جستجوی مقالات مرتبط با کلیدواژه « مراقبت ویژه » در نشریات گروه « پزشکی »

It is essential to provide family-centered care and pay attention to the families of critically ill patients. Consequently, the present study determined the relationship between the needs and resilience of family members of patients hospitalized in Intensive Care Units (ICUs) of hospitals affiliated to Shahrekord University of Medical Sciences in 2021.

The present cross-sectional, descriptive-correlational study, was conducted in order to investigate the relationship between the needs and resilience of families of critically ill patients. The study population included the family members of all patients hospitalized in the ICUs of hospitals affiliated to Shahrekord University of Medical Sciences in 2021, who were selected by available sampling. For this purpose, 149 family members were selected and answered the demographic questionnaire, the Connor-Davidson Resilience Scale (CD-RISC) and Critical Care Family Needs Inventory (CCFNI).

Based on the findings, the average score of family needs was 143.14 ± 21.75, which showed a high level of needs. The highest need of family members was related to the dimension of assurance and information and the lowest need was related to the dimension of support. The mean resilience score was 70.04 ± 16.89, which shows that the family members had acceptable resilience. According to the adjusted resilience score of family members, the highest score was related to the dimension of spirituality and the lowest score was related to the dimension of control. There was a direct and significant relationship (P<0.05) between resilience and all the dimensions of family needs.

Improving nurses' knowledge and awareness of the needs, mental health status and resilience of family members in ICUs can lead to improved resilience and reduction of negative psychological consequences of family members during hospitalization and even after discharge by adopting solutions to meet these needs, as well as implementing training programs. Supporting the family is essential to identify and understand the importance and priority of their needs to meet these needs properly and to pay attention to the mental health and resilience of families.

Occupational stress in nurses of special departments, in addition to the health of nurses, has an impact on their job satisfaction, and spirituality as one of the components of health can lead to the improvement of occupational performance by controlling the stress caused by work, therefore, the present study aims to determine the relationship between health spirituality has been done with occupational stress and job satisfaction of special care nurses.

This cross sectional study was conducted among a total of over 100 nurses working in the critical care units of hospitals in the city of Varamin and suburbs in 2021. Using census sampling, data were collected using Spiritual Well Being Scale (SWBS), Nursing Stress Scale (NSS), and Minnesota Job Satisfaction (MSQ) questionnaire. Descriptive and analytical statistics were performed using SPSS version 22 software.

The nurses had average levels of spiritual health (91.23 ± 13.27, range: 34-118), job stress (92.51 ± 21.11, range: 44-134), and job satisfaction (49.52 ± 10.89, range: 26-70). The Pearson correlation showed that religious health (r = 0.244, P = 0.014), existential health (r = 0.248, P = 0.013), and spiritual health (r = 0.207, P = 0.039) were positively related to job satisfaction in the domain of occupation type. There was no significant correlation between spiritual health and job stress (P>0.05).

Higher spiritual health may be associated with greater job satisfaction in the type of job. It is suggested that the role of spiritual health and its relationship with job satisfaction and job stress should be analyzed in advanced analyses, taking into account intervening variables.

Endotracheal tube care is one of the main principles of care in critical care units, which requires annual evaluation. The present study was conducted with the aim of investigating the training effect of endotracheal tube care standards on the care performance of nurses in critical care units.

This semi-experimental study with before and after design was conducted in Shahid-Beheshti teaching hospital of Kashan in 2022-2023. The research units included 101 nurses working in the intensive care units of the hospital, who were included in the study by census. Tracheal tube care behaviors were observed in two stages (before and after training). A checklist of tracheal tube care behavior was used. Data were analyzed with descriptive statistics and dependent t-tests, chi-square in SPSS software version 21.

In this study, 101 nurses (84.7%) with a mean age of 36 years and 8 years of work experience were examined. The results showed a significant difference between the mean cuff pressure before (34.38mmHg) and after training (33.08mmHg; p=0.049). Further results indicated differences in the frequency of care behaviors such as the depth of insertion and fixation of the endotracheal tube, use of gas, checking the cuff of the endotracheal tube during the shift and before suction, observing the proper position, performing physical therapy, catheter sterility, duration of suction, and the number of suction times before and after training (P<0.05).

The tracheal tube care standards training program has a positive effect on care performance of nurses. Therefore, it seems necessary to plan and implement annual continuing education programs regarding updating and improving the care performance of nurses in critical care units.

safe nursing care is the use of knowledge and skills by nurses to provide quality patient care and it is considered one of the health goals in intensive care units. The feeling of being supported by the hospital play a key role in achieving this goal; it  can lead to job satisfaction, good job performance, and patient satisfaction. This study aims to determine the relationship between perceived organizational support and safe nursing care in nurses working in the intensive care units (ICUs) of public hospitals in Tabriz, Iran.

This is a descriptive-correlational study with a cross-sectional design that was conducted on 200 nurses working in the ICUs of hospitals affiliated to Tabriz University of Medical Sciences in 2021-2022, who were selected using a quota sampling method. Eisenberger et al.’s perceived organizational support scale and Rashvand et al.’s safe nursing care questionaire were used to collect data. Data analysis was done in SPSS v.16 software using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, analysis of variance, and Pearson correlation test). 

The mean score of perceived organizational support was 23.20±9.57, which was lower than the cutoff point. Safe nursing care was at a favorable level with a mean score of 322.89±34.1. The perceived organizational support had no statistically significant correlation with safe nursing care and its dimensions.
Conclusion Despite the unfavorable perceived organizational support of ICU nurses in Tabriz, their safe nursing care is favorable. There is no statistically significant relationship between their perceived organizational support and safe nursing care. This finding is probably due to the prevailing rules and professional beliefs in the work of nurses, which has caused the care provided to be safe despite the perception of low organizational support.

Nurses are the largest group of healthcare providers, especially during the COVID-19 pandemic. Patients with COVID-19 are in dire need of spiritual care due to being alone in quarantine, away from their families. The present study aims to assess the spiritual care competence of nurses in the special care units for COVID-19 in teaching hospitals in Arak, Iran 

This is a descriptive cross-sectional study. Participants were 142 nurses working in the special care units for COVID-19 in hospitals affiliated to Arak University of Medical Sciences in 2022, who were selected by a census method. The data collection tool was the spiritual care competence scale. The data were analyzed in SPSS software, version 16.

The mean total score of spiritual care competence was 100.71±14.45, which was higher than the median score of 81. The spiritual care competence had a significant relationship with marital status (P=0.044), willingness to work overtime (P<0.001), age (P=0.011), total work experience (P=0.03), and work experience in the special care unit (P=0.025), such that spiritual care competence was higher in older married nurses with a willingness to work overtime and a higher work experience.

The spiritual care competence of nurses in the study hospitals is at a favorable level. The results of this study can help future studies in improving the quality of nursing care and the competence of nurses in spiritual care.

In the new age, there is a growing need for nurses with specialized roles for technological advancement, aging, and the development of chronic diseases to receive quality care and reduce treatment costs.

For this purpose, English language databases Web of Sciences, Science direct Proquest, Pubmed, Scopus from 1980 to 2019 and Persian databases, Iran Medex, SID, and Magiran from 1991 to 1397 using the keywords of the specialist nurse, The role of the specialist nurse in the intensive care unit, and its English equivalents. Of the 1,600 initial studies, 12 articles were finalized.

The study findings identified the role of the specialist nurse in the intensive care unit, and it shows that a specialist nurse has a complex, permanent, diverse, and dynamic nature, and that a specialist nurse plays a vital role in providing patient care, including providing quality care in bed, reducing treatment costs, and preventing nosocomial infections.

The study findings identified the concept of a specialist nurse in the intensive care unit. The results also show that a specialist nurse plays an essential role in providing patient care, including providing quality care in bed, reducing treatment costs, and preventing nosocomial infections. Awareness of the characteristics of the concept of the role of the specialist nurse in the intensive care unit, its precedents, and broad consequences will further lead to the promotion of the position, importance, and application of this concept in the nursing profession and an exploratory tool for further research and development. The body of knowledge in this profession is considered.

As direct and continuous care providers to patients, nurses face various types of psychological stress in the work environment more than other groups. Meanwhile, moral distress in special care units is much more impressive. This study aimed to explain the moral distress experienced by nurses that provided care to patients with COVID-19 patients in special care units.

We performed a conventional qualitative content analysis in 2020-2021. The study population included nurses caring for COVID-19 patients in special care units selected by purposive sampling in educational hospitals affiliated with Mazandaran University of Medical Sciences. In-depth, semi-structured interviews were carried out for data collection. Graneheim and Lundman qualitative approach was used to analyze the data. The trustworthiness of the study was assessed by Guba and Lincoln's stringent criteria.

In this study, 14 nurses (25-48 yeas of age) were interviewed. We found three main layers and eight sub-layers, including multiple annoyances (mental and physical stress, negative effects on family and friends relationships, negative effects on professional work), work pressure (hard conditions of the patient and companion, difficulty and work stress, weak management), and persistence and adaptation (self-protection, coping with difficult conditions).

Based on this study, nurses should be encouraged to express their feelings so that they can establish a balance between the difficulty of ethical decisions and meeting the patient's needs and managing their emotions.

Patients of special care units for children and infants are separated from their families with restrictive policies. The present study was conducted with the aim of Design and psychometric Questionnaire of obstacles in implementation of family-centered care in Pediatric and Neonate intensive care units from the Parents' perspective.

After the field study, the face validity of the 36-item questionnaire was conducted using both quantitative and qualitative methods. Quantitative face validity of the questionnaire was done by 10 parents, qualitative face validity by 5 pediatric faculty members, and content validity by 10 nursing faculty members. Two-stage reliability was performed two weeks apart by 20 parents of patients hospitalized in special departments for children and infants. Cronbach's alpha coefficient was used for internal consistency. The factor analysis of the questionnaire was done by 150 parents with children and infants hospitalized in special care units.

14 questions were removed and the CVI and CVR of the 22-question questionnaire were calculated as 0.95 and 0.93, respectively. Cronbach's alpha of the questionnaire was 0.91 and intra-cluster correlation was 0.93. Factor analysis with principal component analysis extracted four factors of being cumbersome to parents' presence, inappropriate organizational structure, nurses' fear of insufficient knowledge of parents and fear of harming the patient with an explanatory rate of 61.65% of the total variance.

The 4-dimensional questionnaire of barriers to the implementation of family-centered care from the perspective of parents is a reliable and valid tool to investigate the barriers to the implementation of family-centered care in special care departments for children and infants.

There are obstacles for the implementation of family-centered care in special care departments for children and infants by nurses. The present study was conducted with the aim of designing and psychometrically evaluating the obstacles to the implementation of family-centered care from the perspective of Nurse of Hamadan, 2023.

After the field study, the face validity of the 36-item questionnaire was conducted with both quantitative and qualitative methods. Quantitative face validity was done by 10 nurses, qualitative face validity by 5 nursing faculty members, and content validity by 10 faculty members. Reliability was carried out in two stages, two weeks apart, by 20 nurses of children's departments. Cronbach's alpha coefficient was calculated for internal consistency. Factor analysis of the questionnaire was done by 95 special care nurses.

The content validity index and content validity ratio of the 25-question questionnaire were calculated as 0.90 and 0.95, respectively, and 11 questions were removed. Cronbach's alpha of the questionnaire was 0.95and intra-cluster correlation was 0.955. KMO equal to 0.859 and Bartlett's sphericity test showed that the correlation matrix is suitable for factor analysis. Factor analysis extracted five factors of parental burdensomeness, high workload, inappropriate executive policy, low self-confidence of parents and provision of adequate care by the nurse with an explanation rate of 75.69% of the total variance.

The questionnaire of obstacles to the implementation of family-centered care from the nurse point of view is a reliable and valid tool to investigate the obstacles to the implementation of family-centered care in Pediatric and neonate intensive care units.

It is essential to pay attention to the psychological complications after a heart attack in line with other physiological complications. The proximity of these patients to death has caused death anxiety, which can weaken their morale. This study aims to determine death anxiety and demoralization in patients with acute myocardial infarction admitted to post-cardiac care units of the Iran University of Medical Sciences in 2021.

The present study is a descriptive cross-sectional study that was performed on 206 patients with myocardial infarction admitted to the educational-medical centers of Iran University of Medical Sciences in the first half of 2021. Data collection tools included the demographic profile form, Templer death anxiety questionnaire, and Kissane demoralization. Data were analyzed using SPSS software, version 20 and Pearson correlation coefficient, independent t test, and analysis of variance.

Most patients in the study were male, married, and self-employed with a mean age of 57.97±12.49 years. The mean score of death anxiety in patients with myocardial infarction was 6.26±1.62 (moderate). Most patients (43.7%) had moderate death anxiety. The mean score of demoralization syndrome was 11.88±5.34 (severe). Most patients (60.7%) had severe demoralization syndrome.

The death anxiety of patients after myocardial infarction was moderate and their demoralization syndrome was severe, therefore it is necessary to pay attention to them and recognize the factors affecting nurses working in intensive care units and recommend being included in the training of care for these patients.

Patient hospitalization in the intensive care unit puts families in a whirlpool of emotional stress. Due to the importance of nurses in addressing the needs and worries of this family, this study investigates the relationship between the family’s perception of the roles of nurses with satisfaction and worries in intensive care units.  

This is a cross-sectional (descriptive-analytical) study. The study samples include all the families of adult patients hospitalized in the intensive care unit of Gonbad city hospitals (2020-2021), of which 140 people, who were included in the study using convenience sampling method. Data collection tools included questionnaires of family members' perception of the role of intensive care unit nurses, worry questionnaire and family satisfaction questionnaire of patients admitted to the intensive care unit. Data were analyzed using independent t-statistics, ANOVA, Pearson's correlation coefficient and linear regression coefficient using SPSS version 22. A significance level of 0.05 was considered.

Among the families, 75% with a mean and standard deviation of 3.04 ± 1.11 had the most perception of the role of nurses. The mean and standard deviation of family satisfaction was 73.98±20.87. Family perception of the role of nurses towards them showed a weak positive and significant correlation with satisfaction (P=0.002, r=0.250). Also, worry could not explain the family's perception of the role of nurses.

The results of this research show that the family's perception of the role of nurses has a weak correlation with their satisfaction and concern. How the nurses themselves understand their roles towards the family should be investigated in future research.

The outbreak of the COVID-19 crisis has unprecedented pressure to the health systems around the world. Missed nursing care as a care that is needed by the patient but is omitted affects the quality and safety of care. The aim of this study was to investigate the rate and causes of missed nursing care of COVID-19 hospitalized patients in Intensive Care Units (ICUs) of Saqez and Diwandara hospitals.

This cross-sectional descriptive study was conducted in 2021 on 110 nurses working in the special care units for COVID-19. Demographic Characteristics Questionnaire and the Forgotten Care Questionnaires were used to collect information. Data were analyzed using STATA version 12 software and Mann-Whitney, Kruskal-Wallis and Spearman's correlation coefficient tests.

The mean score of missed nursing care in ICUs for Covid-19 was 55.18 (20.24). The most common missed nursing care was controlling the patient's O2 saturation (18.75%) and recording the necessary information of patients (17.86%). The highest percentage of the factors related to missed nursing care was assigned to the lack of nursing staff (86.61%). The most common causes of neglected nursing care were lack of nursing staff (86.61%), lack of assistants or secretaries (74.77%), and the large volume of activities related to the admission and discharge of patients (67.66%).

A high percentage of nursing care in the special care units of Covid-19 is lost under the influence of factors such as the shortage of nursing staff and forced overtime working hours beyond the tolerance of nurses. Nursing managers can create appropriate interventions to support the professional role of nurses during the pandemic by considering related factors.

With the rapid growth of information technology (IT) and the expectations of health care environments, the presence of nurses with informatics skills in the health care environment to effectively use and manage health care information in health care delivery seems necessary; therefore, this study was conducted to evaluate the IT competency of special care nurses from their point of view.

This cross-sectional study aimed to investigate the IT competency of nurses in the special care departments of Afzalipur Hospital of Kerman University of Medical Sciences in 1400 SH. The study population included 60 nurses working in the intensive care units (ICU and CCU) who were included in the study using a census method. The Nursing Informatics Competency Assessment Tool (NICAT) was used in this research.

The findings of the study showed that the average score of IT qualification of nurses in the special care department (2.70 ± 0.85) is within the range of “competent”. The data showed that the highest score of IT competency of the studied nurses was attributed to the computer literacy section (2.82±0.93), and the lowest score was related to the information management skills section (2.58±0.85).

It is suggested that clinical nursing managers improve the IT competency of nurses by implementing educational programs in the field of “IT literacy in the hospital”, especially in the division of information management skills which had the lowest average score, so that they can use the latest evidence to provide more effective care at the bedside.

Mortality is one of the common consequences of non-trauma patients (NTP) admitted to the intensive care unit. In this study, hemoglobin concentration and its relationship with clinical outcome in NTP was investigated

This cross-sectional study was performed on the records of 400 non-trauma patients admitted to the General Intensive Care Unit of Besat Hospital in Hamadan during 2020-2022 in terms of hemoglobin concentration and its relationship with clinical outcome. Study data were analyzed using SPSS software version 23 and Student t-tests, one-way analysis of variance, and Pearson correlation coefficient.

In this Cross-sectional study, cancer (18.8%), drug poisoning (14.8%), poisoning (14.5%), and DKA (8.8%) were the most common causes of non-trauma hospitalization. The incidence of in-hospital death was 18.8%. Sepsis, pulmonary embolism, myocardial infarction, meningitis and DIC with 46.7%, 22.7%, 18.7%, 6.7% and 5.3% were the most common causes of death, respectively. There was a significant relationship between hemoglobin concentration with age, sex and duration of hospitalization (p<0.05). A significant relationship was observed between lower hemoglobin concentration before and during hospitalization with increased mortality (p<0.001).

In the present study, the hemoglobin of non-trauma patients decreased during hospitalization compared to pre-hospitalization period and this decrease in hemoglobin level was associated with increased mortality of non-trauma patients in the hospital.

Due to the high mortality of patients admitted to the intensive care unit, the provision of high quality nursing care, especially for patients admitted to these wards, is of great importance, so the quality of death and dying in these wards is necessary. The aim of this study was to determine the quality of dying and death from the perspective of nurses working in intensive care units.

The present study was performed cross-sectional in the teaching hospitals of Kurdistan University of Medical Sciences. The research samples in this cross-sectional study were 105 nurses working in intensive care units who were selected by census. Data collection tools included two sections: demographic information, Quality of Dying and Death Questionnaire (QODD).

The results of the present study showed that the mean and standard deviation of the quality of dying and death variable were 37.15±13.47 and below the mean. Among the items related to the quality of death, the highest average was related to receiving appropriate sedation during the stay in the intensive care unit (5.80±2.41) and being touched or hugged by loved ones (4.90±2.78) and the lowest average quality of care was related to having a spiritual ceremony before the patient's death (2.12±2.59) and having one or more visits to a religious or spiritual counselor (2.24±2.66). There was a statistically significant relationship between the quality of dying and death and the history of passing training courses related to dying and death (P=0.03).

It is recommended to hold training courses related to quality dying and death care criteria for personnel working in intensive care units, as well as to evaluate the quality of mortality care from the perspective of the families of patients admitted to the intensive care unit.

Work-related rumination is the cause of various psychological stresses in nurses and threatens their mental health. The aim of this study was to evaluate work- related rumination and related factors in Iranian nurses working in critical care units.

In this cross-sectional study, 182 nurses working in critical care units were selected by convenience sampling method. Data were collected through work-related demographic information questionnaire and rumination questionnaires (WRRQ) and analyzed using SPSS-v20 software.

Work-related rumination in Iranian nurses working in critical care units was moderate (Mean =42.82). The highest and lowest averages were related to the dimensions of detachment and problem solving pondering, with averages of 15.41 and 13.32, respectively. There was a significant relationship between age, work experience and type of employment with work-related rumination (p <0.05).

Using the results of this study can help health policy makers to improve the effectiveness of designed measures and programs. Designing personal development programs can provide ideal conditions for nurses to grow up and develop and also reduce their exposure to work-related rumination stimuli and their adverse outcomes.

The decision to extubate the patient is crucial and challenging. The use of corticosteroids to reduce airway edema and extubation failure in intensive care patients is debatable.

In an observational prospective cohort study from April 2021 to July 2021, 110 patients undergoing head and neck surgery at Imam Khomeini Hospital's special wards were enrolled. Inclusion criteria: Patients undergoing head and neck surgery. Exclusion criteria: previous corticosteroid use, presence of tracheostomy tube, history of head and neck surgery. The intervention group (n=55) received intravenous dexamethasone 8 mg three times a day for the first 24 hours and 4 mg twice a day for the next 24 hours. The control group did not receive any corticosteroids (n=55). All the patients were weaned with the same protocol, including pressure support ventilation with pressure support 6-8 cm H20 and PEEP <5 cm H2o and FIO2 ≤0.4 for 1-2 hours without respiratory distress, hypoxia, tachycardia, and diaphoresis. Before extubation, the cuff leak test was done for all the patients with the cut-off point of 110 ml. The Chi-square or Fisher's exact test was performed for categorical variables, and a t-test was used to describe the quantitative variables. P-values less than 0.05 were considered statistically significant.

The mean age was 52.1±14.1, and there was no difference between the two groups. Demographic characteristics, including sex, body mass index, duration of surgery, kind of intubation, and Acute Physiology and Chronic Health Evaluation (APACHE) II score, were not significantly different. The length of stay in the intensive care unit in the dexamethasone group was significantly longer than the control group (104 vs. 79-hour, P=0.001, CI 95%: 10.995-40.878). The rate of failure in extubation and postoperative stridor was not significantly different between the two groups (P=0.237).

Dexamethasone usage seems not to be effective in reducing airway edema, and its routine use is not recommended in reducing stridor after endotracheal tube removal.

Intrahospital Transport (IHT) of critically ill patients is always associated with the incidence of Adverse Events (AEs). Identifying and managing these events ensures the safety of patients. The aim of this study was to determine the incidence of AEs and related factors in IHT of critically ill patients.

In this prospective observational study, 171 cases of Intensive Care Unit (ICU) patients transferred in the first half of 2019 were investigated. After obtaining the approval of the Research Ethics Committee, the study data were collected and recorded by using a researcher-made checklist during the transfer process.

In 79.54% of IHTs, at least one AEs occurred. The highest number of AEs (37.39%) occurred during transfer phase. Decreased Spo2 (43.39%) and decreased level of consciousness (42.15%) were the most common ADs, respectively. Multiple logistic regression analysis identified endotracheal intubation as independent predictor of AEs in the transportation process.

According to the findings, the incidence of AEs during the IHT process of ICU patients is high. Critically ill patients with endotracheal intubation were at higher risk. Adoption of strategies such as efficient and adequate transfer team composition, continuous monitoring of patient status, use of standard checklists and sound equipment are crucial.

Following the outbreak of Coronavirus disease 2019 (COVID-19) in the world, the issue of relocating infected patients and personal protection to prevent this new and mysterious disease has been raised and followed up. One of the most important and serious complications of transmission of this disease is nosocomial transmission. Therefore, the first and the most important issue is to examine the need for patient transfer. Also, the necessary precautions for the transfer of this group of patients should be pre-defined and seriously implemented and followed up. The required health protocols and precautions can be categorized into four main categories: patient safety, health care and security staff, safety of those likely to be on the move, and disinfection of equipment used after transfer and relocation. Inter and intra-hospital transportation involves various challenges and risks. This article is a review of field research and defined protocols that have been conducted and implemented during the pandemic period of COVID-19 virus disease, which can be used to improve the mobility of patients by considering the conditions and facilities of our country.This research was conducted using search engines in reputable databases including Scopus, Web of Science, PubMed Science Direct, Google Scholar and review of scientific interviews and conferences held on the transfer of coronary heart disease patients and patients with acute conditions or intensive care requirements. As COVID-19 is a new emerging disease and due to lack of sufficient and convincing evidence on the various and possibly unknown dimensions of this disease, studies and protocols present for the transmission of other patients with acute and infectious diseases have been used in this study.