Journal of Hayat

The effect of topical application of Rosemary essential oil on inflammation and pain severity caused by needle insertion into arteriovenous fistula in patients undergoing chronic hemodialysis: A clinical trial study

Marziyeh Asadizaker

Background & Aim: Pain and inflammation caused by needle insertion into the fistula is a common problem in hemodialysis patients. The aim of this study was to evaluate the effect of topical application of Rosemary essential oil on inflammation and pain severity caused by needle insertion into arteriovenous fistula in patients undergoing chronic hemodialysis.
Methods & Materials: In this clinical trial, 60 hemodialysis patients from the hemodialysis ward of Golestan hospital and Imam Khomeini hospital in Ahvaz were randomly assigned to two groups using block randomization. The intervention group received rosemary essential oil, while the control group received distilled water applied to the needle insertion site 5 minutes before each hemodialysis session. Pain severity was assessed using the VAS scale and inflammation severity was determined using the Phlebitis checklist at baseline and during six sessions. Data were analyzed using t-test, chi-square test and repeated measures analysis of variance (ANOVA) on SPSS software version 22.
Results: The results showed that the mean score for pain increased in the control group from 5.13±1.74 to 5.93±1.67, while it decreased in the intervention group from 5.83±1.53 to 3.77±1.43 (P=0.003). Additionally, the mean score for inflammation increased during the sessions in the control group, ranging from 1.27±1.20 to 2.07±1.08. However, in the intervention group, the mean score for inflammation decreased from 2.57±1.92 to 1.33±1.44. Nevertheless, this difference was found to be statistically insignificant (P=0.267).
Conclusion: The findings of the present study showed that the topical application of rosemary essential oil had a significant effect on reducing pain resulting from needling. However, its effect on reducing the severity of arteriovenous fistula inflammation in patients undergoing hemodialysis was not statistically significant. Based on these results, it is recommended to provide training to nursing staff and hemodialysis patients regarding the use of rosemary essential oil as a means to alleviate pain experienced during the procedure. Further research is required to investigate its potential for reducing the severity of fistula inflammation.
Clinical trial registry: IRCT2019102804526N1

The effect of auriculotherapy on mother-infant attachment: A clinical trial

Mahboubeh Valiani

Background & Aim: Establishing effective communication and forming a strong attachment with a newborn baby are crucial tasks during the postpartum period. The bond between mother and baby has a profound impact on the child's well-being, as well as the mother's health. The aim of the present study was to investigate the effect of auriculotherapy on the mother-infant attachment.
Methods & Materials: This randomized controlled clinical trial was conducted between March 2021 and September 2022 on a sample of 106 pregnant women who referred to the maternity ward of Shahid Sadoughi Hospital in Isfahan for normal vaginal delivery. The participants were randomly assigned to either the intervention group, which received auriculotherapy in addition to routine care, or the control group, which received only routine care. Auriculotherapy involved the stimulation of specific acupuncture points including oxytocin, uterus, Shen Men, thalamic, lung 1, and lung 2. Data collection was carried out using a checklist of demographic characteristics and the Maternal Postnatal Attachment Scale. Statistical analysis was performed using SPSS software version 26, employing independent t-test, paired t-test, exact Fisher's test, and chi-square test. A significance level of P<0.05 was considered statistically significant.
Results: The results showed that there was no statistically significant differences observed in demographic variables between the intervention and control groups (P>0.05). However, the mean score of attachment after delivery in the auriculotherapy group was significantly higher compared to the control group (P=0.004).
Conclusion: Based on the findings of this study, it has been determined that auriculotherapy exhibits the potential to enhance maternal attachment to the baby. Given its ease of use and non-invasive nature, it is strongly recommended to consider incorporating auriculotherapy as an intervention to improve mother-baby attachment during the postpartum period.
Clinical trial registry: IRCT20091219002889N12

A concept analysis of uncertainty in nursing: The Walker and Avant’s approach

Ahmad Nasiri

Background & Aim: Uncertainty is a multifaceted concept, inherently unavoidable, and can pose a significant obstacle to proper decision-making. In the nursing profession, which is marked by various challenges, nurses are expected to make precise and appropriate decisions. Confidence in decision-making is considered a vital element in the nursing profession. Given the ambiguities surrounding the concept of uncertainty, we aimed to conduct a concept analysis of uncertainty in nursing using the Walker and Avant’s approach.
Methods & Materials: This study is a concept analysis using the Walker and Avant’s approach to analyze the concept of uncertainty. Initially, a search was conducted on databases including Science Direct, SID, Medline, Iran Med, ProQuest, PubMed, and Scopus, using keywords such as uncertainty, nurse, and concept. A comprehensive review of articles published between 1990 and 2021 was then carried out, resulting in a total of 9 relevant articles.
Results: The literature review showed that uncertainty is an abstract and intricate concept that poses challenges in making informed decisions. In the context of nursing, uncertainty shares similarities with terms like confusion and doubt, while standing in contrast to concepts like self-confidence and assurance. The antecedents of uncertainty include the inability to make decisions and a lack of accountability. The consequence of uncertainty is the recognition of information needs, active pursuit of answers, and ultimately making informed and appropriate decisions.
Conclusion: The findings of this study indicate that nurses encounter uncertainty when they are unable to make independent decisions. As uncertainty in nursing decision-making directly affects patient care, managers and planners can take proactive measures to mitigate this issue. By promoting knowledge and awareness, fostering motivation, and encouraging continuous learning among nurses, the level of uncertainty can be reduced. This, in turn, will contribute to the improvement and enhancement of patients’ health outcomes.

Relationship between physical presenteeism and productivity of nurses in intensive care units of hospitals affiliated with Tehran University of Medical Sciences

Nahid Dehghan Nayeri

Background & Aim: Presenteeism and productivity are two crucial aspects within the realm of human resources. Presenteeism poses a significant challenge as it refers to employees being present at the workplace despite being unwell. In the context of nursing services, the productivity objective encompasses attaining a level of nursing care that is both suitable and cost-effective. Due to the importance of presenteeism and productivity, this study was conducted to determine the relationship between physical presenteeism and productivity of nurses in intensive care units of hospitals affiliated with Tehran University of Medical Sciences.
Methods & Materials: The present study is a descriptive-analytical study that was conducted in 2020-2021. The sample included 305 nurses working in intensive care units within hospitals affiliated with Tehran University of Medical Sciences. The participants were selected using a stratified simple random sampling technique. The data collection was conducted using a demographic questionnaire, the Stanford presenteeism Scale 6-item questionnaire and the Productivity Assessment Questionnaire. Data were analyzed through SPSS software version 16 using descriptive statistics (mean and standard deviation) and inferential statistics (Pearson correlation coefficient, Spearman correlation coefficient, t-tests, ANOVA and regression analysis).
Results: The levels of presenteeism and productivity among nurses were found to be average based on the mean scores of 19.15±4.7 and 47.4±10.19, respectively. Furthermore, there was a significant inverse correlation between productivity and presenteeism (r=-0.345). Regarding the demographic variables, only age, working experience in intensive care units, hospital and current department showed a significant inverse relationship with nurses' productivity (P<0.001). The inclusion of these demographic variables and the two main research variables in the regression analysis produced a significant impact on this relationship.
Conclusion: The results of this study showed that nurses' presenteeism diminishes their productivity, which imposes considerable indirect costs on the organization. Given the high prevalence of presenteeism among nurses and its detrimental consequences, it is recommended to undertake various measures aimed at mitigating this issue. These measures can encompass adjusting organizational and managerial policies, revising administrative rules and regulations to permit sick leave during illnesses, and creating conditions conducive to employees taking time off when unwell.

The effect of cognitive-behavioral therapy on alleviating loneliness among elderly women

Parvaneh Mousavi

Background & Aim: Feelings of loneliness can affect the mental health of the elderly and lead to cognitive problems. As a potentially effective treatment approach, cognitive-behavioral therapy (CBT) has emerged as an intervention to alleviate loneliness among the elderly. This study aims to determine the effect of CBT on alleviating loneliness among elderly women referred to health centers in Khomeini Shahr.
Methods & Materials: This quasi-experimental study was conducted in 2020 on a sample of 60 elderly women who had been referred to health centers in Khomeini Shahr. The participants were conveniently selected and then randomly assigned to either the intervention or control groups. Data were collected using a demographic information form and the Deshiri et al’s loneliness questionnaire, which were administered before, immediately after, and one month after the intervention. The intervention group received eight counseling sessions of CBT that lasted for 60 minutes each, while the control group did not receive any counseling. Data analysis was carried out using the SPSS software version 23, employing descriptive and inferential statistics.
Results: The results obtained from conducting a two-way repeated measures analysis of variance (ANOVA) showed a significant statistical difference in the mean score of loneliness resulting from communication with family, the score of emotional symptoms of loneliness and the total score of loneliness in the intervention group before and after the intervention (P<0.001). However, no statistically significant difference was observed in the control group (P>0.05). Furthermore, when comparing the mean score of loneliness resulting from communication with friends in the intervention group, no statistically significant difference was observed before and after the intervention (P=0.094). Similarly, no statistically significant difference was observed in the control group (P=0.338).
Conclusion: The results of the current study indicate that CBT is an effective approach to alleviate loneliness in elderly women. Therefore, it is suggested that this method be implemented as a means to reduce feelings of loneliness among elderly women.

The role of hidden curriculum in the formation of professional identity among undergraduate nursing students

Fatemeh Bahramnezhad

Background & Aim: Various factors play a significant role in shaping the professional identity of nursing students, and among these factors, the impact of the hidden curriculum holds utmost importance. However, this process remains still unknown. The aim of the study is to explore the role of hidden curriculum in the formation of professional identity among undergraduate nursing students.
Methods & Materials: This is a qualitative research using the grounded theory approach. The participants in this study included 35 undergraduate nursing students from Tehran University of Medical Sciences during the 2020-2021 academic year who participated in semi-structured interviews. The interviews lasting between 30 and 60 minutes were conducted with each participant. Subsequently, the interviews were transcribed and analyzed following the framework proposed by Strauss and Corbin in 2008.
Results: After analyzing the data, three main categories and 12 subcategories have emerged. The theory developed in this research was formed through the core category of “identity instability within the nursing profession”. The main categories that emerged were “ambiguity and lack of motivation in professionalization”. The study identified "the governance of a discriminatory culture" as the underlying process, while “the promotion of demotivation resulting from inefficient patterns” served as the basis of this study.
Conclusion: Based on the study's findings, the process of developing a professional identity can be metaphorically likened to a river. In this analogy, discrimination serves as the clouds hovering over this river, casting a shadow on the identity development process. While inefficient patterns can be likened to lightning bolts that further complicate the process. Furthermore, the rocky bed of the river, symbolizing the lack of motivation among learners towards professionalism, makes it even more challenging to build a strong professional identity.

The effect of acceptance and commitment therapy on the resilience of women experiencing spousal abuse

Sakineh Taherkhani

Background & Aim: In women experiencing intimate partner violence, resilience can serve as a protective factor against the worsening of psychological problems. Acceptance and Commitment Therapy has emerged as a potential means to enhance resilience in these individuals. The aim of this study is to determine the effect of Acceptance and Commitment Therapy on the resilience of women experiencing spousal abuse.
Methods & Materials: This is a quasi-experimental study. A total of 80 women experiencing spousal abuse were selected through quota sampling from the women referring to the health houses affiliated to the Mashhad ol-Kube health center in Arak, Iran between 2020 and 2021. The participants were then divided into intervention and control groups using the block randomization method. The intervention group received the Acceptance and Commitment Therapy in eight sessions, lasting 90 minutes each, once a week. The data collection tools included a questionnaire on personal and health characteristics, the Revised Conflict Tactics Scale, and the Connor‐Davidson Resilience Scale. The Resilience Scale was completed by both groups one week and five weeks after the intervention. The data were analyzed through the SPSS software version 23 using descriptive statistics, independent t-test, Chi-square test, Fisher’s exact test, and two-way repeated measures ANOVA. A significance level of P<0.05 was used to determine statistical significance.
Results: The mean and standard deviation of the resilience score for the intervention group increased from 59.21±13.29 before the intervention to 64.31±11.27 and 72.34±10.49 in the post-test and follow-up periods. For the control group, these figures were 52.47±17.2, 51.94±14.72, and 52.47±15.3, respectively. Based on the results of the two-way repeated measures ANOVA, there was a statistically significant difference in the mean score of resilience between the intervention and control groups at the three time points examined (P<0.001).
Conclusion: The implementation of Acceptance and Commitment Therapy can significantly improve the resilience of women experiencing spousal abuse. This intervention holds great potential for being incorporated into mental health improvement programs specifically designed for women who have experienced spousal abuse.

The return-to-work process in the patients after cardiac surgery: A grounded theory study

Zahra Sabzi

Background & Aim: The availability of information regarding people's experiences of returning to work after heart surgery, taking into account the socio-cultural context of Iranian society, is limited. The aim of this study is to discover the process of returning to work after heart surgery.
Methods & Materials: A qualitative study using the grounded theory approach was conducted between 2021 and 2022. Through purposive and theoretical sampling, 21 participants who had undergone heart surgery and were in the process of returning to work were selected. They were chosen from the cardiac surgery ward of Amiralmomenin Hospital in Kordkuy, as well as among patients seeking treatment from cardiac surgeons in Golestan province. Data were collected through conducting semi-structured interviews and taking field notes. Data analysis was conducted using the method proposed by Corbin and Strauss in 2015.
Results: "Feeling of doubt about return-to-work", "perceived psycho-social support", "personal and occupational factors", "unfavorable consequences of heart surgery" and "limited support from governmental/non-governmental institutions" were determined as contextual factors influencing the process of return-to-work. Moreover, "effort to adjust the job", "situation evaluation" and "self-management" were introduced as strategies, while "adaptability to the job" were identified as the consequence of returning to work. Finally, the core variable of the study was determined to be "the thoughtful effort to match the job".
Conclusion: Based on the results, it was determined that several individual and environmental factors influence the process of return-to-work for people who have undergone heart surgery. To facilitate a successful return to work, it is crucial to provide psycho-social support from both the family and work environment. It is recommended that policy makers in the health and social affairs sectors take active steps to empower people during the post-recovery period. Additionally, fostering collaboration between the Ministries of Labor and Health, as well as insurance organizations, can greatly facilitate the return to work of individuals after heart surgery.