have never been compared to date.

The aim of this study was to compare the effect of listening to instrumental music and listening to Quran recitation on the anxiety level of patients with acute coronary syndrome.

This semi-experimental study was conducted among 96 patients with ACS referred to Hajar Hospital, Shahrekord, Iran, from 3/10/2019 to 4/30/2019. The patients were entered into the study using the convenience sampling method and then randomly assigned to the three groups of Quran recitation, instrumental music, and control. In this study, the patients’ anxiety level was measured using Spielberger’s state-trait anxiety inventory (STAI) before and after listening to Quran recitation and instrumental music. Data were analyzed by SPSS version 16 using descriptive and analytical tests, including paired samples t-test, Chi-square, and one-way ANOVA.

Anxiety level decreased from 43.1 ± 6.15 to 38.5 ± 3.82 in Quran recitation group (P < 0.001) and from 44.2 ± 1.21 to 39.1 ± 4.17 in the instrumental music group (P = 0.035), and from 46.3 ± 3.84 to 44.7 ± 6.21 in the control group (P < 0.001). There was no significant difference between the three groups before the program. However, the mean score of anxiety level showed a significant difference, indicating that listening to Quran recitation had a greater effect than listening to instrumental music in reducing the patients’ anxiety (P = 0.02).

Both interventions can be useful in decreasing the anxiety level of patients with ACS; however, the Holy Quran recitation had a greater effect in this regard.

The operating room environment is considered to be a stressful workplace due to its special conditions. Due to the debilitative effects of occupational stress, the present study aimed to assess and describe occupational stress in operating room staff.

This descriptive-analytical study was conducted using Osipow job stress questionnaire to measure the occupational stress of the operating room staff at the teaching hospitals affiliated to Shahrekord University of Medical Sciences, Iran. The sample size consisted of 120, including operating room technology graduates and anesthesiologists, who were selected via census sampling.

The majority of the participants were married women (mean age: 33.66±6.377 years) with the mean work experience of 10.02±6.259 years. Based on Osipow job stress questionnaire, 71% of the subjects achieved occupational stress scores of 150-199, and the highest level of occupational stress was observed in the physical environment and workload. No significant correlations were observed between occupational stress and age, gender, work experience, marital status, and academic education, while the number of children was correlated with occupational stress (P=0.022).

The level of occupational stress in the operating room staff was moderate to severe, and proper strategies must be adopted for the improvement of their physical work environment and adjustment of their workload.

One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses.
This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis.
Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients’ health, commitment to the completion of the care process, and protection of patient's rights).
The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy.