Journal of Hayat

Pilot Study in Qualitative Research: The Roles and Values

Robab Latifnejad Roudsari

A pilot or preliminary study is referred to a small-scale of a complete survey or a pretest for a particular research instrument such as a questionnaire or interview guide (1). Pilot studies could be conducted in qualitative, quantitative, and even mixed methods research (2).

General application of pilot studies can be summarized in four areas: 1) to find problems and barriers related to participants' recruitment 2) being engaged in research as a qualitative researcher 3) assessing the acceptability of observation or interview protocol and 4) to determine epistemology and methodology of research. Three specific functions of pilot studies in qualitative research are assigned to three main qualitative methodologies including phenomenology, grounded theory, and ethnography. It allows exercising epoch within the phenomenological research, increasing theoretical sensitivity in grounded theory, and familiarity with fieldwork in ethnography (3-5).

Effect of Rhythmic Breathing on Pain Intensity during Insertion of Vascular Needles in Hemodialysis Patients

Gholam-Hosein Falahinia

Background & Aim: Patients with end-stage renal disease undergoing hemodialysis are repeatedly exposed to stress and pain from approximately 300 punctures per year to their arteriovenous fistula . Patient comfort with the procedure is therefore of greatest importance for long-term compliance with the treatment and until a successful renal transplant. This study was conducted to determine the effect of rhythmic breathing on pain intensity when the needles are inserted into vascular access for hemodialysis .

Methods & Materials: This was a quasi -experimental one-group time-series study. Thirty five patients in hemodialysis ward of Hamadan Besat hospital entered into the study via convenient sampling method. In this study, pain intensity during the insertion of hemodialysis vascular needles was measured in six sessions through two methods of routine intervention and rhythmic breathing. The data were collected using visual analog scale. Paired t-test was used to determine pain intensity mean difference between the two conditions .

Results: Overall, the results showed that the mean pain intensities were 5.45±1.15 and 2.19±0.92 in two conditions including routine intervention and rhythmic breathing , respectively. Paired t-test showed a significant difference between the routine intervention and rhythmic breathing (P<0.001) .

Conclusion: These findings showed that rhythmic breathing was effective in reducing pain when the needles were inserted into the vascular access. Therefore, it is recommended to use rhythmic breathing as a simple and non-expensive method to reduce pain in patients before insertion of hemodialysis vascular needles .

Effect of Coping Skills Training on Quality of Life among Parents of Children with Leukemia

Somayeh Borji

Background & Aim: Cancer is the most common childhood chronic medical illnesses that can affect quality of life of the children and their families. The aim of this study was to determine the effect of coping skills training on quality of life among parents of children with leukemia.

Methods & Materials: This non-randomized clinical trial was conducted from March to June 2013. Ninety eight parents of children with leukemia who were referred to two selected hospitals affiliated to Tehran University of Medical Sciences were enrolled to study using convenience sampling method. The participants were allocated to two experimental (n=48) and control (n=50) groups. Data were collected through two questionnaires including demographic characteristics of the parents and children, and the Persian version of the Caregivers Quality Of Life index Cancer. Coping skills training including social communication skills was performed through small group discussion (5-8 members) in four 2-hours sessions for the experimental group. The questionnaires were completed four weeks after the intervention by the parents. Data were analyzed using the independent t-test, paired t-test, Fisher's exact test and Chi-squared test in the SPSS-16.

Results: The results showed significant increase in the overall quality of life after the intervention (P<0.001). The quality of life of parents in the experimental group was improved significantly in comparison with the control group (P=0.045). Mental/emotional burden (P<0.001) and lifestyle disruption (P<0.001) decreased significantly after the intervention.

Conclusion: The coping skills training affected the quality of life among parents of children with leukemia . Effective educational interventions may help to increase the quality of life of parents who have children with Leukemia.

Development of Adaptation Questionnaire using Roy’s Adaptation Model and its Psychometrics on Veterans with Lower Limb Amputation

Zahra Farsi

Background & Aim: The Roy’s adaptation model is a helpful instrument to be used in treatment processes of patient s with chronic diseases. According to chronic nature of amputee veterans' diseases, it is expected that the implementation of care plan s based on this model can increase adaptation in the patients . The present study was performed to design and determine validity and reliability of a researcher-designed adaptation questionnaire based on the Roy’s adaptation model on war veterans with lower limb amputation .

Methods & Materials: This study was conducted among war veterans referred to the veteran clinic of Orthotics and Prosthetics center using convenience sampling method during 2012-2014 . M ain concepts of adaptation defined based on the Roy’s adaptation model were used to provide items. The validity and reliability of the questionnaire was assessed using the content validity index (CVI), content validity ratio (CVR), face validity, internal consistency (Cronbach's alpha), and stability (test-retest reliability) tests.

Results: Thirty five items were developed including 15 items on physiological area, 11 items on self-concept area, four items on dependence/ independence area, and five items on role playing area. The CVI was 0.95 . The Cronbach's alpha was 0.78. The correlation coefficient values were more than 0.7 in each area .

Conclusion: The psychometric analysis of the questionnaire showed proper validity and reliability for measuring adaptation on war veterans with lower limb amputation. The questionnaire is recommended to be used in nursing practice .

Experiences of Living with Coronary Artery Bypass Graft: a Qualitative Study

Mohammad Abbasi

Background & Aim: Coronary artery bypass graft is a critical intervention for patients with coronary artery disease. This surgery is associated with significant changes and unique experiences in lives of patients. This study was conducted to understand the experiences of patients with coronary artery bypass graft.

Methods & Materials: This qualitative study was conducted using an interpretive phenomenological approach. Eleven patients were selected from outpatient cardiology clinics of Tehran Heart Center using purposive sampling method. Data were gathered through semi-structured in-depth interviews lasting 55-70 minutes. The van Manen six steps analysis was used to analyze the data .

Results: During the data analysis, the main themes of e xperiences of living with coronary artery bypass and rebirth were extracted. These themes contained living with healthy heart, feeling back to the young and attempts for health maintenance .

Conclusion: According to the study, participants were inclined to maintain the new lifestyle, dietary changes and also adhere to medications prescription. Nurses can help patients with properly designed educational program based on experiences of the patients.

Influence of Doula on the Primiparous Parturients' Anxiety in the Delivery Ward

Mahnaz Khatiban

Background & Aim: Women who experience anxiety during labor are more vulnerable to physical and mental illnesses. Emotional support by a knowledgeable individual can improve physical and even mental conditions. This study aimed to determine the effect of presence of a Doula in delivery unit on parturient women’s anxiety .

Methods & Materials: This is an experimental study using a randomized interrupted time series with a control group. Using convenience sampling, 64 parturient women with research inclusion criteria were randomly assigned to the control or intervention groups. The parturient women in the intervention group benefited from presence of a Doula and her support. The control group received the usual care without presence of the Doula. Data were collected using the Spielberger state-trait anxiety inventory and a checklist. The results were analyzed using parametric and non-parametric statistical tests in the Stata-11 .

Results: The age, education, family income, location of residency, the trait and state anxiety did not have any differences between the two groups at the baseline. After the intervention, the state anxiety was reduced significantly in the intervention group compared with the control group at the time of leaving the labor room, delivery room and recovery room (P<0.001) .

Conclusion: According to the present research findings, Doula can significantly reduce the anxiety level and its complications among parturient women during childbearing .

Effect of Open and Closed Endothracheal Suctioning on Physiologic Parameters and Stability in Premature Infants undergoing Mechanical Ventilation

Rahele Janani

Background & Aim: Premature infants are the most admitted group to NICUs. Stabilization of cardio pulmonary parameters is a main goal in NICUs. Mechanical ventilation and endothracheal suctioning are the most common and effective procedures to stabilize cardio pulmonary parameters. The aim of present study was to compare the effects of two endothracheal suctioning methods (open and closed) on physiological stability in premature infants under mechanical ventilation .

Methods & Materials: In this clinical trial, 90 preterm infants (GA: 27-34 weeks) hospitalized in the NICUs of Alzahra and Taleghani hospitals were selected and randomly assigned to two groups. In one group, infants were suctioned using open suctioning method and in the other group, infants were suctioned using closed suctioning method. The physiologic parameters (O2 sat, HR, mean BP variation) and stability (recovery time of HR, BP) were compared between the groups. Data were analyzed using descriptive and inferential statistical methods such as x², independent t-test and mixed model in the SPSS-21 .

Results: There was significant statistical difference between the two groups on mean BP (P=0.016). Recovery time of the BP and HR was shorter in the closed suctioning group. Physiologic stability was better in the closed suctioning group (P<0.05) .

Conclusion: Variation of the mean BP and recovery time was more in the open suctioning group compared with the closed suctioning group. Considering better physiologic effects of closed suctioning, it is recommended to assess the combined effect of closed suctioning with weight on physiologic parameters of premature infants .

Spiritual Health among Nursing and Midwifery Students at Kerman University of Medical Sciences

Neda Rahimi

Background & Aim: The present study aimed to investigate the spiritual health among nursing and midwifery students at Kerman University of Medical Sciences in 2012 .

Methods & Materials: This was a cross-sectional study in which all 222 nursing and midwifery students studying at Kerman University of Medical Sciences were recruited to study. Data were gathered using t he Palutzian & Ellison questionnaire of spiritual well-being. The obtained data were then analyzed in the SPSS-20 using parametric statistical tests such as independent t-test and Anova .

Results: Results showed that spiritual well-being of nursing and midwifery students was in the good range. Except gender, no statistically significant relationships were observed between the mean of spiritual well-being and parameters such as age, marital status, academic year, and field of study .

Conclusion: According to the findings , spiritual health among nursing and midwifery students was moderate. It is necessary to promote spirituality among nursing and midwifery students .