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   Table of Contents - Current issue
May-June 2022
Volume 27 | Issue 3
Page Nos. 169-250

Online since Monday, May 23, 2022

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Positive consequences of the hidden curriculum in undergraduate nursing education: An integrative review p. 169
Hadi Abbaspour, Hossein Karimi Moonaghi, Hossein Kareshki, Habibollah Esmaeili
Background: Hidden Curriculum (HC) plays an essential role in nursing education and professionalism. However, its positive consequences have been overlooked. Thus, this study aimed to explore and discuss the positive consequences of HC in nursing undergraduate education. Materials and Methods: A comprehensive literature search was conducted to investigate articles published between January 2010 and December 2020. Furthermore, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to select articles, and Consolidated criteria for Reporting Qualitative research (COREQ) and Strengthening the Reporting of Observational studies in Epidemiology (STROBE) tools were employed to appraise qualitative and quantitative studies, respectively. The applied search strategy resulted in a final list of 16 articles out of a total of 132 articles. Next, the data were integrated and categorized using the Whittemore and Knafl methodology. Results: Three categories were identified: Individual Consequences; involving increased self-confidence, self-esteem, assertiveness, adaptation, autonomy, and lifelong learning. Social Consequences; involving enhanced socialization, cultural consciousness, and social interactions. Professional Consequences; involving professional socialization, professional identity, professional ethics, link theory and practice, and professional dignity. Conclusions: Altogether, we concluded that the emergence of HC and its positive and remarkable consequences in nursing knowledge helps the personal, social, and professional development in nursing.
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The effects of a multimedia education on self-efficacy and self-esteem among patients with acute coronary syndrome: A clinical randomized trial p. 181
Zahra Ahmadi, Shahla Abolhassani, Alimohammad Hasheminia, Soleiman Kheiri
Background: Acute Coronary Syndrome (ACS) is the first leading cause of death in the industrial world. It is associated with low self-esteem and self-efficacy. Given that patient education is a key role of nurses, this study sought to evaluate the effects of multimedia education on self-efficacy and self-esteem among patients with ACS. Materials and Methods: This randomized clinical trial was conducted in 2017 on 60 patients recruited from the two coronary care units of Hajar and Kashani hospitals, Shahrekord, Iran. Participants were randomly allocated to an intervention and a control group. The study intervention was a multimedia educational program. Data were collected before and 1 and 2 months after the intervention onset using a demographic questionnaire, the Cardiac Self-Efficacy Scale, and Coopersmith Self-Esteem Inventory. Data analyses were performed using repeated measures analysis of variance, t-test, Chi-square test, and Fisher's exact test. Results: The mean score of self-efficacy in the intervention group (F2 = 119.26, p < 0.001) and in the control group (F2 = 74.21, p < 0.001) significantly increased across the three measurement time points. The mean score of self-esteem in the intervention group significantly increased across the three measurement time points (F2 = 101.19, p < 0.001), while it remained significantly unchanged in the control group (F2 = 2.56, p = 0.086). Conclusions: Multimedia education is effective in significantly improving self-efficacy and self-esteem among patients with ACS. Therefore, nurses can use this strategy to improve these patients' self-efficacy and self-esteem.
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Development of smart postpartum care application based on community health centers, as a method for mentoring postpartum mothers: A mixed method approach p. 188
Anggorowati , Sari Sudarmiati, Teguh Prakoso
Background: Early detection of postpartum problems can help reduce maternal mortality in Indonesia. Early detection can be achieved by monitoring postpartum mothers using a guidance system. The purpose of this study was to describe the development of a guidance system, namely, Smart Postpartum Care (SMAP CARE) and present its functional and acceptance tests. Materials and Methods: This study was a development study conducted in 2019 using a mixed-method approach. Data were collected through Focus Group Discussions (FGDs) and a literature study. The FGD participants consisted of six doctors, six nurses, and midwives from six community health Public health center in Semarang City, Indonesia. The collected data were analyzed using the Colaizzi method. The content of the postpartum mentoring application was based on input from the experts in health education and health services. Before widely applied, a feasibility study on the application was carried out in community health centers involving postpartum mothers and health care teams. Results: Five themes were generated from FGDs: (1) postpartum monitoring facilities; (2) monitoring postpartum mothers through visits to health centers and home care; (3) problems with postpartum mothers (including problems with mothers, babies, and the environment); (4) management of high-risk postpartum mothers; and (5) the risk of postpartum mothers, which could cause death. The SMAP CARE provides some features to educate postpartum mothers, for example (a) changes in the physiological aspects of postpartum mothers, (b) breast milk, (c) newborn care, (d) signs of danger in newborns, (e) problems with babies, (f) problems with postpartum mothers, and (g) signs of danger in postpartum mothers. Conclusions: The application developed in this research, SMAP CARE, helps to facilitate mentoring for postpartum mothers and can be extended to community health centers in Indonesia.
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The effectiveness of self-compassion based training program on resilience of mothers of children with type 1 diabetes in Isfahan, Iran p. 193
Marzieh Najafi, Mousa Alavi, Mohammad Akbari, Sima Gezelbash
Background: Concerns about the complications of diabetes and the responsibility of constantly managing a child's blood glucose are stressful for parents, especially for mothers, and can reduce their resilience. This study aimed to investigate the effectiveness of a self-compassion-based training program on the resilience of mothers of children with type 1 diabetes. Materials and Methods: This is a randomized clinical trial study. The statistical population of the study consisted of all mothers of children with type 1 diabetes who were being treated at the Isfahan Endocrine and Metabolism Research Centre, Iran. The study samples were recruited conveniently, 64 of whom were randomly divided into two groups (compassion training program = 32; control group = 32). The intervention group participated in eight training sessions. Data were analyzed using t-test, and Analysis of Covariance (ANCOVA) tests for between-group comparisons of dependent variables. Results: There was no significant difference between the mean scores of resilience before intervention (p > 0.05). Mean scores of resilience in the intervention group were significantly higher than the control group immediately (F1,60 = 9.726 p = 0.003) and 1 month after intervention (F1, 60 = 13.146, p = 0.001). Conclusions: It may be worthwhile to suggest compassion-based training program for mothers of children with type 1 diabetes to improve their resilience.
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Evaluating the use of communication board on cortisol level and physiological parameters in mechanically ventilated patients p. 198
Anahita Divani, Arpi Manookian, Shima Haghani, Mohsen Meidani, Mojdeh Navidhamidi
Background: Mechanically ventilated patients experience a high level of anxiety due to their therapeutic condition. Anxiety is one of the strongest emotions that patients under mechanical ventilation experience due to their inability to communicate with others. The aim of this study was to investigate the effect of using a communication board on these patients' by assessing serum cortisol level and vital signs. Materials and Methods: This randomized clinical trial study was conducted in 2020. This study included 60 ventilated patients, who had been randomly assigned into two intervention and control groups. After blood sampling and evaluation of cortisol and physiological parameters, patients in the control group received routine communication by nurses, whereas those in the intervention group received communication using a communication board. Subsequently, the serum cortisol level and physiological parameters were measured again. Results: No significant difference was observed between the two groups in terms of demographic characteristics. There was a significant difference in blood cortisol levels before and after in the intervention group (t29 = 15.52, p < 0.001). After the intervention, the intervention group's systolic blood pressure (t58 = −3.78, p < 0.001), diastolic blood pressure (t58 = −3.79, p < 0.001), and heart rate (t58 = −2.09, p = 0.041) were significantly lower than the control group. Conclusions: Communication through a communication board in mechanically ventilated patients leads to decreased cortisol levels and physiological parameters. It is recommended to do more studies about communication boards' content and use this tool for more prolonged periods.
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The lived experiences of iranian patients with rheumatoid arthritis: A qualitative research p. 204
Simin Jahani, Shayesteh Haghighi, Somayeh Ansari, Elham Rajaei, Neda Sayadi
Background: Rheumatoid Arthritis (RA) is a chronic inflammatory disease that affects various systems of the body. The present study was conducted with the aim to explain the lived experiences of Iranian patients with RA. Materials and Methods: According to the research question, the phenomenological research approach was used. The participants were selected through purposive sampling, and sampling was continued until data saturation was achieved. The data was collected by conducting unstructured interviews and using an audio recorder. To interpret the data, an interpretive/hermeneutic approach was implemented using Van Manen's method. In addition, Lincoln and Guba's criteria were used to evaluate data robustness. Results: A total of 24 participants participated in the study. Overall, 145 basic concept codes were extracted which were classified into the four main themes of self-management with the participation of the family, spiritual resilience in the face of existing problems, the tendency to hide the disease, and the fear of an uncertain future. Conclusions: It is recommended that care providers use the findings of this study to develop care plans in the various aspects of the physical, mental, social, and spiritual needs of patients with RA based on their concerns and deep experiences. It is also suggested that other qualitative research approach methodologies such as grounded theory for explaining the process of patient care and providing an appropriate model, or action research for solving the problems of hospitalized patients through suitable care at home be implemented.
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Effective factors on implementation of pediatric home care program amid COVID 19 pandemic: Facilitators and barriers p. 211
Zobeideh Behjeh, Marzieh Adelmehraban, Mahboobeh Namnabati
Background: Home care service is considered as comprehensive care for children with chronic disease or COVID-19. This study aimed to investigate the factors affecting the implementation of a home care nursing program for such children in 2019–2020. Materials and Methods: A descriptive-analytical study was conducted with 198 nurses working in pediatric wards of selective hospitals of Isfahan University of Medical Sciences. The data were collected through an author-administered questionnaire with 44 questions. The questionnaire was designed in two parts. Part one involved gathering the demographic data of the participants. Facilitating and barrier factors of the implementation of the care were prioritized and examined in part two by using the Likert scale in both the individual and the organizational domains. The data were analyzed using the mean frequency and paired t test. Results: The mean (SD) score of individual and organizational facilitating factors were 65.65 (16.24) and 65.98 (11.29), respectively, and the mean (SD) score of the organizational barriers was 82.04 (14.36), which was significantly higher than the mean score (SD) of the individual barriers of 57.94 (14.82) (t197 = 21.32, p < 0.05). The most important individual facilitating factor (53.82%) was “respectful communication with the family,” and the most important organizational facilitator (80.40%) was “Physicians' support of the nurses.” Conclusions: Organizational factors were the most significant barriers. Therefore, the findings of this study will help policymakers in the program implementation.
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The effect of the clinical supervision model on nurses' performance in atrial fibrillation care p. 216
Maryam Mokhtari, Asghar Khalifehzadeh-Esfahani, Shahla Mohamadirizi
Background: A model of clinical education for reducing the theory-practice gap is the clinical supervision model. The purpose of this study was to evaluate the effect of the clinical supervision model on nurses' performance in Atrial Fibrillation (AF) care in a Critical Care Unit (CCU). Materials and Methods: This quasi-experimental study was conducted with a pretest-posttest design. Through stratified random sampling, 36 eligible nurses working in the CCU in Hospitals in Isfahan, Iran, were selected. The data gathering tools included a demographic questionnaire (7 items) and a performance checklist (44 items). Data were analyzed using descriptive (mean and standard deviation) and analytical statistics (ANOVA, LSD, post hoc test, and paired t-test). The level of statistical significance was p ≤ 0.05. Results: Paired t-test showed that there was a significant difference between the mean total scores of nurses' performance and its dimension before and after the intervention (p < 0.001). The results of ANOVA before the intervention showed that there was a significant difference between the mean (SD) scores of care [63.14 (13.08), t = 13.66], pharmacologic [68.98 (13.15), t = 8.20], and electrical cardioversion dimensions [63.37 (10.47), t = 16.82, p < 0.001]. The results of ANOVA showed that the mean (SD) scores of the all dimensions did not differ significantly after the intervention [82.91 (9.75), 84.95 (83.87), and 83.51 (8.07), respectively, p > 0.05]. Conclusions: The clinical supervision model can be used as an educational model combined with supervision to improve nurses' performance in providing care to patients with AF.
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Identifying and responding to the sexual reproductive health needs of women with heart disease: A qualitative study p. 221
Shahnaz Kohan, Minoo Movahedi, Masoumeh Sadeghi, Nafisehsadat Nekuei
Background: Recognizing the needs of women with heart disease in the field of reproductive health and meeting them can reduce the related complications. The aim of this study was to identify the sexual and reproductive health needs of these women. Materials and Methods: The present study was conducted with qualitative approach (Content analysis). Ten married women of reproductive age with heart disease and 20 providers and managers in, Isfahan, Iran, were selected by using purposive and snowball methods (in 2020). The research setting included heart disease clinics, offices of health team, comprehensive health centers, and the Isfahan Maternal Health Department. Data were collected by semi-structured individual face-to-face interviews in the clinic or other appropriate locations. Some interviews were conducted virtually. Analysis was performed by Qualitative contentment analysis / Conventional content analysis. Results: Sexual and reproductive health needs of women with heart disease were emerged in five main categories, “planned childbearing,” “ssociocultural support,” “Early reproductive health care of girls,” “health team attention to sexual health,” and “health system revision.” Conclusions: Providing comprehensive reproductive health services before and during pregnancy, family planning, and sexual health for women with heart disease is necessary. It seems that using a multidisciplinary team approach could improve their reproductive health.
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How a self-management program affects blood pressure among indonesians with hypertension: A quasi-experimental study p. 229
Yupin Aungsuroch, Rapin Polsook, Sakuntala Anuruang, Sitha Phongphibool, Joko Gunawan, Nazliansyah
Background: The prevalence of persons with hypertension remains high, especially in Southeast Asia, such as in Indonesia. Therefore, an effort to control blood pressure is needed. This study aimed to examine the effect of a self-management program on blood pressure among persons with hypertension in Indonesia. Materials and Methods: A quasi-experimental study with pre-test post-test with control group design was used. Seventy-seven participants were selected using convenience sampling in Belitung, Indonesia. A digital sphygmomanometer was used to measure blood pressure. Paired t-test and independent t-test were used for data analysis. Knowledge of hypertension, diet, exercise, and medication records were measured via validated questionnaires and observation sheets. Results: There was a significant effect of the eight-week self-management program on systolic blood pressure (t30 = 6.45, p = 0.01) and diastolic blood pressure (t30 = 2.53, p = 0.02). A significant difference in blood pressure was also identified between the experiment and control group, particularly in systolic blood pressure (t59 = –2.89, p = 0.05) with a large effect size (0.71). Conclusions: Brisk walking with a duration of at least 30 minutes per day, dietary modification program specifically focusing on weight loss and anti-hypertensive food, monitoring program, and health education for eight weeks, are considered effective to control blood pressure among patients with hypertension, and these interventions should be a part of nursing interventions and sustainable health development programs in the community.
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Investigating the prevalence of contact dermatitis and its related factors among hospital staff during the outbreak of the COVID-19 epidemic: A cross-sectional study p. 236
Masoomeh Abdi, Bita Falahi, Farzad Ebrahimzadeh, Kiomars Karami-zadeh, Lida Lakzadeh, Zahra Rezaei-nasab
Background: Frequent hand washing and prolonged mask use during the Coronavirus disease (COVID-19) pandemic may cause contact dermatitis in hospital staffs. This study was conducted to investigate the prevalence of contact dermatitis and its related factors among hospital staff during the COVID-19 pandemic. Materials and Methods: The present cross-sectional study was conducted among the hospital personnel of Aligoudarz Shahid Valian Hospital, Lorestan, Iran, from March to June 2020. Sampling was performed using the complete enumeration method and 142 hospital staff (physicians, nurses, service personnel, nurses' aides, secretaries, and laboratory and radiology experts) participated in the study. Data were collected using a 3-part questionnaire containing a demographic characteristics form, job information form, and the Nordic Occupational Skin Questionnaire (NOSQ). The obtained data were analyzed using descriptive statistics, Chi-square, and Spearman's correlation coefficient in SPSS. Results: The prevalence of hand dermatitis in participants was 88.02%, and facial dermatitis with the surgical mask was 71.83% and with n95 mask was 81.69%. The most-reported symptom was dryness of the hand. The most common symptom observed after prolonged use of surgical (55 Samples; 38.73%) and n95 masks (79 Samples; 55.63%) was redness. The frequency of hand washing (F = 8; p = 0.017) and the use of liquid soap (F = 4; p = 0.047) had a significant interrelation with the severity of dermatitis. Conclusions: Planning for preventive actions and management of the current situation should be a priority among the policies of hospital managers given the high prevalence of hand and face dermatitis among hospital staff.
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The story of female sex workers in the shadow of sex work coercion: A qualitative study p. 243
Zahra Boroumandfar, Reza Esmaeili, Negar Mohaghegh
Background: What has been less considered in the literature of the sex work research, especially in Iran, is to look at the causes of sex work from the perspective of women. The present study sought to understand the causes of the problem and the experience of female sex workers. Methods: The present study was conducted by using qualitative method. Twenty-eight sex workers participated in the study voluntarily and with informed consent. The researcher conducted deep semistructured interviews. Purposive sampling continued until data saturation was reached. Conventional content analysis of the transcribed interviews and field notes were performed to identify key themes, first by each of researchers separately and then in joint discussions. Results: The main theme of the study, according to the participants, was the sense of “what pushed me into sex worker” which included the five main categories of “despair, psychic restlessness, getting drunk by alcohol and drug, incomplete families, not to be left behind by the sudden social changes.” Conclusions: Social and health consequences, especially reproductive health of female sex, workers are affected by several factors. However, to deal with this social and health problems, specific attention should be paid to social factors affecting health. Accordingly, each of the influential variables known in this study could be a target for the country's intervention programs, especially in public health centers and even charities related to the healthcare counseling of sex workers.
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Lactation and COVID-19 infection p. 250
Hardeep Kaur, Shatrughan Pareek
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