Nursing and Midwifery Studies
Volume:13 Issue: 1, Jan-Mar 2024

Most serious adverse events in health care are related to non-technical skills failures. Anesthesiology profession, due to its vital, risky and decisive nature, is more focused on technical, physiological and medicinal aspects compared with other professions, and anesthesia experts and researchers have not paid serious attention to non-technical aspects of their work. This study examined the effect of simulation-based interprofessional education (SBIPE) in small groups on non-technical skills of anesthesiologists and nurse anesthetists. This single-blind randomized controlled trial was conducted during April and May 2023 on anesthesiologists and nurse anesthetists in the operating room of Imam Khomeini Hospital, Ahvaz, Iran. Participants included 64 anesthesiologists and nurse anesthetists who were randomly assigned into an intervention group (n=32) and a control group (n=32). The intervention group was divided into small groups to receive three hours of SBIPE. The Anesthetists' Non-Technical Skills (ANTS) scale which encompasses four components of task management, team working, situation awareness, and decision-making was used to collect data. To analyze the data, independent and paired t-tests were used. In the intervention group, the mean scores of task management, team working, situation awareness and decision-making were 9.32±2.29, 7.96±2.05, 7.84±1.91 and 6.00±1.61 at baseline and increased to 12.36±2.18, 12.28±2.31, 12.28±2.19 and 10.04±1.62, respectively (P<0.001). In the control group, however, changes were significant only in the task management component (9.20±2.27 to 10.76±1.59) (P=0.004). Compared with simulation-based uniprofessional education, SBIPE was more effective in improving non-technical skills of anesthesia providers. Therefore, similar interprofessional education programs can be used to improve non-technical skills of anesthesiologists and nurse anesthetists.

Fatigue is a challenging problem for nurses working in the emergency department and makes them dissatisfied with their jobs. This study examined the effects of a mindfulness training intervention on fatigue and job satisfaction in emergency nurses. A quasi-experimental study was conducted with 80 emergency department nurses in 2022. Participants were randomly assigned into an intervention group (n=40) and a control group (n=40). The intervention group received eight mindfulness training sessions, while the control group received no intervention. Data was collected using the Minnesota Satisfaction Questionnaire and the Multidimensional Fatigue Inventory a few days before the start and immediately after the end of the intervention. Descriptive statistics, t-test, paired t-test, and analysis of covariance (ANCOVA) were used to analyze the data. The two groups did not differ significantly in their pretest fatigue mean scores. However, all posttest fatigue mean scores decreased in the intervention group, and the between-group differences were statistically significant (P < 0.05). The two groups also did not differ significantly in their pretest scores for internal, external, and general job satisfaction (P> 0.05). However, all posttest job satisfaction mean scores increased in the intervention group, and the between-group differences were statistically significant (P < 0.05). The ANCOVA showed that the nurses’ pretest scores had no significant effect on the posttest scores for fatigue and job satisfaction. This study supports the potential benefits of the mindfulness intervention in overcoming fatigue and improving job satisfaction of nurses working in emergency department. Nurses are recommended to learn and implement mindfulness-based interventions to reduce their fatigue and improve their job satisfaction.

Pruritus is a troublesome symptom in patients with chronic kidney failure (CKF). Topical treatment is the first choice for many skin conditions including pruritus. This study examined the effect of topical lipogel containing Ziziphus jujube and Echium amoenum extracts on pruritus in hemodialysis (HD) patients. A double-blind crossover trial was conducted with 50 HD patients. A demographic and medical information form and the 12-item Pruritus Severity Scale were used to collect data. Participants were randomly assigned into a placebo group and an intervention group. The intervention was carried out for four weeks. The groups were then switched after a 2-week washout period and followed for the next four weeks. The severity of pruritus was measured before and once a week after the intervention for 4 weeks. The independent samples t-test, the Mann-Whitney U test, the chi-square test, and repeat measures analysis of variance (RMANOVA) were used to analyze the data. The mean baseline pruritus scores were 15.14±2.59 and 14.34±2.6 in the intervention and placebo groups, respectively (P=0.581). The mean pruritus score decreased by three points in the intervention group and one point in the placebo group at the end of the intervention. The results of the RMANOVA also showed that over time, the herbal lipogel significantly reduced the mean pruritus scores in the intervention group (P<0.0001), while it remained relatively unchanged in the placebo group. The use of a topical lipogel containing extracts of Ziziphus jujube and Echium amoenum can effectively reduce pruritus in HD patients. Therefore, this lipogel may safely be used to relieve pruritus in patients receiving HD.

Several studies have investigated the effects of acupressure in patients with known diabetes. However, no studies have investigated the effects of acupressure on women with prediabetes. The present study aimed to investigate the effects of self-administered acupressure on fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), and anxiety levels in prediabetic women. This randomized controlled trial was carried out on 50 women with prediabetes who referred to the Diabetes Clinic of Mazandaran University of Medical Sciences, Sari, Iran, from September 4, 2021, to February 20, 2023. Participants were randomly assigned to two groups of 25 to receive either metformin and self-administered acupressure or metformin and sham point pressure. FBS, HbA1c, and anxiety levels were measured in both groups before and 12 weeks after the intervention. All patients also received routine training. Data were analyzed using chi-square test and Fisher's exact test, independent samples t-test and analysis of covariance (ANCOVA). The two groups did not differ significantly in their mean baseline FBS and HbA1c values. However, the mean baseline anxiety was significantly higher in the control group (P=0.009). After the intervention, the mean FBS, HbA1c, and anxiety were significantly lower in the intervention group (P<0.001). After controlling for the effect of baseline anxiety scores using ANCOVA, we found that the intervention was effective in reducing mean anxiety (P<0.001). Self-administered acupressure reduced FBS, HbA1c, and anxiety levels in prediabetic women. Therefore, it is recommended that nurses and physicians train prediabetic patients to use self-administered acupressure to manage their anxiety and prediabetic symptoms.

Infertility encompasses complex medical, psychological, social, and cultural challenges, significantly impacting those affected. The process of In Vitro Fertilization (IVF) often adds considerable stress. This study investigated the effects of Mindfulness-Based Stress Reduction (MBSR) on the psychological health, quality of life, and marital satisfaction in infertile women undergoing IVF. This randomized controlled trial employed a consecutive sampling to include 44 women with infertility, undergoing IVF from September 2021 to February 2023. Participants were allocated into intervention and control groups, 22 each, through block randomization. The intervention group participated in an 8-week MBSR program, while the control group received education on parenting styles across four sessions. Assessment tools comprised the Brief Symptom Inventory, the brief World Health Quality of Life Questionnaire, and the Enrich Marital Satisfaction Questionnaire Short Form. Assessments were conducted at baseline, after the intervention, and two months after the intervention. Data analysis utilized the chi-square, t-test, and repeated measures analysis of variance. The mean baseline psychological symptoms, quality of life, and marital satisfaction scores did not significantly differ between the two groups. The mean baseline score for psychological symptoms in the MBSR group was 109.36±19.52, which decreased to 77.82±19.89 and 58.82±9.26 immediately after and two months after the intervention (P<0.001). The mean baseline quality of life score in the MBRS group was 47.39±3.43 which increased to 54.70±3.90 and 59.71±3.57 in consecutive measurements (P<0.001). The mean score for marital satisfaction in the MBRS group was 123.59±19.44 and increased to 143.45±18.41 and 158±12.44 over time (P<0.001). In the control group, the mean psychological symptoms increased over time, but the quality of life and marital satisfaction did not change significantly. MBSR could significantly reduce psychological distress and enhance both the quality of life and marital satisfaction in infertile women undergoing IVF.

Patient safety is one of the most critical factors influencing the quality of nursing care, but some challenges cause failure to maintain patient safety. This study was conducted to identify the challenges that clinical nurses face in maintaining patient safety. This qualitative study was completed in 2021-2022 on clinical nurses of public and private hospitals in selected cities of Iran. Purposive sampling was used to select participants and data were collected through semi-structured in-depth interviews. The interviews were analyzed using Lindgren, Graneheim and Lundman content analysis method. Three categories of "organizational challenges," “work-related and individual challenges,” and “challenges raised by patients or companions” emerged from the data as factors leading to failure in maintaining patient safety. Nurses, nursing managers at the organizational level, and nursing policymakers at the national level should be aware of their role in patient safety violations and then manage these challenges by formulating appropriate programs, policies, and interventions.

The recent public health crisis of the COVID-19 pandemic has influenced the professional identity of nurses as well as nursing students globally. Gender and its intersections are critical moderators of professional identities. The study aimed to elaborate on the reflections of male nursing students in India, about nursing and gendering in nursing, in the context of the COVID-19 pandemic. A qualitative phenomenological exploration was conducted using semi-structured interviews during the March 2021 among seven male nursing students who were purposively selected from a nursing college, Bangalore, South India. Thematic manual analysis as described by Braune and Clarke were used to transcribe the interviews and derive themes and subthemes. The major themes that emerged were; enhanced visibility and professional identity, resisting gender norms in nursing, and reaffirming the decision of choosing nursing. Based on the interviews, we conclude that the COVID-19 pandemic has catalyzed negotiations in the perceived gender positions of male nursing students. We contribute to the existing literature by illuminating how critical situations like the COVID-19 pandemic are contributing to resisting gender norms in professional nursing.

Burns are a major health challenge in developing countries. Post-discharge problems of patients with burn are complex and require home care and educational interventions. However, few studies are available in this area. This study explored challenges of home care in burn patients from the perspective of patients, family caregivers, and health care providers. This qualitative study was conducted during 2022 and 2023. Participants were purposively recruited from Imam Musakazem Hospital in Isfahan, Iran. Data were collected using semi-structured interviews. The qualitative content analysis approach proposed by Graneheim and Lundman was used for data analysis. The trustworthiness of the data was ensured using the criteria of confirmability, credibility, dependability, and transferability proposed by Lincoln and Guba. The study comprised 24 participants, including seven patients, four family caregivers, two physicians, two managers, and nine nurses. Three main categories were extracted including “the vague structure of home care,” “inefficient home care” and “informal home care.” Each category included 2-3 subcategories. The home care program for burn patients requires reforms, such as changes in the administrative structure of home care, increasing the quality of home care centers, interdisciplinary collaboration between health team members, and boosting patients and their families’ awareness about the goals and application of the home care program.