Journal of Holistic Nursing and Midwifery
Volume:33 Issue: 4, Autumn 2023

Feelings of loneliness and attitudes toward ageing in the elderly are associated with physical and psychological problems and increase the need for care services.

The purpose of this study was to investigate the factors related to feelings of loneliness and attitudes toward ageing in the elderly referred to centers covered by the country's pension fund

Methods and materials: 

This cross-sectional study was performed on 235 elderly people covered by the Rasht State Pension Fund who were selected by proportionate stratified sampling. Data were collected using a demographic information checklist, Social and Emotional. Loneliness Scale for Adults (SELSA-S) and Aging Attitude Questionnaire (AAQ). Data analysis was performed using descriptive statistics, Spearman correlation coefficient, Mann-Whitney, Kruskal-Wallis tests, and multiple linear regression model.

The majority of samples (52.3%) were in the age range of 60 to 64 years. 53.6% of them were male and 93.2% were married. 51.1%  had high school  diploma. The mean scores of loneliness and attitudes toward ageing were 6.0 ±27.7and 7.3± 81.1 respectively. loneliness score was different based on  education (P = 0.004), monthly income (P = 0.017) and interacting with others (P = 0.035) and attitudes towards was statistically significant different based on  age (P = 0.002), post-retirement employment (P = 0.044), living status (P = 0.005), use of psychiatric drugs (P = 0.008) and interacting with others (P = 0.043) . Also, after adjusting the effects of individual-social variables using multiple linear regression, the attitude toward ageing was considered as a predictor of loneliness (B=-0.22, CI95% ;-0.33 to -0.11, P=0.001).

Attitudes toward ageing are one of the predictors of loneliness in the elderly. Therefore, by modifying some demographic factors and designing interventions and educational programs, it is possible to change the attitude towards ageing and reduce the feeling of loneliness in the elderly.

Patients with severe COVID-19 symptoms need respiratory support. Therefore, nurses should use oxygen therapy knowledge and skills to treat such patients. Despite heavy investment in health care training to improve nurses’ skills, such as oxygen therapy skills, only a small portion of training is transferred to the workplace. 

The present study aims to predict training transfer (use of oxygen therapy in the workplace) among nurses using the theory of planned behavior (TPB).

This cross-sectional study was conducted on nurses who participated in the oxygen therapy workshop and was selected using the method proposed by a random sample of 127 nurses. The TPB questionnaire and the oxygen therapy checklist were used to collect data. To analyze the data, structural equation modeling was applied.

The results showed that nurses’ attitudes toward oxygen therapy (β=0.358, 95%CI, 0.182%-0.542%, P=0.01), subjective norms regarding oxygen therapy (β=0.246 95%CI, 0.0.018%-0.223%, P=0.01), and perceived behavioral control over oxygen therapy (β=0.229, 95%CI, 0.050%-0.264%, P=0.01) are significant predictors of intention toward oxygen therapy application. Moreover, the results showed that perceived behavioral control over oxygen therapy (β=0.412, 95%CI, 0.226%-0.499%, P=0.01) and intention toward the use of oxygen therapy (β=0.360, 95%CI, 0.241%-0.640%, P=0.01) are significant predictors of nurses’ actual use of oxygen therapy. 

The TPB can predict the intention to use oxygen therapy and the actual use of oxygen therapy in nursing staff. Therefore, this theory can guide health officials to create a suitable environment for using oxygen therapy.

A juvenile detention center is a place where teenagers with risky behaviors, such as competitiveness, separation from family, impatience, aggression, physical abuse, suicide, addiction, and theft, are kept to be corrected and trained. Acceptance and commitment therapy (ACT) can greatly reduce high-risk behaviors in these individuals.

This study aimed to investigate the effect of ACT on the risk-taking behaviors of delinquents in a juvenile detention center. 

This quasi-experimental study was performed on 60 male juvenile delinquents aged 12-18 years in a juvenile detention center in Southeast Iran. The participants were recruited by the census method and assigned to the intervention and control groups (30 in each group) using simple random sampling. The participants in the intervention group attended eight 90-min sessions of ACT, and the participants in the control group received routine training in the center. Iranian adolescents’ risk-taking scale was used to assess the risk-taking of samples before and one month after the ACT intervention. The study data were analyzed using descriptive (frequency, percentage, mean, and standard deviation) and inferential statistics (independent samples t-test, paired-samples t-test, chi-square test, and the analysis of covariance).

Most adolescents in the intervention and control groups were in the age group of 16-20 years (96.7%, and 93.3%, respectively) and had a middle school degree (56.7%, and 40%, respectively). A comparison of the mean risk-taking behaviors scores in the intervention (56.53±11.4) and the control groups (57.28±11.18) showed that the participants in both groups were engaged in high-risk behaviors and were similar. However, in the post-test stage, the mean risk-taking behaviors score in the intervention group decreased (39.64±10.26) compared with the control group (56.31±11.5) with a significant intergroup difference (P<0.05). Also, the Mean±SD risk-taking scores after the intervention were higher than the control group calculated by the covariance analysis for the intervention group participants. These differences were statistically significant (Cohen’s d=15.24, 95% CI, 10.91%-19.56%).

According to the results, ACT reduced high-risk behaviors in juvenile delinquents. Thus, such psychological interventions can be performed to reduce high-risk behaviors in vulnerable groups such as adolescents in juvenile detention centers. Also, the effectiveness of these interventions can be evaluated in longitudinal studies.

Sexual violence during pregnancy causes adverse physical and psychological consequences for pregnant women and their fetuses.

This study aimed to explore the effect of couple-centered counseling on sexual self-concept and violence among pregnant women.

This randomized controlled clinical trial with two groups (26 women in each group) was conducted on pregnant women exposed to sexual violence who lived in Hamadan City in the west of Iran. The mothers exposed to sexual violence were randomly assigned to two groups. Data were collected using the sexual violence and the sexual self-concept questionnaires. For the experimental group, 6 one-hour couple counseling sessions were held. After the end of the sessions, the study questionnaires were completed again by two groups. Data analysis was done using the chi-square, Fisher exact, independent t-test, paired t-test, and analysis of covariance tests. The significance level of the tests was considered 0.05.

The Mean±SD age of pregnant women in the intervention group was 28.65±5.96, and in the control group was 28.77±6.73 years; the mean age of the spouses in the intervention group was 33.62±6.05 and in the control group was 35.04±7.34 years. The results showed that the mean scores of sexual violence after the intervention were 26.10±2.04 in the intervention group and 35.08±2.04 in the control group (P=0.001, Cohens’ d=4.40). The Mean±SD scores of sexual self-concept after the intervention were 8.13±2.02 in the intervention group and 13.33±2.02 in the control group (P=0.001, Cohens’ d=2.57). Moreover, the intervention group experienced a significant decrease (P=0.001) in the dimensions of negative sexual self-concept, including anxiety, fear, monitoring, and depression (P=0.001).

According to these results, couple-centered counseling has effectively reduced sexual violence and negative sexual self-concept by raising couples’ awareness.

Patient safety, especially in children, is one of the most important issues and challenges in medicine in developed and developing countries.

The present study aimed to assess compliance with safety in pediatric wards’ nursing care, equipment, and physical setting.

In a cross-sectional study, safety compliance in 342 nursing care, equipment, and physical setting was assessed in three pediatric wards of pediatric education and treatment centers in Rasht City, Guilan Province, Iran. Data were collected via convenient sampling using 6 checklists: Safety-related individual, occupational and organizational factors, nursing care, equipment, and the physical setting. Descriptive statistics and the Mann-Whitney and Kruskal-Wallis tests were used for data analysis.

Results showed that 36% of nurses were less than 30 years, 100% were female, 80% were married, and 88% had a BS in nursing degree. Nursing care (98.92%), physical settings (93.75%), and equipment in pediatric wards had high safety. The safety of nursing care in terms of shift work (P=0.03), overtime (P<0.05), and participation in training-safety workshops (P=0.03) was significant.

Overall, the safety of pediatric patients can be improved by reducing work shifts and overtime of nurses, participating in training-safety workshops, and having an adequate supply of equipment needed to ensure safe practice in pediatric wards.

Autism spectrum disorder (ASD) presents numerous challenges for families with affected children due to communication and social interaction difficulties. Adopting a family-centered care approach can enhance the quality of care and increase the satisfaction of families seeking medical services for children with ASD.

This study aims to assess the status of family-centered care and its related factors among mothers of children with ASD in Rasht City, Iran.

A cross-sectional analytical study was conducted on 183 mothers of children with ASD in Rasht, utilizing a census approach at Guilan Welfare Centres in September 2020. Data collection tools involved questionnaires on individual-family characteristics and the measure of processes of care, a 20-item questionnaire, which was validated and reliable. Descriptive and inferential statistics, including the Pearson test, independent t-test, analyses of variance, and multiple linear regression, were used for data analysis.

Out of 183 participants (69.31%), met the study criteria most mothers held a diploma (41%) and were housewives (74.3%). The scores for “empowerment and partnership” and “general information” aspects were below mean score, while “specific information”, “comprehensiveness and coordination” of services, and “respect and support” aspects received scores above mean score. The aspect of “specific information” received the highest score (55.4±16.2), while the “general information” aspect received the lowest (45.3±88.1). The regression model revealed that the child’s gender (B=-0.58, 95% CI, -1.07% to 0.001%, P=0.001), sufficiency of health insurance (B=-1.19, 95% CI, -2.17% to -0.21%, P=0.017), and severity of ASD (B=-1.25, 95% CI, -2.46% to -0.04%, P=0.042) significantly influenced empowerment and participation, general information, and specific information aspects. The family residence also impacted the aspect of respect and support (B=-1.24, 95% CI, 0.57% to 1.17%, P=0.001).

The study findings revealed that mothers’ understanding of family-centered care in empowerment/participation and general information was below mean score. This finding highlights the importance of focusing on family-oriented approaches while providing services and care to families with children with ASD.

Dyspnea, one of the most common symptoms in individuals with lung cancer, affects the patient’s quality of life and functions.

This study aimed to determine nonpharmacological methods lung cancer patients use for dyspnea management and to evaluate their opinions, needs, and preferences regarding these.

In this cross-sectional study, 60 patients were included. They were treated in an outpatient chemotherapy unit and agreed to participate. The study data were collected using the “patient self-description form”, “verbal rating scale”, “dyspnea frequency determination form”, and “dyspnea management form”. Descriptive statistics, the chi-square test, and the Kruskal-Wallis test were used to analyze the obtained data. The significance level was considered <0.05.

The study samples comprised 65% males and 35% females with a Mean±SD age of 63.6±1.73 years. The Mean±SD verbal rating scale score of the patients was 5.2±2.6 (from 0 to 10), and the frequency rates of dyspnea were as follows: 48.3% “a few times a week”, 26.7% “a few times every day”, 10% “less than once a week”, 8.3% “once a week”, and 6.7% “all the time”. As a result of the study, it was found that the methods of slowing down (96.7%), resting and not exerting effort (93.3%), sitting position, and elevating the head of the bed (90%) were frequently used. Also, it was found that using a fan on the face (25%) and acupuncture (1.7%) were used less frequently. Results also showed female patients used listening to music (P=0.028) and daydreaming (P=0.042) more than male patients.

Dyspnea is a common symptom in individuals with lung cancer, but its management is still inadequate, and we know little about effective coping strategies. The factors that most affect the perception of dyspnea are known as physiological factors. Still, it should be remembered that psychological, emotional, and environmental factors are also effective in shortness of breath.

Premenstrual syndrome (PMS) stands as one the most prevalent health issues, especially among female university students. The syndrome substantially impacts their quality of life and academic performance. The progressive muscle relaxation technique is a calming method that can help lower anxiety, cultivate a sense of pain control, and divert away from the painful body part.

The study sought to determine the effect of progressive muscle relaxation technique on premenstrual syndrome among female nursing students.

A quasi-experimental study was conducted on 80 female students (40 students in the study group and 40 in the control group) enrolled in the third and fourth academic years (2020-2021). Students were randomly assigned to either the control or study group using a random number generator program. The progressive muscle relaxation technique was performed 30 minutes daily for 4 weeks. Baseline data were collected from all students. The premenstrual syndrome scale assessed the intensity of PMS before and after the intervention. Data analysis was performed using the chi-square test, the student t-test, the Monte Carlo test, the Mann-Whitney test, and the marginal homogeneity test. P<0.05 were considered significant.

The study found that the Mean±SD age of the study and control group participants were 22.02+0.73 and 21.95+0.67 years, respectively. Also, more than two-thirds of the students in the study and control groups (70% and 67.5%, respectively) were from rural areas. After the intervention, a statistically significant decrease was observed in the intensity of all physical, psychological, and behavioral symptoms among the study group compared to the control group (P<0.05). In addition, the total score of PMS intensity was significantly decreased among the study group after the intervention (P=0.001). In contrast, the total score of the intensity of PMS symptoms was significantly increased in the control group (P=0.034).  

The study concluded that young adult girls who practiced progressive muscle relaxation techniques exhibited less severe premenstrual syndrome symptoms than those who did not.

The clinical environment, which includes "simulation labs, educators, teaching hospital, and clinical staff," serves as an active pedagogical strategy that helps students translate their knowledge into technical skills and foster critical thinking. However, this strategy needs a periodic evaluation from students' perspectives to be updated with technological advancements.

This study aims to evaluate the clinical learning environment of the "Nursing the Childbearing Family" course from the students' perspectives.

A study with an observational prospective design was conducted at simulation labs of the Childbearing Family c.ourse, School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA. A convenient sample of 62 students (84.93% participation rate) willingly took part in this investigation. A structured questionnaire comprising 54 questions (50 multiple-choice and 4 open-ended questions) was used to students' perspectives and clinical learning environment. Descriptive (frequency, percentage, mean, and standard deviation) and inferential statistics (the Pearson test and paired t test) were used to describe and compare the mean scores of the student's performances before and after receiving the simulation training labs.

A total of 62 BSc nursing students (with a 100% response rate) enrolled in the Childbearing and Family Nursing course during the academic year took part in this study. The participants' mean ± age was 20.75 ± 0.97 years. Most of the study standards indicators of comparing students' perspectives before and after clinical training reflected a statistically significant difference (P<0.05). Notably, a significant relationship was observed between the students' views regarding the clinical site and clinical instructors (r= -0.641, P=0.001).

Most students held positive perspectives toward the four standards of students' clinical site, students' view of their clinical instructor, effective working relationships between the university and the clinical site, and students' perspectives of the simulation labs before and after the clinical training were positively significant. However, some views underscored the need for more coverage on some topics, such as obstetric emergencies, breech position, and amniotic fluid embolism. Therefore, the current study confirmed that assessing the clinical environment instilled more confidence in participants to go beyond the course procedures and seek more complex scenarios.