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ORIGINAL ARTICLES
Empathy, burnout, demographic variables and their relationships in oncology nurses
Fariba Taleghani, Elaheh Ashouri, Morteza Saburi
January-February 2017, 22(1):41-45
DOI
:10.4103/ijnmr.IJNMR_66_16
PMID
:28382057
Introduction:
Development of nurse–patient empathic communication in the oncology ward is of great importance for the patients to relieve their psychological stress, however, nursing care of cancer patients is accompanied with high stress and burnout. The present study aimed to define the level of empathy and its association with burnout and some demographic characteristics of oncology nurses. Materials and Methods: This descriptive/correlation study was conducted in a professional cancer treatment center in Isfahan. Through census sampling, 67 oncology nurses were selected. The data collection tools were Jefferson Scale of Nursing Empathy, Maslach Burnout Inventory, and demographic characteristics questionnaire. Results: Mean nurses' empathy and overall burnout scores were 62.28 out of 100 and 38.8 out of 100, respectively. Score of empathy showed an inverse correlation with overall burnout score (
r
= −0.189,
P
= 0.04), depersonalization (
r
= −0.218,
P
= 0.02), and personal accomplishment (
r
= −0.265,
P
= 0.01). Multiple regression test was used to detect which dimension of burnout was a better predictor for the reduction of empathy score. Results showed that the best predictors were lack of personal accomplishment (
P
= 0.02), depersonalization (
P
= 0.04), and emotional exhaustion (
P
= 0.14), respectively. The most influential demographic factor on empathy was work experience (
r
= 0.304,
P
= 0.004). One-way analysis of variance showed that official staff had a higher empathy score (
f
= 2.39,
P
= 0.045) and their burnout was lower (
f
= 2.56,
P
= 0.04).
Conclusions:
Results showed a negative relationship between empathy and burnout in oncology nurses. Therefore, nursing support from managers to reduce burnout increases empathic behavior of nurses.
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22
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499
Effect of lavender scent inhalation on prevention of stress, anxiety and depression in the postpartum period
Maryam Kianpour, Akram Mansouri, Tayebeh Mehrabi, Gholamreza Asghari
March-April 2016, 21(2):197-201
DOI
:10.4103/1735-9066.178248
PMID
:27095995
Background:
Stress, anxiety, and postpartum depression are the most common problems among women in their childbearing age. Research has shown that aromatherapy administered during labor reduces anxiety in mothers. With regard to the specific biological conditions in postpartum period and the subsequent drop in hormone levels, this study investigated the effect of lavender on prevention of stress, anxiety, and postpartum depression in women.
Materials and Methods:
In a clinical trial, 140 women admitted to the obstetric and gynecological unit were randomly divided into aromatherapy and non-aromatherapy groups immediately after delivery. Intervention with aromatherapy consisted of inhaling three drops of lavender essential oil every 8 h with for 4 weeks. The control group received routine care after discharge and was followed up by telephone only. After 2 weeks, 1 and 3 months of delivery, women were assessed by the 21-item Depression, Anxiety, and Stress Scale and the Edinburgh stress, anxiety, and depression scale in the two groups. Data analysis was performed by Mann-Whitney, analysis of variance (ANOVA), and
post hoc
tests. Level of significance was set as 0.05 for all tests.
Results:
The results showed that the mean stress, anxiety, and depression at time point of 2 weeks (
P
= 0.012,
P
< 0.0001, and
P
= 0.003, respectively) and stress, anxiety, and depression scores at time points of 1 month (
P
< 0.0001) and 3 months after delivery (
P
< 0.0001) were significantly lower in the study group compared with the control group.
Conclusions:
Inhaling the scent of lavender for 4 weeks can prevent stress, anxiety, and depression after childbirth.
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1,192
Physical violence against health care workers: A nationwide study from Iran
Masoud Fallahi-Khoshknab, Fatemeh Oskouie, Fereshteh Najafi, Nahid Ghazanfari, Zahra Tamizi, Shahla Afshani
May-June 2016, 21(3):232-238
DOI
:10.4103/1735-9066.180387
PMID
:27186199
Background:
Workplace violence is a serious and problematic phenomenon in health care settings. Research shows that health care workers are at the highest risk of such violence. The aim of this study was to address the frequency of physical violence against Iranian health personnel, their response to such violence, as well as the contributing factors to physical violence.
Materials and Methods:
A cross-sectional study was conducted in 2011, in which 6500 out of 57,000 health personnel working in some teaching hospitals were selected using multi-stage random sampling. Data were collected using the questionnaire of “Workplace Violence in the Health Sector” developed by the International Labor Organization, the International Council of Nurses, the World Health Organization, and the Public Services International.
Results:
The findings revealed that 23.5% of the participants were exposed to physical violence in the 12 months prior to the study. Nurses were the main victims of physical violence (78%) and patients' families were the main perpetrators of violence (56%). The most common reaction of victims to physical violence was asking the aggressor to stop violence (45%). Lack of people's knowledge of employees' tasks was the most common contributing factor to physical violence (49.2%).
Conclusions:
Based on the results, legislating appropriate laws in order to prevent and control violence in the workplace is necessary. Moreover, developing educational programs to manage the incidence of physical violence should be on health centers' agenda.
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20
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591
Effect of hope therapy on depression, anxiety, and stress among the patients undergoing hemodialysis
Meisam Rahimipour, Nahid Shahgholian, Mohsen Yazdani
November-December 2015, 20(6):694-699
DOI
:10.4103/1735-9066.170007
PMID
:26793255
Background:
Renal failure is a major public health problem in the world. These patients experience high levels of psychological tension, anxiety, and depression, which leads to their lowered quality of life, increased health care costs, and early mortality. Due to medication side effects in these patients, non-medicational methods are more in demand now. This study aimed to investigate the effect of hope therapy on depression, anxiety, and stress among the patients undergoing hemodialysis.
Materials and Methods:
This is a clinical trial. Fifty patients undergoing hemodialysis were selected. Patients were assigned to two groups of hope therapy and placebo. Intervention of hope therapy was administered for 60–90 min during dialysis sessions once a week for eight sessions. In the placebo group, non-specific intervention was administered with the same number of sessions. Depression, Anxiety, and Stress scale (DASS)-21 questionnaire was completed at the end of the last session and 4 weeks later. Data were analyzed by paired
t
-test, repeated measures analysis of variance (ANOVA), and least significant difference (LSD)
post hoc
test through SPSS 18.
Results:
There was a significant difference in mean scores of depression, anxiety, and stress in hope therapy group before, immediately after, and 1 month after intervention (
P
< 0.05), while there was no significant difference in mean scores of depression, anxiety, and stress before and immediately after intervention in the placebo group. Changes in mean scores of depression, anxiety, and stress were significantly higher in hope therapy group compared to placebo (
P
< 0.05).
Conclusions:
The obtained results showed that hope therapy is effective on reduction of depression, anxiety, and stress.
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494
The effect of inhalation aromatherapy with damask rose (
Rosa damascena
) essence on the pain intensity after dressing in patients with burns: A clinical randomized trial
Ali Bikmoradi, Mehdi Harorani, Ghodratollah Roshanaei, Shirin Moradkhani, Golam Hossein Falahinia
May-June 2016, 21(3):247-254
DOI
:10.4103/1735-9066.180380
PMID
:27186201
Background:
Pain is one of the common problems encountered by patients with burns, which increases after each dressing. This study aimed to investigate the effect of inhalation aromatherapy with damask rose essence on the pain of patients with burns that is caused after dressing.
Materials and Methods:
A randomized clinical trial was conducted on 50 patients with second- and third-degree burn wounds. The baseline pain of the patients was assessed 30 min before they entered into the dressing room on the first and second days of intervention. The patients in the experimental group inhaled five drops of damask rose essence 40% in distilled water, while those in the control group inhaled five drops of distilled water as placebo. The pain intensity was assessed using Visual Analogue Scale at 15 and 30 min after the patients exited from the dressing room. Data were analyzed by SPSS (version 18) using descriptive and inferential statistics.
Results:
There was significant difference between the mean of pain intensity before and after intervention at 15 and 30 min after dressing (
P
< 0.001). Moreover, there was significant difference in reduction of pain intensity before and after aromatherapy in the experimental group (
P
< 0.05). Also, there was a significant reduction in severity of pain after dressing in the experimental group compared with the control group (
P
< 0.05).
Conclusions:
Inhalation aromatherapy with damask rose could be effective for relieving the pain caused after dressing in patients with burns. Therefore, it could be suggested as a complementary therapy in burn patients for pain relief.
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749
The relationship between nurses' clinical competence and burnout in neonatal intensive care units
Fatemehzahra Soroush, Ali Zargham-Boroujeni, Mahboobeh Namnabati
July-August 2016, 21(4):424-429
DOI
:10.4103/1735-9066.185596
PMID
:27563328
Background:
Nurses' clinical competency plays an important role in the care of preterm infants. On the other hand, burnout is one of the most important factors in reducing the nurses' efficiency. With regard to the importance of the role of nurses, and the vulnerability of the infants, the purpose of this study was to investigate the relationship between nurses' burnout and clinical competency in NICUs.
Materials and Methods:
The descriptive cross-sectional study was conducted with the participation of 86 nurses working in the NICUs of hospitals in Isfahan, Iran. Census sampling method was used in the NICUs of educational hospitals in 2014. Data were collected by a questionnaire including demographic characteristics, Patricia clinical competency, and Maslach burnout scales. Data were analyzed by the statistical tests of independent
t
-test and Pearson correlations test with the significance level of α < 0.05.
Results:
Six dimensions of clinical competency and three dimensions of nurses' burnout were assessed at three levels (weak, moderate, and strong levels). Statistical tests showed that clinical competency was at a moderate level in all fields. Of the dimensions of nurses' burnout, emotional exhaustion was moderate, depersonalization was weak, and personal performance was strong. The results showed that nurses` burnout and clinical competency in the NICUs were at a moderate level and had a significant negative relationship (
r
= −0.322,
P
= 0.003).
Conclusions:
Results showed that burnout had a negative relationship with competency. Therefore, managers are suggested to improve nurses' competency and diminish their job burnout through better and more applicable planning.
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3,378
456
Supporting hemodialysis patients: A phenomenological study
Nahid Shahgholian, Hojatollah Yousefi
September-October 2015, 20(5):626-633
DOI
:10.4103/1735-9066.164514
PMID
:26457103
Background:
Chronic renal disease and hemodialysis cause numerous psychological, social, cultural, and spiritual challenges for both patients and their families. Overcoming these challenges is possible only through providing holistic support for the patients. Today, despite the support provided by family and professional caregivers for the patients, patients still express dissatisfaction with the support provided and believe it to be inadequate. In fact, patients and family caregivers and healthcare practitioners seem to have different understandings of the notion of support. Thus, the researcher decided to examine the concept of support from the viewpoint of hemodialysis patients.
Materials and Methods:
This descriptive phenomenological research was conducted on 17 patients with end-stage renal disease (ESRD) who were undergoing hemodialysis. Purposive sampling was performed and continued until data saturation. Data were collected through 30–60 min unstructured interviews and analyzed using Colaizzi's method.
Results:
From the analysis of data, 4 themes (psychological support, accompaniment, social support, and spiritual support) and 11 sub-themes were obtained. Psychological support consisted of two sub-themes of psychological support by healthcare practitioners and emotional support by family and relatives. Accompaniment included three sub-themes of assistance in transportation, providing and using medicine, and daily activities. Social support was identified with four sub-themes of promotion of the society's understanding of the patients' condition, improvement of communication with others, the need for employment, and independence. Spiritual support was identified with two sub-themes of the need for faith and trust in God or Imams and the need to resolve spiritual contradictions.
Conclusion:
The results showed that from the viewpoint of the participants, the concept of support consisted of psychological support, social support, accompanying the patient, and spiritual support. Hence, it can be concluded that this concept should be considered in healthcare planning, in order to improve the health and quality of life of these patients and their adaptation to the disease and its treatment process.
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3,511
424
The effect of vitamin D supplementation on blood sugar and different indices of insulin resistance in patients with non-alcoholic fatty liver disease (NAFLD)
Mehdi Foroughi, Zahra Maghsoudi, Gholamreza Askari
January-February 2016, 21(1):100-104
DOI
:10.4103/1735-9066.174759
PMID
:26985230
Background:
Vitamin D supplementation has been shown to decrease insulin resistance through which it might cause fatty liver. Fatty liver increasingly results in type 2 diabetes mellitus (T2DM). Insulin resistance and fatty liver are particularly closely related. The aim of present study is to examine the effect of vitamin D supplementation on blood sugar and different indices of insulin resistance in patients with non-alcoholic fatty liver disease (NAFLD).
Materials and Methods:
This randomized placebo-controlled clinical trial was conducted on 60 patients with NAFLD, who were divided equally into intervention and control groups. Patients in the intervention group received vitamin D3 (50,000 IU) and patients in the control group received placebo capsules every week for 10 weeks. Blood sugar, homeostatic model assessment-insulin resistance (HOMA-IR), and homeostatic model assessment-beta cell (HOMA-B) were checked at baseline and after 10 weeks of the intervention. Adjustment for variables was performed by analysis of covariance (ANCOVA).
Results:
Vitamin D supplementation resulted in increased serum 25-hydroxy vitamin D [25(OH) D] concentration in the intervention group compared to the control group [+68 (12) vs. −1.9 (2.44);
P
= 0.001]. Intake of vitamin D supplements led to a marginally significant decrease in fasting blood glucose [FBS: −12 (4) in the intervention group compared to − 3 (2) in the control group;
P
= 0.055]. Also, HOMA-IR decreased in the intervention group compared to the control group [−1.75 (0.23) vs. 0.12 (0.41);
P
= 0.066].
Conclusions:
Vitamin D supplementation resulted in decreased HOMA-IR and FBS concentration in patients with NAFLD; however, it did not affect the insulin level and HOMA-B significantly.
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3,200
511
The effect of aromatherapy by essential oil of orange on anxiety during labor: A randomized clinical trial
Fahimeh Rashidi-Fakari, Mahbubeh Tabatabaeichehr, Hamed Mortazavi
November-December 2015, 20(6):661-664
DOI
:10.4103/1735-9066.170001
PMID
:26793249
Background:
Labor is a stressful situation that may have an adverse impact. Aromatherapy is a method to control anxiety and stress of women. This study was conducted to investigate the effect of aromatherapy using essential oil of orange on women's anxiety during labor.
Materials and Methods:
In this clinical trial study, 100 women during labor were randomly assigned to two groups: intervention group and control group. The women in the intervention group were exposed to orange essential oil, but the women in the control group were exposed to distilled water. The women's anxiety was assessed using the Spielberger inventory. Moreover, physiological parameters such as systolic and diastolic blood pressure, respiration and pulse rates were assessed in all the women before and 20 min after the intervention. The data were analyzed by Chi-square, Wilcoxon, paired
t
-test, and Mann–Whitney U test. Data were evaluated with the SPSS 16 program. The significance level of
P
< 0.05 was considered.
Results:
The level of anxiety of women in both intervention (
P
= 0.03) and control (
P
= 0.003) groups reduced after the intervention. However, the reduction was more in the intervention group (difference in anxiety scores after the intervention in comparison to before intervention = −3.08) in comparison to the control group (score = −1.14). No significant change was found in the physiological parameters of women in the intervention group after the intervention.
Conclusions:
Aromatherapy is a noninvasive and effective method to help women overcome their anxiety during labor. Orange scent can be useful in childbirth units to help women who are experiencing stress in labor.
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14
4,466
822
REVIEW ARTICLE
An integrative review of literature on determinants of nurses' organizational commitment
Seyyed Abolfazl Vagharseyyedin
March-April 2016, 21(2):107-117
DOI
:10.4103/1735-9066.178224
PMID
:27095982
Background:
This integrative review was aimed to examine in literature and integrate the determinants of nurses' organizational commitment in hospital settings.
Materials and Methods:
In this study, an integrative review of the literature was used. The search strategy began with six electronic databases (e.g. CINAHL and Medline). Considering the inclusion criteria, published studies that examined the factors influencing nurses' organizational commitment in the timeframe of 2000 through 2013 were chosen. Data extraction and analysis were completed on all included studies. The final sample for this integrative review comprised 33 studies.
Results:
Based on common meanings and central issues, 63 different factors contributing to nurses' organizational commitment were integrated and grouped into four main categories: Personal characteristics and traits of nurses, leadership and management style and behavior, perception of organizational context, and characteristics of job and work environment.
Conclusions:
In general, categories emerged in this study could be useful for formulating initiatives to stimulate nurses' OC. However, little is known about the relative significance of each identified factor among nurses working in different countries. Qualitative research is recommended for narrowing this gap. Future research should be directed to examine the psychometric properties of the organizational scales for nurses in different cultures.
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14
6,482
569
Challenges in conducting qualitative research in health: A conceptual paper
Hamidreza Khankeh, Maryam Ranjbar, Davoud Khorasani-Zavareh, Ali Zargham-Boroujeni, Eva Johansson
November-December 2015, 20(6):635-641
DOI
:10.4103/1735-9066.170010
PMID
:26793245
Background:
Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices.
Materials and Methods:
This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature.
Results:
One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real-life experiences in conducting qualitative research in health reveal these issues.
Conclusions:
The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others.
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1,037
ORIGINAL ARTICLES
Effect of lavender essence inhalation on the level of anxiety and blood cortisol in candidates for open-heart surgery
SeyedAbedin Hosseini, Alemeh Heydari, MohammadAli Vakili, Shahram Moghadam, SadeghAli Tazyky
July-August 2016, 21(4):397-401
DOI
:10.4103/1735-9066.185582
PMID
:27563324
Background:
Surgery, as a treatment, is a stressful experience. The anxiety is more severe in open-heart surgery patients due to its risk and complications. The present study aimed to determine the effect of lavender essence on the levels of anxiety and blood cortisol in candidates for open-heart surgery.
Materials and Methods:
This was a single-blind clinical trial, a random allocation study with a control group conducted on 90 candidates for open-heart surgery in two groups of study and control. The study and control groups inhaled two drops of lavender and distilled water for 20 min, respectively. Spielberger questionnaire was filled by the patients. A 2 ml blood sample was taken to measure the cortisol level and patients' vital signs were recorded before and after intervention. Data were analyzed by chi-square in the form of mean, SD, and frequency distribution, independent
t
-test, paired
t
-test, and analysis of covariance (ANCOVA), with a significance level of
P
= 0.05 to modify the pre-test scores.
Results:
Results showed a significant reduction in mean anxiety score from 56.73 (5.67) to 54.73 (5.42) after intervention in the study group, compared to the control group [1.11 (1.17)] (
P
< 0.001). There was also a higher difference in cortisol level in the study group compared to the control group [1.88 (0.56) vs. 0.42 (0.45)]. ANCOVA test showed that the 10.8% variance in anxiety score and 69.6% decrease in blood cortisol resulted from inhalation of lavender.
Conclusions:
Results showed the positive effect of lavender essence on anxiety and blood cortisol level among the patients. Aromatherapy with lavender is suggested to be considered as a nursing intervention in clinical settings.
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12
5,422
817
Kirkpatrick evaluation model for in-service training on cardiopulmonary resuscitation
Safoura Dorri, Malekeh Akbari, Mahmoud Dorri Sedeh
September-October 2016, 21(5):493-497
DOI
:10.4103/1735-9066.193396
PMID
:27904633
Background:
There are several evaluation models that can be used to evaluate the effect of in-service training; one of them is the Kirkpatrick model. The aim of the present study is to assess the in-service training of cardiopulmonary resuscitation (CPR) for nurses based on the Kirkpatrick's model.
Materials and Methods:
This study is a cross-sectional study based on the Kirkpatrick's model in which the efficacy of in-service training of CPR to nurses was assessed in the Shahadaye Lenjan Hospital in Isfahan province in 2014. 80 nurses and Nurse's aides participated in the study after providing informed consent. The in-service training course was evaluated in reaction, learning, behavior, and results level of the Kirkpatrick model. Data were collected through a researcher-made questionnaire.
Results:
The mean age of the participants was 35 ± 8.5 years. The effectiveness score obtained in the reaction level (first level in the Kirkpatrick model) was 4.2 ± 0.32. The effectiveness score in the second level of model or the learning level was 4.70 ± 0.09, which is statistically significant (
P
< 0.001). The effectiveness score at the third and fourth level were 4.1 ± 0.34 and 4.3 ± 0.12, respectively. Total effectiveness score was 4.35.
Conclusions:
The results of this study showed that CPR in-service training has a favorable effect on all four levels of the Kirkpatrick model for nurses and nurse's aides.
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594
REVIEW ARTICLE
Barriers and facilitators of nursing research utilization in Iran: A systematic review
Mahnaz Sanjari, Hamid Reza Baradaran, Maryam Aalaa, Neda Mehrdad
September-October 2015, 20(5):529-539
DOI
:10.4103/1735-9066.164501
PMID
:26457088
Background:
According to professionalization in nursing profession, the nursing researches expanded dramatically and rapidly in a very short period. Research results showed improvement in quality of provided care by using research findings. But there is still a gap between nursing research and practice, which led scientists to explore the barriers and facilitators of research utilization that could affect the application of research results. The aim of this review was to appraise and synthesize evidences of studies about the facilitators and barriers to research utilization in Iranian nurses.
Material and Methods:
A systematic review of quantitative and qualitative studies about the barriers and facilitators of nursing research utilization in Iran was undertaken.
Results:
The results showed that items such as "The nurse is isolated from knowledgeable colleagues with whom to discuss the research," "There is insufficient time on the job to implement new ideas," "The nurse does not have time to read research," "The nurse does not feel she/he has enough authority to change patient care procedures," "The facilities are inadequate for implementation," "Physicians will not cooperate with implementation," and "The relevant literature is not compiled in one place" were rated as the main barriers.
Conclusions:
The results of 10 studies about research utilization in Iran showed that the barriers and facilitators remained constant through time and across different locations. The rank orders of barriers and facilitators were the same approximately. The nurse managers and administrators could utilize the findings of this review to allocate human resources and other sources and promote nursing research utilization in clinical field.
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4,049
457
ORIGINAL ARTICLES
The effect of massage therapy on occupational stress of Intensive Care Unit nurses
Fateme Nazari, Mojtaba Mirzamohamadi, Hojatollah Yousefi
July-August 2015, 20(4):508-515
DOI
:10.4103/1735-9066.161001
PMID
:26257809
Background:
One of the main causes of stress in the lives of people is their jobs. Occupational stress is causing a wide range of significant issues in health and community services. Nursing is the most stressful profession in the health services. Massage therapy is one way of coping with stress. This study was conducted to determine the effect of massage therapy on stress in nurses.
Materials and Methods:
This study was a clinical trial on 66 male and female nurses working in intensive care units (dialysis, ICU, and CCU) of Isfahan University of Medical Sciences, Iran, in 2013. Participants were selected according to the aims and inclusion criteria of the study. Then, they were randomly divided into experimental and control groups. The Occupational Stress Inventory (OSI) (Osipow and Spokane, 1987) was completed by participants of the two groups before, immediately after, and 2 weeks after the intervention. General Swedish massage was performed on participants of the experimental group for 25 min in each session, twice a week for 4 weeks. Data were analyzed by descriptive and inferential statistics [Chi-square,
t
-test, and repeated measures analysis of variance (ANOVA)] using SPSS software.
Results:
Results showed that the difference in overall mean occupation stress scores between experimental and control groups 2 weeks after the intervention was significant (
P
< 0.001).
Conclusions:
According to the results, it is recommended that massage, as a valuable noninvasive method, be used for nurses in intensive care units to reduce their stress, promote mental health, and prevent the decrease in quality of nursing work life.
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4,874
571
REVIEW ARTICLE
Challenges of family caregivers of patients with mental disorders in Iran: A narrative review
Mohammad Akbari, Mousa Alavi, Alireza Irajpour, Jahangir Maghsoudi
September-October 2018, 23(5):329-337
DOI
:10.4103/ijnmr.IJNMR_122_17
PMID
:30186336
Background:
Family caregivers of patients with mental disorders play the most important role in the care of psychiatric patients (PPs) and preventing their readmission. These caregivers face different challenges in different cultures. We conducted this study to determine the challenges of caregivers of patients with mental disorders in Iran.
Materials and Methods:
This study is a narrative review with a matrix approach conducted by searching electronic databases, SID, IRANMEDEX, MAGIRAN, PUBMED, SCOPUS, Web of Sciences, from February 2000 to 2017. Searched keywords include challenges, family caregivers of psychiatric patient, family caregivers and psychiatric patient, mental illness, families of psychiatric patient, and Iran. One thousand two hundred articles were found in English and Farsi, and considering inclusion and exclusion criteria, 39 articles were examined.
Results:
The results of the studies show that not meeting the needs of caregivers, burnout and high burden of care, high social stigma, low social support for caregivers, and low quality of life of caregivers were among the most important challenges faced by caregivers.
Conclusions:
Despite the efforts of authorities in Iran, family caregivers of patients with mental disorders still face challenges. Therefore, the need for all-inclusive support for family caregivers of patients with mental health problems is necessary.
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10
5,193
644
ORIGINAL ARTICLES
Depression and anxiety in pregnancy and postpartum in women with mild and severe preeclampsia
Zahra Abedian, Narges Soltani, Naghmeh Mokhber, Habibollah Esmaily
July-August 2015, 20(4):454-459
DOI
:10.4103/1735-9066.161013
PMID
:26257800
Background:
Risk for anxiety and depression is increased in women with high-risk pregnancy. The aim of this study was to evaluate anxiety and depression in women with mild and severe preeclampsia at admission and 6 weeks postpartum.
Materials and Methods:
In this cohort study, 122 preeclamptic women who were admitted to the Public hospital and Tamin Ejtemaee hospital of Mashhad were included. Selection was done by convenience sampling method. Beck Depression Inventory II (BDI-II) and Spielberger State-Trait Anxiety Inventory (STAI) were completed at admission and 6 weeks after delivery. Data were analyzed by SPSS 16 using Chi-square, Fisher’s exact test, Mann-Whitney U test, and Repeated measurement.
Results:
The mean depression score was 4.81 ± 4.09 at admission and 11.17 ± 5.5 at 6 weeks postpartum. The mean of trait anxiety was 42.5 ± 10.5 at admission and 32.3 ± 6.5 at 6 weeks postpartum, and the mean of state anxiety score at admission was 43.09 ± 9.5 and at 6 weeks postpartum was 31.99 ± 5.9. There was a significant difference between the scores of depression (F = 3.8,
P
< 0.001), state anxiety (F = 1.52,
P
< 0.001), and trait anxiety (F = 1.5,
P
< 0.001) at admission and 6 weeks postpartum. No significant differences were found between severity of preeclampsia and the scores of depression, state anxiety, and trait anxiety at admission and 6 weeks postpartum.
Conclusions:
The mean score of state and trait anxiety decreased significantly in preeclamptic women from admission to 6 weeks postpartum, but the mean score of depression increased. Severity of preeclampsia was not an independent risk factor of depression and anxiety.
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Social support: An approach to maintaining the health of women who have experienced stillbirth
Maryam Allahdadian, Alireza Irajpour, Ashraf Kazemi, Gholamreza Kheirabadi
July-August 2015, 20(4):465-470
DOI
:10.4103/1735-9066.160998
PMID
:26257802
Background:
Stillbirth is one of the deepest losses that can inflict a broad range of cognitive, mental, spiritual, and physical turmoil. Many researchers believe that the failure to provide the care required by health teams during the hard times is the main determinant of maternal mental health in the future. In other words, social support can significantly improve the mental health outcomes of mothers after stillbirth. This study aimed to explore social support to aid mothers in adaptation after the experience of stillbirth.
Materials and Methods:
This was a qualitative content analysis in which 15 women who had experienced stillbirth participated. They were selected through purposeful sampling method. Data were gathered by individual interviews recorded on audiotapes, transcribed, and analyzed. Interview transcriptions were coded and then classified. Finally, two main categories and five subcategories emerged.
Results:
Analysis of participants’ viewpoints and their statements about social support led to the emergence of the two main categories of support from relatives and support from social support systems with two and three subcategories, respectively. Analysis of findings showed that mothers experiencing stillbirth need the support of their spouse and family and friends through sympathizing, in performing everyday activities and to escape loneliness. These women require support from a peer group to exchange experiences and from trauma counseling centers to meet their needs.
Conclusions:
It seems necessary to revise and modify the care plan in the experience of stillbirth using these results and, of course, to be considered by a panel of experts in order to provide social support to these women. Thus, midwives and healthcare provider can act, based on the development and strengthening of social protection of women experiencing stillbirth, to provide these women with effective and appropriate care.
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Effects of hope promoting interventions based on religious beliefs on quality of life of patients with congestive heart failure and their families
Niloufar Binaei, Mahin Moeini, Masoumeh Sadeghi, Mostafa Najafi, Zahra Mohagheghian
January-February 2016, 21(1):77-83
DOI
:10.4103/1735-9066.174755
PMID
:26985226
Background:
Heart failure is one of the most important and prevalent diseases that may have negative effects on the quality of life (QOL). Today, the promotion of QOL in patients with heart failure is important in nursing care programs. This research aimed to determine the efficacy of hope-promoting interventions based on religious beliefs on the QOL of patients with congestive heart failure (CHF).
Materials and Methods:
In this randomized clinical trial (IRCT2014100619413N1) conducted in Isfahan, Iran, 46 adult patients with CHF were selected and randomly assigned to study and control groups. Ferrans and Powers Quality of Life Index (QLI) was completed by both groups before, immediately after, and 1 month after the intervention. For the study group participants and their families, 60-min sessions of hope-promoting interventions based on religious beliefs were held twice a week for 3 weeks. Independent
t
, repeated measures analysis of variance (ANOVA), Chi-square, Mann–Whitney, and Fisher's exact tests were adopted for data analysis.
Results:
The mean (standard deviation) overall QOL score in the area of satisfaction significantly increased in the study group, compared to the controls, immediately [70.7 (8.5) vs. 59.2 (12.5)] and 1 month after the intervention [75.2 (7.4) vs. 59.4 (12.9)] (
P
< 0.05). There was also a similar difference between the two groups in the area of importance immediately [73.6 (5.8) vs. 65.7 (7.5)] and 1 month after the intervention [76.3 (8.1) vs. 66.8 (8.5)] (
P
< 0.05).
Conclusions:
Hope-promoting intervention based on religious beliefs is a useful method for improving QOL in patients with CHF.
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2,157
274
Application of the health belief model and social cognitive theory for osteoporosis preventive nutritional behaviors in a sample of Iranian women
Ali Khani Jeihooni, Alireza Hidarnia, Mohammad Hossein Kaveh, Ebrahim Hajizadeh, Alireza Askari
March-April 2016, 21(2):131-141
DOI
:10.4103/1735-9066.178231
PMID
:27095985
Background:
Osteoporosis is the most common metabolic bone disease. The purpose of this study is to investigate the health belief model (HBM) and social cognitive theory (SCT) for osteoporosis preventive nutritional behaviors in women.
Materials and Methods:
In this quasi-experimental study, 120 patients who were women and registered under the health centers in Fasa City, Fars Province, Iran were selected. A questionnaire consisting of HBM constructs and the constructs of self-regulation and social support from SCT was used to measure nutrition performance. Bone mineral density was recorded at the lumbar spine and femur. The intervention for the experimental group included 10 educational sessions of 55-60 min of speech, group discussion, questions and answers, as well as posters and educational pamphlets, film screenings, and PowerPoint displays. Data were analyzed using SPSS 19 via Chi-square test, independent
t
-test, and repeated measures analysis of variance (ANOVA) at a significance level of 0.05.
Results:
After intervention, the experimental group showed a significant increase in the HBM constructs, self-regulation, social support, and nutrition performance, compared to the control group. Six months after the intervention, the value of lumbar spine bone mineral density (BMD) T-score increased to 0.127 in the experimental group, while it reduced to −0.043 in the control group. The value of the hip BMD T-score increased to 0.125 in the intervention group, but it decreased to −0.028 in the control group.
Conclusions:
This study showed the effectiveness of HBM and constructs of self-regulation and social support on adoption of nutrition behaviors and increase in the bone density to prevent osteoporosis.
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647
Evaluating the effects of vitamin D and vitamin E supplement on premenstrual syndrome: A randomized, double-blind, controlled trial
Hajar Dadkhah, Elham Ebrahimi, Nahid Fathizadeh
March-April 2016, 21(2):159-164
DOI
:10.4103/1735-9066.178237
PMID
:27095989
Background:
Premenstrual syndrome (PMS) can cause problems in daily work and relationships.
Materials and Methods:
Eighty-six women were randomly assigned to two intervention groups and one control group. Patients were asked to fill out the PMS Daily Symptoms Record for 2 months, and then the participants were randomly assigned to one of the three study groups. Medical intervention was carried out for 2 months with the participants in each group receiving either a tablet containing 200 mg vitamin D, 100 mg vitamin E, or a placebo each day, respectively. After 2 months, the results of pre- and post-intervention were compared.
P
< 0.005 was considered significant.
Results:
After the intervention, the mean score of the syndrome significantly decreased in all the three groups (12, 16, and 8 participants had decreased scores in vitamin D, vitamin E, and placebo, respectively). The differences between groups were not significant (
P
> 0.05).
Conclusions:
Supplemental therapy with vitamins D and E is an effective and affordable treatment for PMS.
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9
3,410
418
Validity and reliability of the persian version of templer death anxiety scale in family caregivers of cancer patients
Mohammad Ali Soleimani, Nasim Bahrami, Ameneh Yaghoobzadeh, Hedieh Banihashemi, Hamid Sharif Nia, Ali Akbar Haghdoost
May-June 2016, 21(3):284-290
DOI
:10.4103/1735-9066.180390
PMID
:27186206
Background:
Due to increasing recognition of the importance of death anxiety for understanding human nature, it is important that researchers who investigate death anxiety have reliable and valid methodology to measure. The purpose of this study was to evaluate the validity and reliability of the Persian version of Templer Death Anxiety Scale (TDAS) in family caregivers of cancer patients.
Materials and Methods:
A sample of 326 caregivers of cancer patients completed a 15-item questionnaire. Principal components analysis (PCA) followed by a varimax rotation was used to assess factor structure of the DAS. The construct validity of the scale was assessed using exploratory and confirmatory factor analyses. Convergent and discriminant validity were also examined. Reliability was assessed with Cronbach's alpha coefficients and construction reliability.
Results:
Based on the results of the PCA and consideration of the meaning of our items, a three-factor solution, explaining 60.38% of the variance, was identified. A confirmatory factor analysis (CFA) then supported the adequacy of the three-domain structure of the DAS. Goodness-of-fit indices showed an acceptable fit overall with the full model {χ
2
(df) = 262.32 (61), χ
2
/df = 2.04 [adjusted goodness of fit index (AGFI) = 0.922, parsimonious comparative fit index (PCFI) = 0.703, normed fit Index (NFI) = 0.912, CMIN/DF = 2.048, root mean square error of approximation (RMSEA) = 0.055]}. Convergent and discriminant validity were shown with construct fulfilled. The Cronbach's alpha and construct reliability were greater than 0.70.
Conclusions:
The findings show that the Persian version of the TDAS has a three-factor structure and acceptable validity and reliability.
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273
REVIEW ARTICLE
Effect of massage therapy on labor pain reduction in primiparous women: A systematic review and meta-analysis of randomized controlled clinical trials in Iran
Mehdi Ranjbaran, Maahboobeh Khorsandi, Pegah Matourypour, Mohsen Shamsi
July-August 2017, 22(4):257-261
DOI
:10.4103/ijnmr.IJNMR_109_16
PMID
:28904535
Background:
Pain is a common experience for women during labor. Therefore, pain relief care for mothers during labor is very important. This meta-analysis was conducted to evaluate the efficacy of massage therapy on labor pain reduction in primiparous women. Materials and Methods: In this meta-analysis, the databases of Web of Knowledge, PubMed, Scopus, Cochrane, Iranmedex, Scientific Information Database (SID), and Magiran were searched for published articles in English and Persian language up to January 2016. Among the studies, with regard to the inclusion and exclusion criteria, 10 studies were selected. Data were analyzed by using Stata software version 11, and standard mean difference (SMD) of effects of massage therapy was calculated. The heterogeneity among studies was evaluated by the Chi-square based Q-test and
I
2
statistics. Results: The results of Chi-square based on Q-test and
I
2
statistics showed heterogeneity among studies in the latent phase (Q = 63.52,
P
value < 0.001 and
I
2
= 87.4%), active phase (
Q
= 26.42,
P
value < 0.001, and
I
2
= 77.3%), and transitional phase (
Q
= 104.84,
P
value <0.001, and
I
2
= 95.2%). Results showed that massage therapy reduces labor pain in the latent phase (SMD = −1.23, 95% CI: −1.73 to −0.74), active phase (SMD = −1.59, 95% CI: −2.06 to −1.12), and transitional phase (SMD = −1.90, 95% CI: −3.09 to −0.71).
Conclusions:
This study provides valid evidence for the effect of massage therapy in Iran for labor pain relief. Therefore, the use of massage therapy can be recommended in the primiparous women.
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3,723
614
Nurses' human dignity in education and practice: An integrated literature review
Akram Parandeh, Morteza Khaghanizade, Eesa Mohammadi, Jamileh Mokhtari-Nouri
January-February 2016, 21(1):1-8
DOI
:10.4103/1735-9066.174750
PMID
:26985216
Background:
Human dignity, as a fundamental human right and a moral obligation, has been emphasized in different fields of nursing. The aim of the present integrative review was to explore the nature of nurses' human dignity in educational and clinical settings.
Materials and Methods:
A literature review was conducted on quantitative and qualitative research papers in English and Persian using the PubMed, ProQuest, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Google Scholar, SID, and Irandoc databases from the year 2000 to 2013. Keywords for the search included dignity, nursing, faculty, nurse clinicians, nursing student, and humanism. In total, 12 research papers met the inclusion criteria for the integrative review.
Results
: From this review, four key themes emerged. The themes consisted of concept of human dignity (it was as an expression of the professional value in nursing settings), factors affecting human dignity (including respect, communication, autonomy and power, competency and ability, structure of the workplace, and value-based education), dimensions of human dignity (including intrinsic and professional domains), and consequences of human dignity [positive (individual and professional growth and caring professional behavior) and negative (loss of motivation, intention to leave the profession, and non-professional image of nursing in the minds of people)].
Conclusions
: The small number of studies found for the review indicates the need for further research in the field of nurses' dignity. Recognizing nurses' dignity can help to improve the nursing practice and provide them a dignified workplace.
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ORIGINAL ARTICLES
Effect of Olea ointment and Acetate Mafenide on burn wounds – A randomized clinical trial
Mohsen Zahmatkesh, Mohammad Jalili Manesh, Ronak Babashahabi
September-October 2015, 20(5):599-603
DOI
:10.4103/1735-9066.164507
PMID
:26457099
Background:
The main goals in treating burns are to accelerate tissue renovation and prevent infection. Topical antibiotics are used in the treatment of burns, but they can cause side effects. Recently, a traditional ointment (Olea) has been used in Iran in the treatment of burns. This study examines the effect of topical honey ointment in healing of burn patients.
Materials and Methods:
In this randomized controlled trial (RCT), 30 hospitalized patients selected by conventional sampling (10 in Olea group and 20 in Acetate Mafenide ointment group) were evaluated. Inclusion criteria were: having second-degree burns and body surface area equal to or < 40%. One group was treated using topical Olea ointment and the other with Acetate Mafenide ointment (8.5%). Chi-square, Fisher exact test, and Kaplan–Meier were used. Significance level was considered as
P
< 0.05.
Results:
None of the patients in the Olea group needed surgery for debridement, while in the second group, 13 patients (65%) needed debridement (
P
= 0.001). In the Olea group, 1 patient (10%) and in the second group, 19 patients (95%) had positive cultures after 7 days (
P
< 0.001). The mean time of granulation tissue formation in the Olea group was 12 days (10.3–13.6) and in the other group, it was 17 days (13.3–20.6) (
P
< 0.001).
Conclusions:
Olea ointment is a useful treatment for burns, and it can prevent infections, accelerate tissue repair, and facilitate debridement. Therefore, using this ointment is recommended for the treatment of burns.
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Online since 14 January, 2015