مقالات رزومه دکتر طاهره طولابی

Multiple symptoms and comorbidities complicate management of heart failure. Studies on the identification of comorbidities (cardiac and non-cardiac) and attention to symptom burden in Iran are limited, so the aim of this study was to evaluate the burden of symptoms and comorbidities in hospitalized heart failure patients. In the present descriptive-analytical study, data were collected from 94 patients admitted to the cardiac wards of Lorestan University of Medical Sciences from December 2018 to April 2020. Samples were entered sequentially. Edmonton (ESAS) and Charlesson tools were used for data collection (CCI). The highest frequency of comorbidities was related to coronary artery disease (heart attacks) 73 (77.7%), hypertension71 (75.5%), peptic ulcer47 (50%), valvular problems40 (42.6%) were, diabetes mellitus 30 (31.9%), kidney disease 25 (26.6%) and COPD23 (24.5%). The lowest frequency of comorbidities was related to liver disease1 (1.1%) and HIV0 (0%). The results also showed that the highest incidence of symptoms in patients with heart failure included chest pain of 6.52 ± 1.77, shortness of breath of 6.41± 1.73, anxiety of 6.22 ± 1.56 and constipation of 6.36± 1.72They were. Depression, loss of appetite, nausea, drowsiness, and lack of well-being or health were the next most common symptoms. Patients with heart failure who have multiple comorbidities (cardiac and non-cardiac), and have multiple symptoms, and in the care of these patients should be considered all aspects, including comorbidities and symptoms. We will need complex management to assist in the care and treatment of these patients.

Covid-19 is a novel disease with many unknown clinical and managemental dimensions. To effectively diagnose, control, and treat the disease, it is required to divulge its clinical symptoms and their qualities. On the other hand, no one can better interpret the clinical symptoms than the caregivers infected by the disease. So, the aim of this study was to exploring the experiences of infected health-care providers about clinical manifestations of Covid-19 disease.

The present qualitative research was conducted using the conventional content analysis method in Iran from March to Jun 2020. Participants in this study included 18 infected health care providers with Covid-19, who were selected based on purposeful sampling method. The data was collected by phone call interviews and analyzed according Lundman and Graneheim approach.

Qualitative data analysis revealed 10 categories including respiratory disorders, fever and chills, body pain, fatigue, headache, skin disorders, gastrointestinal disorders, taste and olfactory disturbances, insomnia and also stress and anxiety. Patients with Covid-19 may experience specific or non-specific disorders. It is necessary to consider people with non-specific manifestations as suspicious cases and screen them with proper diagnostic tests. This can help to identify true positive patients and provide them with more effective health cares, and prevent further spread of the disease by isolating suspected individuals.

Cooling the dialysate is an important factor that contributes to the hemodynamic stability in patients during hemodialysis. The aim of this study was to determine the effect of cool dialysate on vital signs, and the adequacy and common complications of hemodialysis.

The present crossover, triple‑blind, clinical trial was performed on 62 dialysis patients, who were selected through stratified block randomization. First, one group underwent hemodialysis using a cool dialysate (35°C), and the other received routine hemodialysis (36.5°C). Each patient received a total of eight hemodialysis sessions. Then, treatment methods were swapped, and each group received the other group’s method. The patients’ blood pressure, pulse rate, and temperature were measured before dialysis, and in the first, second, third, and fourth hours of dialysis. The frequency of common complications of hemodialysis and dialysis efficacy were measured. The marginal model and Generalized Estimating Equations (GEE) were used to analyze the data.

The participants’ systolic (p = 0.01) and diastolic blood pressures significantly increased with a decrease in temperature (p = 0.005). The patients’ pulse rate (p = 0.143), adequacy of dialysis (p = 0.922), and common complications of hemodialysis did not significantly differ between the two temperatures (p > 0.05).

Reducing dialysate temperature from 36.5 to 35°C led to hemodynamic stability; the blood pressure of the patients undergoing hemodialysis was more stable with the cool dialysate method and the number of drops in the blood pressure during the hemodialysis was reduced.

Nowadays, patients’ privacy as an important part of patient’s rights, which is related to his dignity, is regarded as the basis of treatment and care; and its significance as an ethical medical principle is on the increase. Therefore, the current research was conducted to investigate the preservation of patients’ privacy. This research is a cross-sectional descriptive study, conducted on 141 patients (with non-convenience sampling) admitted in the emergency department of Shahid Rahimi Hospital in Khoramabad. Data were collected using a three-part questionnaire investigating patients’ privacy. The results of this study revealed that the highest preserved cases in different dimensions of physical, information, and psychological - social privacy were: sitting on the patient’s bed with his permission), seeing parts of the body of other patients and respecting the values and beliefs of the patient by the medical staff. The most satisfaction case of patients was related to the refusal of the treatment staff from an unnecessary touch of the body and the least satisfaction case of patients was with hearing the conversation of other patients with the doctor or nurse unconsciously. Although the privacy of over half of the patients in terms of physical, information, and psychosocial dimensions was at acceptable level, yet, its observation is at very low level in terms of staff’s treatment ;thus, the managers, physicians, and nurses should pay more attention to this critical need.

Despite the importance and the necessity of humanistic approaches to care, there are limited studies into their outcomes for nurses.

The aim of this study was to explore the outcomes of humanistic nursing for critical care nurses (CCNs).

This qualitative study was conducted through conventional content analysis. Data were collected through semi‑structured interviews with 16 CCNs purposively selected from hospitals in Ahvaz, Iran. Trustworthiness of the data was ensured using Lincoln and Guba’s criteria.

The outcomes of humanistic nursing were grouped into three main categories, namely personal growth and self‑actualization, protection of personal dignity, and greater satisfaction and comfort. Each of these categories had three subcategories which were development of abilities, self‑concept and self‑worth, spiritual transcendence; greater popularity, improved social status of nursing, appreciation, respect, and support for nurses; and happiness, satisfaction, and motivation, respectively.

Humanistic approaches to care help fulfill the needs of both patients and nurses. The findings of this study provide a deeper understanding about how to reinforce humanistic behaviors and can be used in nursing education and practice.

technology-based concept mapping is a subset of e-learning and is considered a selective strategy for providing information and educational skills. The aim of this study was to investigate the effectiveness of concept mapping instruction in mobile phones on the creativity of nursing students.

This study was a pretest posttest randomized controlled trial. Sixty eight senior nursing students were selected using the whole enumeration. They were divided equally into the experimental (n=34) and control groups (n=34) by stratified block randomization. In the experimental group, concept mapping instruction was carried out using mobile phones; however, the routine method was used in the control group. Students' creativity was measured by Abedi’s Creativity Test before and after the intervention. Data were analyzed with SPSS software using the paired t-test and multivariate analysis of covariance.

There was no significant difference between the two groups in terms of demographic characteristics (p > 0.999).The mean total creativity score and the mean scores on all the subscales decreased in both groups in comparison to the pre-intervention scores. The changes in the scores of elaboration (p= 0.046), originality (p= 0.022), and total creativity (p= 0.036) showed a significant difference between the control and experimental groups, but there was not any significant difference between two groups in term of fluency (p = 0.08) and flexibility (p=0.143).

Although the easy access of learners to mobile phones made the use of this approach seem useful in students' education, further studies are recommended with higher sample sizes and other creativity assessment instruments.

Ventilator-associated pneumonia (VAP) is the most common infection in intensive care units (ICUs), with the highest mortality rate of all hospital-acquired infections. This study aimed to improve the quality of VAP control in the ICU of a university-affiliated teaching hospital in Kouhdasht, Iran.

This action research was conducted during 2016-2018. The survey data of 18 participants, who were included in the study using the non-probability sampling method, were evaluated. Qualitative data were analyzed using Graneheim and Lundman’s qualitative content analysis, and descriptive indices and t-test were measured to analyze quantitative data. Finally, the qualitative and quantitative data were integrated.This research was developed and implemented in four stages, including assessment and identification of priorities for improvement, design of action plans, implementation of action plans, and reassessment. Data were collected by analyzing 540 performance observations, 55 interviews, six focused group discussions, and two steering group discussions.

The mean scores of VAP control before and after implementing the action plans were 259.33±21.64 and 395.16±13.90, respectively (P<0.001). The qualitative findings indicated that the low quality of the personnel’s working life and poor organizational culture were the main barriers to the quality improvement of VAP control. Improvement was achieved after implementing the action plans for enhancing the nurses' quality of working life and realization of their professional identity.

The results of this study suggested that effective approaches, such as personnel empowerment, improvement of environmental conditions, and provision of facilities and equipment can improve the quality of VAP control in ICUs.