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Nursing and Midwifery Studies - Volume:6 Issue: 2, Apr-Jun 2017

Nursing and Midwifery Studies
Volume:6 Issue: 2, Apr-Jun 2017

  • تاریخ انتشار: 1396/03/30
  • تعداد عناوین: 13
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  • Mahdi Shamali, Atye Babaii *, Mohammad Abbasinia, Mohsen Shahriari, Mohammad Akbari Kaji, Kim Oren Gradel Page 1
    Background
    Due to the frequency and risks associated with endotracheal suctioning, there is a need to examine clinical practice critically and identify clinical research to guide practice. Correct technique and preparation by the clinicians can assist to reduce the risks of adverse events and the level of discomfort for the patients..
    Objectives
    The current study aimed to investigate the effects of routine versus the minimally invasive endotracheal tube suctioning procedure on suction-related pain, airway clearance and airway trauma in patients who were intubated..
    Methods
    In this randomized clinical trial, 64 patients with intubation in the intensive care units (ICUs) of Alzahra Hospital, Isfahan, Iran, were randomly allocated to minimally invasive endotracheal tube suctioning (MIETS) and routine endotracheal tube suctioning (RETS) groups. Pain intensity was assessed immediately before, immediately after and 10 minutes after endotracheal tube suctioning (ETS). Airway clearance was defined by numbers of suctioning and airway trauma noted after suctioning. The Chi-square test, independent T-test, and repeated measures analysis of variance were performed to analyze the data..
    Results
    There was no significant difference in the number of suctions needed to effectively clear airway between the two groups. No significant differences were observed in the pain score changes during the three -time measurements in the MIETS group. However, in the RETS group the increase of pain scores were statistically significant during the three- time measurements. In addition, the number of airway traumatization was significantly higher in the RETS group. The number of medications used as a pain relief during 10 minutes after the ETS was significantly higher in the RETS group..
    Conclusions
    The results of the study suggest that using MIETS instead of RETS caused a lower incidence of airway traumatization and lower suction-related pain intensity. In addition, MIETS was sufficiently effective, the same as RETS, to remove airway secretions. Hence, MIETS may be useful to reduce the complications of ETS as long as being effective to remove airway secretions..
    Keywords: Suction, Pain, Nurses, Intensive Care Units
  • Robab Latifnejad Roudsari, Mahboobeh Rasoulzadeh Bidgoli * Page 2
    Background
    Infertility is a global problem which affects interpersonal and social relationships and threatens marital life of infertile couples. Females with infertility experiences less marital satisfaction than infertile males..
    Objectives
    The present study aimed to examine the effect of collaborative infertility counseling on marital satisfaction in females with infertility, undergoing in-vitro fertilization in Mashhad, Iran..
    Methods
    In this clinical trial, 60 females with primary infertility were selected from Montaserieh infertility research center and randomly allocated into the intervention (n = 29) and control (n = 31) groups. The intervention group received individual counseling, based on the collaborative reproductive healthcare model with collaboration of a midwife, a gynecologist and a clinical psychologist in five sessions during a two-month period. The control group received routine care. Marital satisfaction was evaluated at the beginning of the study and at the day of embryo transfer, using the Hudson index of marital satisfaction. Data were analyzed using statistical tests including independent and paired-samples T-tests..
    Results
    The baseline mean marital satisfaction score of the intervention group was 24.78 ± 13.20 and changed to 22.86 ± 15.01 after the intervention; therefore, the mean difference between the groups was significant (P = 0.027)..
    Conclusions
    Collaborative infertility counseling increased marital satisfaction in females undergoing in vitro fertilization. Therefore, this method can be used to improve the marital satisfaction of females with infertility..
    Keywords: Infertility, Collaborative Counseling, Marital Satisfaction, In-Vitro Fertilization
  • Reza Ghanei Gheshlagh, Abbas Ebadi, Asghar Dalvandi, Mehdi Rezaei, Kian Nourozi Tabrizi * Page 3
    Context: Considering the high prevalence of psychological distresses among patients with chronic physical diseases, the question is why do some of these patients not experience any disorders and cope better with their disease?.
    Objectives
    The current study aims at reviewing the researches on resilience in adult patients with chronic diseases..
    Data Source: In the present systematic review, articles published in English on resilience from March 2000 to July 2015 were searched using the keywords: Resilience OR Resiliency AND Illness OR Disease OR Chronic Disease in databases such as Google Scholar, Science Direct, PubMed, PreQuest, Scopus, and PsycINFO..
    Study Selection: The process of screening and the initial selection of articles were based on systematic reviews and meta-analyses (PRISMA) guidelines. The methodological quality of the articles was studied using a modified version of quality of life index form. Eventually, 17 qualified studies were selected for the review..
    Data Extraction: The form used to extract information included the variables of the first author of the article, the publication year, the place of the study, the type of the study, sample size, the data collecting instruments, and the most important findings..
    Results
    The results included resilience outcomes, protective factors and resilience-related risk factors. Psychological distresses were the most common risk factors, and self-efficacy and adaptive coping constituted the most common resilience-related protective factors. The findings showed that the protective factors, by mediating risk factors, resulted in positive outcomes such as proper treatment adhesion, better quality of life, psychological well-being, and self-care behaviors..
    Conclusions
    Resilience is a balance between risk factors and protective factors, and it develops or disappears through changes in the protective and risk factors. Patients with high resilience tend to enhance their protective factors and manage their everyday life in spite of disease-related limitations..
    Keywords: Resilience, Risk Factors, Protective Factors, Chronic Physical Disease
  • Azam Bagheri, Masoumeh Simbar *, Mansoureh Samimi, Fatemeh Nahidi, Hamid Alavi Majd, Narges Eskandari, Fateme Abbaszadeh Page 4
    Context: Pregnant women’s have access to different models of care especially to those who provide continuous care and this is one of the recommendations of the world health organization (WHO) for promoting maternal health. Moreover, to provide adequate services in care models, the experiences and perceptions of mothers, providers of prenatal care, and other stakeholders should be taken into consideration..
    Objectives
    A systematic meta-synthesis was carried out to inquire into the findings of some qualitative studies aimed to explore the concept and dimensions of continuous midwifery care including experiences, perspectives and perceptions of engaged people..
    Data Sources: This study was the first step of an action research designed to develop a midwifery model of care. Qualitative research articles published between 2005 and 2015 on experiences, attitudes, expectations and opinions of stakeholders in models of midwifery care were collected from Google scholar, Elsevier, and PubMed databases..
    Study Selection: Following the various stages of the scrutiny of the abstracts and contents of the collected articles, five faculty members finally selected 21 qualitative research articles as eligible for inclusion in the meta-synthesis..
    Results
    The findings of meta-synthesis showed that continuous midwifery care for pregnant women as a highly important process revolves around at least five basic themes: continuity of care, compliance with needs satisfaction levels, regulation of care environment, and the philosophy of providing continuous care..
    Conclusions
    Given the importance of access to healthcare as a right for pregnant women and given the key role of continuous midwifery care in health promotion and maternal satisfaction, it is suggested based on the results of the study that rigorous local and national research in this area to be carried out so that adequate models of continuous midwifery care can be designed and implemented based on the findings..
    Keywords: Midwife-Led Care, Continuity of Care, Midwifery, Continuum of Care
  • Nayyereh Davoudi, Nahid Dehghan Nayeri *, Afsaneh Raiesifar, Sarieh Poortaghi, Shamsi Ahmadian Page 5
    Context: Theoretical sampling is the hallmark of grounded theory methodology, but there seems to be little information accessible to researchers regarding process and guidance concerning theoretical sampling. The current study aimed to have a comprehensive and thorough review of the related studies on theoretical sampling and examine definitions, challenges, differences and applicable tips about this type of sampling to provide a comprehensive and clear picture of the sampling process and its probable challenges as well as explaining its practical aspects..
    Objectives
    The ultimate goal of all the explorations is to provide practical sources for researchers to answer their questions about theoretical sampling..
    Data Sources: Databases such as ProQuest, Scopus, Pubmed, Science Direct, Wiley, Ovid, Google Scholar, and also Magiran, SID and Iran Medex (Persian databases) were searched from 1967 to 2015 using keywords of theoretical sampling and qualitative sampling..
    Study Selection: A total of 562 Persian and English studies were found. According to the inclusion and exclusion criteria thirty articles and nine books were examined thoroughly..
    Data Extraction: The narrative literature review was used as the most appropriate method to manage the data..
    Results
    Definitions and characteristics of theoretical sampling; theoretical sampling of data archive; the difference between theoretical, purposeful and selective sampling; saturation and credibility in theoretical sampling were discussed in results..
    Conclusions
    The current study indicated disagreements about some theoretical definitions and operational applications of theoretical sampling; however, the general consensus was that researchers explicated the decision making process in detail. Researchers should justify the selection and the sequence of sampling process to explain the complicated process of analytical abstraction and theory development by empirical data. Hence, the credibility of their theory and research is enhanced..
    Keywords: Theoretical Sampling, Qualitative Sampling, Qualitative Research, Qualitative Method, Grounded Theory
  • Nastaran Mirfarhadi, Atefeh Ghanbari *, Malahat Khalili, Abbas Rahimi Page 6
    Background
    The growing trend of breast cancer in Iran and the adverse consequences arising from the delay in diagnosis and treatment in females has been a challenge..
    Objectives
    This study was conducted to identify the predictors for diagnosis and treatment delay in females with breast cancer in the north of Iran..
    Methods
    This cross-sectional study was performed on 232 patients with a definite diagnosis of breast cancer at Razi Hospital, which is the main referral centre in Guilan Province, Iran, using sequential sampling methods. Data were collected using a six-section questionnaire through interviews and medical records of the patients. Data were analyzed using descriptive statistics, logistic regression and chi square test..
    Results
    Delays of more than one month was observed in 53% of patients and more than three months delay was observed in 31%. Of the patients with a definite diagnosis of breast cancer, 87% returned within seven days for treatment interventions. Three variables of: stage of disease (stage II: P = 0.002, OR = 7.19 and stage III: P = 0.034, OR = 1.95), lack of complementary insurance (P = 0.007, OR = 2.26) and primary insurance (P = 0.067, OR = 3.52) were important risk factors for patient delay. Knowledge and attitude regarding the symptoms of breast cancer (P = 0.007), the most important method for breast cancer diagnosis (P = 0.004), and the importance of self-examination was significantly different between patients with and without delay in the onset of treatment..
    Conclusions
    This study showed that about one-third of patients with breast cancer had a patient delay of more than three months. In addition, 16.8% and 13% of patients experienced system delay in diagnosis and treatment, respectively. The government is responsible to not only teach people on the signs of breast cancer, but also to establish a powerful screening system for breast cancer..
    Keywords: Breast Neoplasm, Delay Treatment, Diagnosis, Iran, Female
  • Reza Yazdanimehr, Abdollah Omidi *, Hossein Akbari, Zohreh Sadat Page 7
    Background
    The pregnancy period is associated with a variety of physical and psychological changes, which can affect the females’ quality of life (QOL)..
    Objectives
    The current study aimed to examine the effect of mindfulness training on QOL among pregnant females..
    Methods
    In this clinical trial, 80 pregnant females eligible for inclusion were selected by convenience sampling method from Akramian, Taleghani and Ketabchi health centers in Kashan, Iran. The participants were randomly allocated into experimental and control groups (n = 40, each group) by block randomization method. Females in the experimental group received eight sessions of 90-minute mindfulness training, while females in the control group only received routine prenatal care services. Data were collected using a demographic questionnaire and a short-form 36 (SF-36) health survey questionnaire to measure the QOL. Chi-square, independent samples T-test and repeated measures analysis of variance were used to analyze the data..
    Results
    The results showed that the total QOL score and subscales of emotional role functioning, vitality, mental health, social functioning and general health in the experimental group had significant changes compared to those of the control group. However, there was no significant difference between other subscales. The mean total QOL score before intervention was 44.84 ± 4.44 and after intervention and follow-up was 50.42 ± 3.71 and 49.42 ± 5.24, respectively (P
    Conclusions
    Mindfulness training can be used as a psychological prenatal care to moderate negative emotions, improve social functioning and cope with psychological and physical changes..
    Keywords: Mindfulness, Quality of Life, Pregnant Females
  • Sima Goudarzian, Nikoo Yamani, Masoud Amini, Parvaneh Abazari * Page 8
    Background
    The first step to establish a new academic major is the need assessment and extraction of professional and specialized tasks..
    Objectives
    The current study aimed to identify and describe the duties of diabetes nurse specialists..
    Methods
    This needs assessment study was performed using modified Delphi technique in Isfahan in 2014 - 2015. The study population consisted of patients with diabetes and their families, nurses, endocrinologists, diabetologists and nursing faculty members. The study was conducted in three rounds: first, through qualitative interviews and focus group discussions, the duties and tasks of diabetes nurse specialists were extracted, then a questionnaire was designed and in two consecutive rounds, the experts expressed their opinions about the tasks..
    Results
    The first round of modified Delphi technique resulted in 500 initial codes. According to these codes, 164 duties were classified into seven categories. In the second round of Delphi approach, the experts reached to 100% consensus in 126 tasks. According to the participants, 74 of the 126 duties were similar, overlapping and inappropriate, and thus were eliminated. In the last round of the study according to the opinions of the experts, 15 more tasks were added to the previous list. Finally, job description for diabetes nurse specialist was developed in six tasks on professional responsibilities, 17 tasks on the area of education, 25 tasks regarding caring and treatment, 6 tasks on society and 13 tasks on management..
    Conclusions
    This study led to identification and classification of diabetes nurse specialist duties. The findings can help nursing faculties and other institutes to develop task based educational programs for nurses in diabetes management..
    Keywords: Delphi Technique, Nurse Specialist, Diabetes Mellitus, Professional Role, Iran
  • Mohsen Salavati, Zahra Khalili, Seyed Reza Borzou *, Maryam Malmir, Saeed Musavi, Shahram Homayonfar Page 9
    Background
    Patients in cardiac care unit (CCU) have some degree of sleep disorders that may consequently increase the risk of dysrhythmia in these patients..
    Objectives
    This study aimed to investigate the effect of sleep hygiene on the incidence of cardiac dysrhythmia in patients with myocardial infarction (MI) hospitalized in CCUs..
    Methods
    In this randomized controlled trial, 62 patients with MI who lacked sleep disorders before admission were assessed using the Pittsburgh sleep quality index and a researcher-made sleep hygiene questionnaire. The patients were selected consecutively and then randomly allocated into the intervention and control groups to either receive the sleep hygiene training or routine care. All patients were under the cardiac monitoring on the second and third days of their hospitalization. Then, the number of PVCs and PACs was recorded during a 6-hour period in these two days. Data were analyzed by chi-square test, independent samples t-test, and Paired t-test..
    Results
    On the third day, the number of PVC (2.06 ± 0.04) and PAC (0.87 ± 0.02) was significantly less in the intervention group than the control group (4.45 ± 3.71 and 2.68 ± 2.53, respectively) (P
    Conclusions
    Performing sleep hygiene principles can reduce the incidence of dysrhythmia after MI. Therefore, nurses can use sleep hygiene practices in combination with other treatments to reduce the incidence of dysrhythmia after MI..
    Keywords: Sleep, Hygiene, Cardiac Dysrhythmia, Myocardial Infarction, Patients
  • Maryam Sedaghati Kesbakhi, Camelia Rohani *, Jamileh Mohtashami, Malihe Nasiri Page 10
    Background
    Empathy is essential in the process of nurse-patient relationships in oncology wards. The lack of a rigorous tool to measure empathy in oncology nurses makes the research difficult..
    Objectives
    Modifying a Persian translation of the Jefferson scale of empathy to create an Iranian version of the Jefferson scale of empathy-nursing student version R (JSE-NS version R), and to determine its validity and reliability in oncology nurses of Tehran Universities of Medical Sciences..
    Methods
    This is a methodological study with cross-sectional design, conducted in 2015. The translation and modification process was conducted according to the World Health Organization guidelines and an Iranian version of the scale was created. Different types of validity, including face and content validity together with construct and convergent validity were assessed. Construct validity was evaluated in a convenience sample of oncology nurses (n = 181) through confirmatory (CFA) and exploratory factor analysis (EFA). By correlation assessment between the total score of the JSE-NS version R and the subscales of the interpersonal reactivity index (IRI), convergent validity was tested. Reliability was ascertained by assessing the internal consistency and stability of the scale. The data were analyzed using SPSS-13 and LISREL 8.8..
    Results
    Face and content validity of the scale was confirmed by an expert panel. The initial CFA did not show a three-factor structure of empathy, thus an EFA was run and a four-factor model with a grand factor was extracted. Subsequently, the results of the final CFA confirmed acceptable goodness of fit indices for the four-factor structure of empathy, and the scale explained 63% of variances in the data. Convergent validity showed a significant correlation between the total score of the scale and most subscales of the IRI (P
    Conclusions
    The Iranian version of the Jefferson scale of empathy-NS version R is a psychometrically sound instrument, implying that it is suitable for measurement of empathy in oncology nurses..
    Keywords: Psychometrics, Empathy, Factor Analysis, Nurses
  • Mehran Tahrekhani, Heidar Ali Abedi * Page 11
    Background
    Brain death crisis as an overwhelming situation can create a critical state for families in which they are unable to make logical decisions for their patients with brain death..
    Objectives
    This study aimed to explore the experiences of family members of patients with brain death, who did not donate their patients’ organs..
    Methods
    A qualitative study was conducted on nine non-donor family members of patients with brain death, selected using the purposeful sampling method. To collect data, deep unstructured interviews were held to reach data saturation. The interviews were transcribed verbatim and analyzed utilizing the phenomenology approach based on the seven-step Colaizzi’s method..
    Results
    The participants of this study explained their situation as ‘an overwhelming situation in families due to patients’ brain death’. Also, the data analysis led to the development of four main themes as follow: ‘overwhelming situation’, ‘perplexity factors’, ‘the sling loops of defect in consent for organ donation’, and ‘compatibility’..
    Conclusions
    The overwhelming effects of the patients’ brain death on the family members and the crisis rising from it influenced the decisions made by family members for organ donation. Therefore, some measures should be taken to cultivate appropriate adaptive behaviors among family members for relieving their sorrow and pain. Moreover, healthcare team members should be informed of the crisis raised from patient’s brain death and help family members make logical decisions with regards to organ donation..
    Keywords: Life Experiences, Family Members, Brain Death, Organ Donation
  • Hassan Babamohamadi, Ali Fakhr-Movahedi, Mohsen Soleimani, Alireza Emadi * Page 12
    Background
    Promoting critical thinking skills is an essential outcome of undergraduate and postgraduate nursing education..
    Objectives
    The current study aims at comparing critical thinking skills of bachelor students of nursing (BSc) and master’s students of critical care nursing (MSc) in the academic year 2014 - 2015..
    Methods
    The current cross-sectional study was conducted on 79 BSc students of nursing and 44 MSc students of critical care nursing in 3 universities of medical sciences including Semnan, Tehran, and Kashan. The California critical thinking test, form B, was used for data collection. Analysis of variance Mann-Whitney, and Kruskal-Wallis tests were used for statistical analyses..
    Results
    The mean scores of BS and MSc nursing students were 11.14 ± 3.01 and 10.05 ± 3.33, respectively, which were not significantly different. The mean scores of students in Semnan, Tehran, and Kashan universities of medical sciences were 9.84 ± 3.13, 9.66 ± 3.32, and 11.79 ± 2.92, respectively, and the total mean score was 10.46 ± 3.24. The scores of critical thinking domains showed that students in Kashan University gained higher scores in interference, and deductive and inductive reasoning domains compared with the students in other universities..
    Conclusions
    The level of critical thinking in BSc students was higher. The overall level of critical thinking skills was low in nursing students. It is suggested that appropriate and effective methods should be employed to create and improve critical thinking in nursing education.
    Keywords: Critical Thinking, Nursing Students, Education, Nursing
  • Farahnaz Abdollahzadeh, Elnaz Asghari *, Leila Doshmangir, Hadi Hasankhani, Maryam Vahidi Page 13
    Background
    Incivility is a prevalent and on rise, but yet vague problem in healthcare settings..
    Objectives
    This study aimed to explore the perception of nurses about workplace incivility via description of actual experiences..
    Methods
    This is a qualitative study with a content analysis approach. Participants were 34 nurses selected through purposive sampling. The data was collected using semi-structured interviews and field notes in training hospitals in Iran. The rigor of the study was established by principles of credibility, transferability, dependability, and confirmability..
    Results
    Data analysis resulted in 975 codes. The classification of the codes resulted in 3 themes. Missed ring in system, working in the shadow of fear, and being scapegoats are the main features to describe the meaning of workplace incivility from the nurses’ perspective..
    Conclusions
    The finding provided basic information to understand the meaning of incivility. Based on the finding, invisibility, unsafe environment, and the carelessness of the other personnel may be perceived as incivility..
    Keywords: Workplace, Violence, Nurses, Qualitative Research, Iran