Journal of Client-Centered Nursing Care
Volume:6 Issue: 1, Winter 2020

Loud noise in the Neonatal Intensive Care Units (NICU) has negative effects on the health and wellness of hospitalized preterm infants. Various technologies for the care of preterm infants, extensive therapeutic interventions, and communication between staff are among the causes of loud noise in these wards. This review article aims to evaluate the effectiveness of noise reduction interventions in NICUs.

A literature search was conducted 2012-2020 in Medline, Embase, CINAHL, SID IranDoc, and Magiran databases. The search words were preterm infant, noise, and neonatal intensive care unit. Interventional and quasi-experimental papers were included in this review. A total of 26 articles were analyzed regarding the noise levels, effects of noise enhancement, and noise reduction interventions. The exclusion criteria were duplicate texts, non-English/Persian articles, editorials, letters, patents, errata, meeting abstracts, and conference papers. Systematic reviews and meta-analyses methodology was followed to perform the review.

The results showed that the sound levels in the NICUs were higher than those mentioned by the WHO standard. The study articles reported personnel training as an effective intervention in noise reduction. But even with the proper training, there were very few changes in the sound levels. The noise level had been reduced to 3-4 dB, and even increased in some cases due to the impossibility of changing the structure of the NICU and changing the existing devices.

Education is the most effective way to reduce noise. To make noise reduction possible, personnel training is essential as the first step. Sound levels must be measured to control the volume. NICUs should be designed with separate beds and acoustic incubators should be used.

Employed and unemployed women have their special problems. This issue could be more important for female-headed households. Hardiness and resiliency are among the characteristics that are critical for fighting against life problems. This study aims to compare the psychological hardiness and resiliency of employed and unemployed female-headed households. 

This research was a comparative cross-sectional study. The sample included 120 female-headed households (60 employed and 60 unemployed) living in Tehran City, Iran from March to June 2018. The subjects were recruited among the women referring to the institutions affiliated with Imam Khomeini Relief Foundation in Tehran, Iran. The data were collected by the psychological hardiness scale and the Connor-Davidson resilience scale and analyzed in SPSS V. 21 using frequency, mean, standard deviation, and multivariate analysis of variance. 

The results indicated a significant difference between employed and unemployed women in terms of psychological hardiness (32.03±11.50 vs 27.91±9.24) (P=0.034). Besides, there was a significant difference between these women in terms of resiliency (64.881±1.03 vs 59.55±12.72) (P=0.016).

The results indicated a significant difference between psychological hardiness and resiliency among employed and unemployed subjects. Also, the fundamental plans should be made for female-headed households so that they can remain independent and pursue a job.

Stroke upsets the quality of life of the patients and their families. The participation of the family in caring for these patients is inevitable. Empowerment programs enhance patients’ motivation and knowledge and improve their quality of life and self-care. This research aimed to determine the effect of a program based on the family-centered empowerment model on the quality of life of patients with stroke.

This clinical trial study was performed on 100 patients with stroke in Shahid Beheshti Hospital in Kashan City, Iran. The subjects were first recruited purposefully and then were randomly divided into two groups. The experimental group received a family-centered empowerment training in 8 sessions, while the control group received no intervention. The patients in the two groups completed the stroke-specific quality of life scale before the intervention, immediately after the intervention, and one and two months after the last training session. The obtained data were analyzed using the Chi-square test, repeated measures ANOVA, and t-test in SPSS V. 19.

Comparison of the experimental and control groups showed that the total score of quality of life significantly changed immediately after the intervention, and one and two months later (P<0.05). Repeated measures ANOVA results reported a significant interaction between time and group in the total quality of life score and some of its dimensions (energy, family role, social role, language, mobility, self-care, upper extremity function, and work/productivity) (P≤0.05). 

This model of empowerment can improve the quality of life of patients with stroke. This model is recommended to use in the educational program of these patients.

Patient safety is one of the principles of health care and evaluation of the patient safety culture motivates to provide safe conditions for patient care. Regarding the invasive procedures and the necessity of special attention to patient safety in the operating room, this study aimed to determine the patient safety culture from the perspective of operating room personnel.

This research was a descriptive cross-sectional study. The study sample consisted of 206 operating room personnel of Mazandaran educational hospitals who were selected by stratified random sampling. Data collection was performed using the patient safety culture questionnaire and a demographic form. The obtained data were analyzed by descriptive and inferential statistics (Pearson correlation test, one-way ANOVA, independent t-test, and Chi-square test) in SPSS V. 20. The significance level was set at less than 0.05. 

Most of the operating room personnel (72.3%) rated the patient safety culture as moderate. Among the dimensions of patient safety culture, “non-punitive response to error” was not favorable (7.4±2) and the dimensions of the “frequency of error reporting” (11.5±2.2), “overall perceptions of patient safety” (15.1±2.4), and “teamwork within units” (15.4±2.9) were rated as favorable. Among the studied variables, there was a significant relationship between occupational groups and safety culture (P=0.04). 

Patient safety culture status was moderate from the perspective of most operating room personnel. Considering the greater sensitivity of safety in the operating room, hospital managers should adopt suitable approaches and policies to promote the patient safety culture.

Job performance is one of the basic concepts in organizations, based on which, the responsibilities and success of each individual in the organization are realized. The main objective of the current study was to investigate the mediating role of perceived organizational support in the relationship between Sense of Coherence (SOC), professional ethics, and the job performance of nurses in Ahvaz City, Iran. 

This study was model-based testing research. The statistical population included all the nurses working in Golestan Hospital of Ahvaz City, Iran, in 2019. Of them, 252 nurses were selected as the study sample using the voluntary sampling method. The research instruments included Paterson’s job performance questionnaire, the SOC scale, professional ethics questionnaire, and survey of perceived organizational support. Model fit was evaluated using path analysis with AMOS software. 

The results showed that all direct paths, except for the path from the SOC to job performance were significant (P<0.01). Moreover, the indirect paths through perceived organizational support to job performance were also significant (P<0.01). 

According to the study results, the proposed model had a good fit, and it can be considered as an important step towards identifying the factors affecting the job performance of nurses.

Pregnancy is considered a period of emotional crisis. However, attention to the mental status of a pregnant mother is often neglected by health care providers. This study was conducted to determine the effect of narrative writing on the depression, anxiety, and stress of pregnant women referring to the pregnancy care clinics in the south health centers affiliated with Tehran University of Medical Sciences in Tehran, Iran.

The research was a quasi-experimental field trial. A total of 120 eligible pregnant women referring to the south health centers of Tehran University of Medical Sciences were recruited by convenience sampling method. The health records of pregnant women were assessed at each center and the eligible subjects were identified. The sampling was performed during one week for the experimental group and during the next week for the control group. Mothers in the experimental group were asked to write a narrative about their deep thoughts and feelings, twice a week for two months according to the given instructions. The mothers in the control group received routine care. At first, both groups completed the Beck depression inventory and depression, anxiety, and stress scale 21 before the intervention. Then, at 4 and 8 weeks after the intervention, both groups just completed depression, anxiety, and stress scale 21. The obtained data were analyzed by the Mann-Whitney test, Chi-squared test, two-sample Kolmogorov-Smirnov test, and repeated measures ANOVA in SPSS V. 22. The significance level was set as 0.5 or less.

Pre-intervention levels of anxiety, stress, and depression were similar in both groups. Four weeks after the intervention, the variables of depression (P=0.014) and anxiety (P=0.004) were significantly reduced in the experimental group, but no statistically significant difference was found for the stress variable in this time interval. Finally, a significant decrease was observed in all three variables as the intervention continued for 8 weeks (P<0.001).

According to the results, the narrative writing could be used as a simple and low-cost method for reducing anxiety, stress, and depression in pregnant women.

Donor milk is a newly emerging phenomenon in Iran and its banks are currently operating at a limited level. Nurses’ knowledge and attitudes toward this issue play a key role in the adoption of human donor milk by families. This study aimed to determine the knowledge and attitude of nurses working in Neonatal Intensive Care Units (NICUs) regarding the use of human donor milk and its advantages and disadvantages.

This research was a descriptive cross-sectional study. One hundred nurses working in the NICUs of three hospitals affiliated to Iran University of Medical Sciences were recruited by census method. The study data were collected by “nurses’ questionnaire towards donor milk and the pros and cons” and “attitude of nurses towards donor milk”. The obtained data were analyzed by the independent t test and analysis of variance in SPSS V. 22.

Most nurses had appropriate knowledge about donor milk. About 68% of them believed that human donor milk would reduce the growth rate of the baby, but 33% said that the formula milk was easier to find and less stressful than donor milk. Nurses did not express a positive attitude toward donor milk in most questions. Approximately 48% were opposed to receiving human donor milk. Forty-five percent of the nurses blamed its costs and investment as the strongest barriers toward consuming donor milk in their cities. Around 68% supported the establishment of a human milk bank in the area or city where they work and reside. The results also showed the knowledge (P=0.031), and attitude (P<0.00) of the nurses were significantly associated with their marital status.

The nurses had appropriate knowledge about human donor milk; however, in most cases, they lacked a favorable attitude toward it. It seems that cultural and religious issues might have played a role in this respect.

Hemodialysis patients encounter various physical, mental, and social health problems. Empowerment programs may facilitate behavioral changes and improve general health. This study aimed to determine the effectiveness of the empowerment program on the general health of hemodialysis patients.

In this clinical trial, 60 patients undergoing hemodialysis were selected from Shahid Beheshti Hospital in Kashan City, Iran. The patients were randomly divided into two groups. In the intervention group, the empowerment program based on the BASNEF (belief, attitude, subjective norm, and enabling factors) model was implemented in 8 sessions. No intervention was performed for the control group. Before and after the intervention, Goldberg’s General Health Questionnaire (GHQ) was completed by the two groups and compared. The obtained data were analyzed using the independent-test, paired t-test, and Chi-square test in SPSS V. 13. 

A significant decrease in the GHQ scores was observed after the intervention in the intervention group but the difference was not statistically significant between the groups (P=0.2). However, the difference between the scores of GHQ subscales, including “somatic symptoms”, “anxiety and insomnia”, and “social dysfunction” were significant (P<0.05). The paired t-test results showed significant differences in the mean scores of GHQ subscales in the intervention group before and after the intervention (P<0.05). But these differences were not significant in the control group (P=0.2). 

The BASNEF model empowerment was effective on the general health of patients undergoing hemodialysis. Using this program is suggested for these patients.