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Fear is an undesirable feeling which most of the time results in physiological changes and can affect on the cardiovascular function of the patient. This research is a cross-sectional descriptive study that describes the congruency opinions between 91 patients /nurses about the reasons for patients’ fear related to coronary angiography in two affiliated hospitals of Tehran University of Medical Sciences. The tools which were used included: questionnaire for study and recognition of patient and nurses demographic characteristics, a check list containing thirty probable reasons for patients’ fear which were filled out by patients and nurses, and a scale for analysis of the reasons for fear which were filled out by patients, descriptive statistics indicators, sign test, and t-test were applied in order to analyze the data, by SPSS software. The results showed that patients’ and nurses’ ideas about the reasons for fear before angiography are similar in two cases and only in one case after the operation. Among the thirty probable reasons which were mentioned for patients’ fear, seventeen cases caused less fear after angiography and two cases caused more fear after that. In the comparison between the intensity of fear caused by other reasons no insignificant result was observed. The comparison of intensity of fear showed that the intensity of patients’ fear after angiography is less than before (p= 0.005). According to these cases it may be concluded that because of the different reasons for patients’ fear concerning angiography, nurses need to pay more attention to patients’ fear. It is also suggested that an assessment tool be used in order to assess issues relating to patients, level of care and training related to coronary angiography.

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Introduction: Bed sore is an important complication of operation. Long immobility, hypotension and hypothermia in perioperative period predispose patients to bed sore. The prevention of bed sore is a priority in caring for immobilized patients and different methods have been used for this purpose. Hydrocolloid dressing is one of these methods.

Materials and Methods: This study is a quasi-experimental research. Subjects consisted of 60 patients aged 40-70 years who had eligibility criteria for this study. Subjects were selected with convenience sampling and randomly allocated to two 30-patient groups (experimental and control). In experimental group, hydrocolloid dressing was used before surgery. No procedure was performed for control group. After surgery sacral area was examined on three occasions to detect bed sore: immediately, 24 and 48 hours after surgery. The data were collected by demographic questionnaire and staging bed sore checklist and analyzed by SPSS statistic program and use of descriptive methods such as Chi square, Fisher exact test, t test, ANOVA and least significant difference (LSD).

Results: Incidence of bed sore was 13.3% in experimental group and %36.7 in control group. Chi square test showed significant difference between incidence of bed sore in two groups (p=0.03). Incidence of bed sore in two groups had no relationship with respect to gender and number of grafts. There was a significant relationship between bed sore and age, body mass index and duration of hypothermia, immobility and cardiopulmonary bypass (p<0.05).

Conclusion: Considering findings of this research, it seems that use of hydrocolloid dressing is effective in preventing perioperative bed sore after coronary artery bypass surgery.

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Introduction: Patients&apos rights have been center of attention in recent decades because of patients&apos vulnerability and worldwide sensitivity to human rights.

 Materials and Method: The current study is a qualitative, phenomenological research which has been carried out in Emam Khomeini Hospital during 2004-2005. The aim of this research was to identify the meaning of patient&aposs rights from the view point of patients and/or their companions. To achieve this, 16 semi-structured interviews were conducted with 12 informants. They were asked to explain their experience regarding the patient&aposs rights. All interviews were recorded. Data analyzing was simultaneously carried out using thematic analysis method.

Results: The emerging themes included expectation for equality and justice in receiving health care services, human respect and privacy need to be informed regarding their diagnosis and having essential facilities in the hospital.

Conclusion: It appears that whether the participants are aware of patients&apos bill of rights or not, they are able to define some rights for themselves. Attention to theses rights can help policy makers to design unique patients&apos bill of rights according to Iranian sociocultural and economic situation.

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Background & Aim: Physical and psychosocial problems along with the changes in life style, put hemodialysis patients under pressure. It seems that social support decreases psychological stresses and improves quality of life. This study aimed to describe hemodialysis patients&apos perceptions on their social supports and related factors.

Methods & Materials: This descriptive-correlational study is a part of a larger study. All patients (n=202) referred to the hemodialysis units of Iran University of Medical Sciences were recruited to the study during a four-months period. Data were collected using "Personal Resources Questionnaire" (PRQ 85-PART 2) and analyzed using SPSS v.14.

Results: Findings revealed that the most patients (64.9%) had perceived social support at high levels. There were significant relationships between social support with economic status, gender and marital status (P<0.05). Findings also indicated that the statements of "I enjoy doing little extra things that make another person&aposs life more pleasant" and, "I belong to a group in which I feel important" had the highest and lowest scores respectively.

Conclusion: Regarding the variety of perceptions in hemodialysis patients on social support and its related factors, nurses can prevent social isolation of these patients through identification of high risk groups and can also reduce their stresses and help them to improve their quality of life by providing adequate supportive interventions.

 

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Background & Aim: Spiritual well-being, religion, and hope are important factors in coping with cancer among patients. Nurses need to understand these concepts within a cultural context. This study aimed to determine the relationship between spiritual well-being, religion, and hope in patients with cancer.

Methods & Materials: In this cross-sectional study, 164 patients with cancer were selected using sequential convenience sampling method. Data were collected using a four-part questionnaire. Descriptive analysis, Pearson correlation and multivariate regression analysis were used to analyses the data.

Results: There were significant correlations between the existential well-being, religious well-being, and the hope. There were also significant correlations between the intrinsic religious, religious practices, and the hope. Existential well-being, organizational religiousness and intrinsic religious beliefs predicted hope.

Conclusion: The results of this study emphasized on the importance of the spiritual well-being and religion as variables affecting on hope in patients with cancer. This would help nurses and clinical specialists to focus on religion and spirituality well-being in order to increase hope in the patients.

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Background & Aim: Because of the importance of empathy and positive impact on the relationship between patients and health care providers, as well as the lack of valid instrument to assess student's empathy in health domain, this study aimed to examine the factor structure and reliability of the Persian version of JSE-HPS in the students of the School of Nursing and Midwifery, Mashhad University of Medical Sciences in Iran.

Methods & Materials: In this cross-sectional study, 398 nursing and midwifery students of Mashhad University of Medical Sciences were selected using stratified random sampling. The data collection instrument was JSE-HP. The confirmatory factor analysis was used to investigate the factor structure of the instrument, and the Cronbach's alpha coefficient was applied to examine its reliability. The data analysis was done using LISREL version 8.8 and SPSS version 20.

Results: The results of the confirmatory factor analysis model showed given that fitness model parameters, including CFI, GFI, AGFI and NFI were approximately 1 and RMSEA index was less than 0.1, the fitness of three-factor model is appropriate. The Cronbach's alpha coefficient for the total instrument was 0.63.

Conclusion: The current study confirmed the three-factor structure of the Persian version of JSE-HPS (20 items), included perspective taking, compassionate care and standing in patient’s shoes. Thus, this instrument is appropriate to measure empathy for patient in the health service provider students.

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Statistics show that brain death constitutes 1-4% of hospital deaths and 10% of the deaths occurred at the intensive care units (1). In the United States, brain death accounts for less than 1% of all deaths (about 15000 to 20000) (2). According to Iranian statistics, more than 15000 brain deaths occur every year in Iran, and driving accidents are one of its main causes (3-6). Then, these patients are taken to the ICUs to be cared for by nurses (7).

Considering the great number of brain deaths in Iran, and also the great number of patients needing transplant who die due to lack of obtaining an appropriate transplant organ, the Ministry of Health has notified to the universities of medical sciences the regulation number 54/100 dated 23.01.1394. In the 4^th clause of this regulation, accurate and specialized medical care in accordance with the instructions, preserving the vital organs of brain death patient (maintaining electrolytes, kidneys, liver, heart, lungs, and stabilizing vital signs) are emphasized which shows the necessity and importance of accurate training for all staffs specially nurses involved in caring for the brain death patients.

Given the high rate of brain death, most patients that ICU nurses face are the brain death patients (8). The caring process of brain death patients has different challenging and undiscovered dimensions due to its difficult and complicated nature which has attracted attention of researchers from all over the world to study its different dimensions. Some of the most important challenges which ICU nurses referred to in the caring process of brain death patients in studies are as follows: understanding the concept of brain death by the ICU nurses is one of the most challenging dimensions of this process (9). Although the meaning of brain death and caring for these patients is one of the vital components of nursing practice at the ICUs (10), understanding the concept of brain death is very difficult for most nurses and challenges all their previous beliefs about death and dying (11) because the concepts and implications for understanding brain death are beyond the understanding of the normal death of a person. This phrase is translated as actual death which means there is no hope for improvement, while the physical appearance of brain death patients, the presence of family members and nurses’ caring activities at the bedside of patients give the impression that they are alive, and all of these contribute to this ambiguity. But this conflict is naturally emotional and experimental for nurses (12). Ronayne in their study found that despite the knowledge about the physiology of brain death, its experience is stressful for nurses even long after facing these patients (8).

One of the other challenges is the announcement of brain death to the patient’s family. Although this is one of the physician’s responsibilities, nurses are also involved in because of their constant presence at the hospital and easy access of patients’ family members to them. This announcement is very stressful and challenging for nurses and is one of the most important parts of caring process (13) because nursing care is not only limited to the patient but also includes facing the specific needs of patient’s family members who are in crisis and experiencing an acute, complex and stressful clinical situation (14). Other nurses’ challenges in the caring process of brain death patients are ethical and legal aspects especially in the field of brain death and organ donation (4). Studies in Iran show that only half of physicians and medical staffs have sufficient awareness about organ donation and its laws, but they do not attempt to encourage organ donation for the fear of increasing mental pressure on patient’s family members (4). However, training is considered an effective factor in facilitating organ donation process (15).

Caring for a brain death patient and possible potential members to donate is another nurses’ challenge in caring process. Caring for a brain dead patient has been always a big challenge for the ICU nurses (14). According to different studies, most nurses believe that they are not ready enough to care for a patient who is a candidate for organ donation (16). So, one of the most difficult responsibilities of ICU nurses is caring for a brain dead patient who is a candidate for organ donation after her/his family’s consent (12). Studies showed that nurses feel hopelessness, inadequacy and depression after caring for a brain dead patient. These feelings may interfere in the quality of patient care and lead the nurse to be burnout (17). Ronayne found that because of the stress of caring for the brain dead patients, some nurses experience cognitive dissonance (8). One of the most important and controversial aspects of caring process is to give the request form of organ donation to the patient’s family. Given that caring process at the ICU involves both the patient and her/his whole family (18), the attitude of staffs especially nurses towards organ donation is very important since their positive attitude leads them to try more to prepare families for organ donation consent (13).

Some research has shown that providing opportunities for training nurses in this area, promotes organ donation and transplant rates since potential donors are timely identified and introduced to the organ bank (19). Nurses found that they need training and support on all aspects of caring for a brain death patient, organ donation and supporting her/his family (15). So, accurate and comprehensive understanding of the caring process of brain death patients especially from the nurses’ perspectives is very important for high quality and comprehensive caring. Due to the shortage of organ donation and the importance of organ health for transplantation, accurate and high quality caring for patient is necessary to make sure that organs remain healthy. Therefore, it is necessary to consider the caring process of the brain dead patient in order to develop an appropriate caring program for these patients.

Thus, considering that nurses are responsible for one of the most stressful caring processes including both caring for a brain dead patient and facing her/his family members (who may not be able to accept their patient’s brain death), and given the necessity of increasing the organ donation rate, and as well as the lack of targeted education on caring for the brain dead patients and insufficient nurses’ knowledge in this area, there is a need for accurate training on this caring process more than before.

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Background & Aim: Cancer as one of the most common illnesses in the world is associated with mental, physical, social and financial problems, which affects not only the patients, but also the family caregivers and creates a burden of care. Some studies have shown that spiritual well-being is effective in reducing the burden of care. Therefore, this research was conducted to determine the correlation between spiritual well-being and burden of care in family caregivers of cancer patients.
Methods & Materials: In this cross-sectional correlational study, 150 family caregivers of cancer patients referred to Taleghani, Shohadaye Tajrish, Masih Daneshvari and Imam Hossein hospitals in Tehran were selected by the convenience sampling method from August to November 2017. The data gathering tool was a questionnaire, and data were analyzed using descriptive statistics, Pearson and Spearman correlation coefficients, independent t-test, analysis of variance and multiple regression analysis at a significance level of 0.05.
Results: The mean and standard deviation of spiritual well-being score and burden of care were 90.36±17.70 and 25.54±11.79, respectively. There was a significant relationship between spiritual well-being (and its components including religious well-being and existential well-being) and burden of care (r=-0.421, P˂0.001). The result of regression test showed that spiritual well-being significantly predicted the burden of care.
Conclusion: The burden of care is experienced by family caregivers during caring for cancer patients, which is related to their spiritual well-being. Therefore, paying attention to the spiritual well-being of these caregivers is emphasized.
 

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Background & Aim: Cardiovascular diseases, especially coronary artery disease, are one of the most common causes of death worldwide. Recently, coronary intervention through the skin has been used for treatment, which has significantly reduced mortality rates. Nursing care behavior is of special importance in reducing the complications of angioplasty. The purpose of this study was to determine the effect of primary nursing care on the patients’ perception of nursing care behavior after coronary angioplasty.
Methods & Materials: In this randomized controlled clinical trial, 60 patients admitted from February 2018 to April 2018, to the CCU of Razi hospital in Birjand were selected by the convenience sampling method and assigned into two groups of 30, using a simple random allocation method. For the patients in the control group, routine care was delivered case by case, and for the patients in the primary nursing care group, care was provided based on the nursing process. At the time of discharge, the Caring Behaviors Inventory (CBI) was completed for the patients via interviews. Data were analyzed using the independent t-test and the significance levels of 0.05.
Results: The results showed that the mean scores of perception of care behavior and dimensions "respect" and "assurance of humanistic presence" in the intervention group were significantly higher than those of in the control group (P<0.05). However, no significant differences were observed between the two groups in the dimensions "positive attitude and relationship", "knowledge and professional skill" and "attention to other experiences" (P>0.05).
Conclusion: Provision of primary nursing care leads to improving the patient’s perception of nursing care behavior, increasing sense of respect, and assurance of humanistic presence of the nurse. Therefore, it is recommended to use this caring method in the cardiac intensive care unit.
 

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Background & Aim: Changes in hemodynamic parameters can indicate the health status of individuals, and treatment measures cause changes in hemodynamic parameters, and affect the treatment process of patients. Different ways of distraction can have different effects. The aim of this study was to determine the effect of music distraction and movie-watching on hemodynamic parameters of patients undergoing extracorporeal lithotripsy.
Methods & Materials: A quasi-experimental study with a three-group, before and after design was performed on 90 patients undergoing extracorporeal lithotripsy in the lithotripsy unit of Ayatollah Kashani hospital affiliated to Shahrekord University of Medical Sciences in 2018. Patients were selected using the convenience sampling method and randomly allocated into three groups. The intervention included visual and auditory distraction. Data was collected before and after the intervention using demographic characteristics questionnaire, calibrated mercury blood pressure monitor, and pulse oximeter. Descriptive statistical tests (mean and standard deviation, percentage, frequency) and inferential tests (paired t-test, Pearson correlation coefficient and analysis of variance) through the SPSS software version 16 were used to analyze the data.
Results: Analysis of variance showed that the mean scores of systolic and diastolic blood pressure, pulse rate and oxygen saturation in the auditory, visual and control groups were not significantly different before the intervention (P>0.05). Also, the mean scores of these variables in auditory, visual and control groups were not significantly different after the intervention (P>0.05). Paired t-test also showed the mean scores of pulse rate (P=0.133), systolic (P=0.159) and diastolic blood pressure (P=0.413), and oxygen saturation (P=0.083) did not have significant differences after the intervention compared to before the intervention between the groups.
Conclusion: According to the results, music and movie-watching did not have a significant effect on hemodynamic parameters of patients undergoing lithotripsy. Due to the lack of confirmatory studies, further research is needed on lithotripsy patients.
 

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Background & Aim: Comfort is the ultimate goal in all the nursing processes. The aim of the study is to examine the comfort status of the hospitalized patients with mental disorders.
Methods & Materials: This study is a descriptive, cross-sectional study that was conducted on 275 patients hospitalized in the psychiatric wards of Lavasani hospital in Tehran in 2020. The study subjects were selected using the convenience sampling method. The patients completed a demographic form and the comfort questionnaire of psychiatric patients. Data were analyzed using descriptive and inferential statistics, independent t-test, analysis of variance, and the Scheffe test through the SPSS software version 24 at a significance level of 0.05.
Results: A total of 184 patients (66.9%) were male. The overall comfort score was 128.76, which was more than median based on the score from 38 to 190.
The highest scores in the dimensions of comfort, were respectively sociocultural domain (65.20±91.55), psychospiritual domain (64.19±31.50), physical domain (58.22±37.06), and environmental domain (49.19±22.39). The Scheffe test showed that the comfort score for the patients with sufficient income was significantly higher (P<0.001). Also, the patients who were employees had a higher comfort score compared to others (P=0.017).
Conclusion: The patients gained the least comfort score in the environmental domain, and the most comfort score in the sociocultural domain. Therefore, devising and implementing all nursing interventions are recommended with the aim of maintaining and improving comfort in the environment of psychiatric departments.

 

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Background & Aim: Hypotension is a common complication associated with plasmapheresis. Elevating the legs and using elastic stockings are nursing interventions aimed at preventing hypotension. The objective of this study was to compare the effects of elastic stockings and leg elevation on the prevention of hypotension during plasmapheresis.
Methods & Materials: This randomized crossover clinical trial was conducted on 35 patients undergoing plasmapheresis at Beheshti Hospital in Hamadan from 2020 to 2021. Patients were selected based on convenience sampling and then allocated to four different methods in four sessions using random permuted block designs: elastic stockings (A), leg elevation (B), a combination of elastic stockings and leg elevation (C), and a control group (D). Blood pressure was monitored before, during (every half hour), and half an hour after the completion of plasmapheresis. Data analysis was performed using SPSS version 24, applying repeated measures ANOVA with a significance level of 0.05.
Results: During plasmapheresis, systolic blood pressure decreased over time in all four methods (P<0.001). Blood pressure measurements in intervention methods A, B, and C were higher than in the control group (P<0.001). Among the intervention methods, blood pressure in method C was higher than in methods A and B, while method B was higher than method A (P<0.001).
Conclusion: The use of elastic stockings in combination with leg elevation is more effective in preventing hypotension. Therefore, it is recommended as an easy and cost-effective method for preventing hypotension in patients undergoing plasmapheresis and for nursing staff to implement.
Clinical trial registry: IRCT20191020045166N1