فهرست مطالب
Journal of Caring Sciences
Volume:2 Issue: 3, Sep 2013
- تاریخ انتشار: 1392/07/05
- تعداد عناوین: 10
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Pages 169-176IntroductionNursing is always accompanied by shift working and nurses in Iran have to work night shifts in some stages of their professional life. Therefore, the present study aimed to describe the novice nurses’ perception of working night shifts.MethodsThe present qualitative study was conducted on 20 novice nurses working in two university hospitals of Jahrom, Iran. The study data were collected through focus group interviews. All the interviews were recorded, transcribed, and analyzed using constant comparative analysis and qualitative content analysis.ResultsThe study findings revealed five major themes of value system, physical and psychological problems, social relationships, organizational problems, and appropriate opportunity.ConclusionThe study presented a deep understanding of the novice nurses’ perception of working night shifts, which can be used by the managers as a basis for organizing health and treatment systems.Keywords: Perception, Nursing, Nursing service Hospital, Night work, Qualitative Research
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Pages 177-185IntroductionFor maintaining the continuity of care and improving the quality of care, effective inter-shift information communication is necessary. Any handover error can endanger patient safety. Despite the importance of shift handover, there is no standard handover protocol in our healthcare settings.MethodsIn this one-group pretest-posttest quasi-experimental study conducted in spring and summer of 2011, we recruited a convenience sample of 56 ICU nurses. The Nurses’ Safe Practice Evaluation Checklist was used for data collection. The Content Validity Index and the inter-rater correlation coefficient of the checklist was 0.92 and 89, respectively. We employed the SPSS 11.5 software and the Mc Nemar and paired-samples t test for data analysis.ResultsStudy findings revealed that nurses’ mean score on the Safe Practice Evaluation Checklist increased significantly from 11.6 (2.7) to 17.0 (1.8) (P < 0.001).Conclusionusing a standard handover protocol for communicating patient’s needs and information improves nurses’ safe practice in the area of basic nursing care.Keywords: Shift handover, patient safety, Intensive care unit, Nursing care
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Pages 187-195IntroductionMany of the patients with Alzheimer disease are taken care of in nursing homes. However the literature on the experiences of Iranian formal caregivers of older adults with Alzheimer disease is scarce. This qualitative study explored the caring experiences of formal caregivers in nursing homes that can improve the quality of care and patient’s quality of life.MethodsThis qualitative study used the principles of descriptive content analysis to analyze these data. Our participants included 11 female and 3 male caregivers aged 25 to 38 years who were selected for interviewing based on a purposive sampling method. The data were analyzed with a content analysis method.ResultsNearly 900 initial codes were extracted and categorized into 6 main themes including «managing difficult behaviors», «dependence on familial care», «continuum of different feelings», «care for a child», «living with the patients» and «not understanding the patients», which was further analyzed in the two subcategories «caring without enough information» and «a dead man moving».ConclusionThe care provided by our informants was mainly influenced by attitudes, culture and religious beliefs of caregivers about family attachment and ample driven reward of helping and caring frail or old people in Islam. These cultural and religious beliefs could facilitate provision of care and confrontation with patients’ child-like behaviors. It is suggested that employment of trained staff and plans for their continued education can improve the quality of care and the quality of the patient''s lifeKeywords: Alzheimer disease, Care experience patient, Nursing homes
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Pages 197-201IntroductionThe patients’ families in intensive care units (ICUs) experience excessive stress which may disrupt their performance in daily life. Empathy is basic to the nursing role and has been found to be associated with improved patient outcomes and greater satisfaction with care in patient and his/her family. However, few studies have investigated the nursing empathy with ICU patients. This study aimed to assess nursing empathy and its relationship with the needs, from the perspective of families of patients in ICU.MethodsIn this cross-sectional study, 418 subjects were selected among families of patients admitted to ICUs in Tabriz, Iran, by convenience sampling, from May to August 2012. Data were collected through Barrett-Lennard Relationship inventory (BLRI) empathy scale and Critical Care Family Needs Intervention (CCFNI) inventories and were analyzed using descriptive and inferential statistical tests.ResultsFindings showed that most of the nurses had high level of empathy to the patients (38.8%). There was also statistically significant relationship between nurses’ empathy and needs of patients’ families (p < 0.001).ConclusionIn this study we found that by increasing the nurse’s empathy skills, we would be able to improve providing family needs. Through empathic communication, nurses can encourage family members to participate in planning for the care of their patients. However, further studies are necessary to confirm the results.Keywords: Empathy, Need, Nurse, Family, Intensive care unit
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Pages 203-209IntroductionIndividualized nursing care is the key element in quality of nursing care. In fact, it changes all standardized nursing procedures and activities. In addition, it tailored nursing activities with unique peculiarity of each patient. Focusing on patient during care process is one main reason for supporting individualized care. Individual differences among patients in terms of their health, illness and needs which emphasize on providing individualized care. This research aimed to demonstrate patients'' point of view about nurses'' support of individualized care.MethodsA descriptive study conducted with participation of 400 being discharged patients from internal and surgical units in teaching hospitals of Tabriz University of Medical Sciences. Proportional stratified random sampling method was used. Data was collected by interviewing with patients using Suhonen Individualized Care Scale, after assessing its content validity and reliability with Chronbach''s alpha method. Data analysis were done by using SPSS ver. 13.ResultsThe mean of patients'' point of view about nurses'' support of individualized care was 2.60 (1.14). The results showed the mean of support for clinical situation 2.61 (1.27), support for personal life situation 2.36 (1.28), and support for decisional control over care 2.77 (1.17). Comparing aspects of support showed that support for decisional control over care was the highest and the lowest was support for personal life situation.ConclusionAccording to results of the study and comparison with other researches in other countries, it is recommended that nursing care planners pay more attention to the aspects of nursing support based on individuals.Keywords: Point of view, Patient, Nursing care, Individuality
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Pages 211-218IntroductionEndometrial biopsy is necessary for diagnosing the reason of abnormal uterine bleeding in perimenopausal women. Currently outpatient endometrial biopsy is used for evaluation of abnormal uterine bleeding which is associated with moderate to severe pain. Using lidocaine is one of the procedures which is used for pain relief while biopsy. This study is aimed at comparing the effect of different local anesthesia procedures on pain relief during endometrial biopsy.MethodsIn this randomized clinical trial, 160 multiparous 40-55 years old women with AUB, candidates for endometrial biopsy, were randomly assigned into four equal groups, to receive: 1-intrauterine lidocaine; 2-cervical spray lidocaine; 3- intrauterine lidocaine plus cervical spray lidocaine; or 4-intrauterine distilled water. Pain relief was measured at 3 different times: during endometrial biopsy, just after and 15 minutes after biopsy.ResultsPain intensity was reduced significantly at different times in intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine receivers in compare with the groups which received cervical spray lidocaine and distilled water. The mean of difference pain relief during biopsy and 15 minutes after that was reduced significantly in the group which received intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine in comparison with the other two groups.ConclusionIntrauterine lidocaine was effective during endometrial biopsy, and using it with cervical spray lidocaine had no more beneficial effect.Keywords: Biopsy, Suction curette, Lidocaine, Anesthesia
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Pages 219-227IntroductionNursing profession requires knowledge of ethics to guide performance. The nature of this profession necessitates ethical care more than routine care. Today, worldwide definition of professional ethic code has been done based on human and ethical issues in the communication between nurse and patient. To improve all dimensions of nursing, we need to respect ethic codes. The aim of this study is to assess knowledge and performance about nursing ethic codes from nurses'' and patients'' perspective.MethodsA cross-sectional comparative study Conducted upon 345 nurses and 500 inpatients in six teaching hospitals of Tabriz, 2012. To investigate nurses'' knowledge and performance, data were collected by using structured questionnaires. Statistical analysis was done using descriptive and analytic statistics, independent t-test and ANOVA and Pearson correlation coefficient, in SPSS13.ResultsMost of the nurses were female, married, educated at BS degree and 86.4% of them were aware of Ethic codes also 91.9% of nurses and 41.8% of patients represented nurses respect ethic codes. Nurses'' and patients'' perspective about ethic codes differed significantly. Significant relationship was found between nurses'' knowledge of ethic codes and job satisfaction and complaint of ethical performance.ConclusionAccording to the results, consideration to teaching ethic codes in nursing curriculum for student and continuous education for staff is proposed, on the other hand recognizing failures of the health system, optimizing nursing care, attempt to inform patients about Nursing ethic codes, promote patient rights and achieve patient satisfaction can minimize the differences between the two perspectives.Keywords: Nurse, Patient, Knowledge, Performance, Code of Ethics
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Barriers of Referral System to Health Care Provision in Rural Societies in IranPages 229-236IntroductionHealth care delivery systems in rural areas face numerous challenges in meeting the community''s needs. This study aimed to describe barriers of health care process in rural societies in Iran.MethodsIn this qualitative study, 26 participants (21 rural health care providers and five rural patients) were selected through purposive sampling. The data was collected via semi-structured individual interviews and small focus group discussions. Data was analyzed with qualitative content analysis.ResultsOne category, “ineffective referral system”, and five subcategories, i.e. being far from the ideal referral system, lack of adequate governmental referral system, lack of connection between different levels of the referral system, self-referential and bypassing the referral system, and insufficient knowledge about the referral system, were found.ConclusionConsidering the obstacles to the referral system, improvements in its structure are necessary to promote the quality of health care in rural areas. Such changes require coordination between the three levels of the referral system, strengthening the public sector of the system, increasing public awareness about the referral system, and prevention of self-referential.Keywords: Health care, Rural communities, Referral
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Pages 237-244IntroductionPostpartum depression and its consequences not only involve mothers and their children but it will also affect their families. Therefore, this study aimed to investigate the effect of mothers receiving peer support on postpartum depression.Methods100 eligible primiparous women participated in a randomized clinical trial. The intervention group received phone calls by their peers from the last three months of pregnancy until two months after delivery. The control group only had access to routine care. Both groups in the second month after delivery were checked regarding depression using Edinburgh Postnatal Depression Scale. Data analysis was performed using independent t-test, chi-square test and covariance analysis.ResultsMean depression score before intervention was 13.92 (3.23) in the control group and 14.06 (3.12) in the intervention group. In week 8 after delivery, mean score of depression in control group was 13.29 (4.08) but in the intervention group it was reduced to 10.25 (4.18). Difference in the reduction of mean postpartum depression score between the two groups showed statistically significant difference (p < 0.001).ConclusionThis study showed that peer support was effective in the prevention of postpartum depression, therefore, it is recommended to be used in the reduction of postpartum depression.Keywords: Support, Peers, Postpartum depression, Clinical trial
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Pages 245-264IntroductionIncreased bleeding is the most common cause of intrauterine device (IUD) removal. The use of alternative therapies to treat bleeding has increased due to the complications of medications. But most alternative therapies are not accepted by women. Therefore, conducting studies to find the right treatment with fewer complications and being acceptable is necessary. This study aimed to compare the effect of mefenamic acid and vitex agnus castus on IUD induced bleeding.MethodsThis was a double blinded randomized controlled clinical trial. It was conducted on 84 women with random allocation in to two groups of 42 treated with mefenamic acid and vitex agnus capsules taking three times a day during menstruation for four months. Data were collected by demographic questionnaire and Higham 5 stage chart (1 month before the treatment and 4 months during the treatment)., Paired t-test, independent t-test, chi-square test, analysis of variance (ANOVA) with repeated measurements, and SPSS software were used to determine the results.ResultsMefenamic acid and vitex agnus significantly decreased bleeding. This decrease in month 4 was 52% in the mefenamic acid group and 47.6% in the vitex agnus group. The mean bleeding score changes was statistically significant between the two groups in the first three months and before the intervention. In the mefenamic acid group, the decreased bleeding was significantly more than the vitex agnus group. However, during the 4th month, the mean change was not statistically significant.ConclusionMefenamic acid and vitex agnus were both effective on IUD induced bleeding; however, mefenamic acid was more effective.Keywords: Intrauterine device, Bleeding, Mefenamic acid, Vitex agnus castus