Search published articles


Showing 19 results for Clinical

Z Parsa Yekta, M Zaceri Moghadam, M Mahmoodi, N Dehghan Naeiri,
Volume 5, Issue 3 (12-1999)
Abstract

This study is a descriptive -analytical research which is designed to evaluate clinical skills of Nurses in coronary care units in affiliated hospitals of Tehran medical sciences University.The specific objectives of this research are as follows: Determining clinical skills of nurses in coronary care unit in the fields of patient assessment, intrepretation of Electrocardiogram, and ABG test administration, Iv therapy, educating the clients , caring the patients under cardiac catheterization and resuscitation ofcardio-pulmonary disorders. The population involved 50 nurses who were working in the coronary care units. The sample and population were the same. The researcher collected the data during a period of 3 months and observed the subjects minimum two full working shifts.The results indicated that nursing skills of the majority of the subjects towards the patientassessment was at weak level, one half of them had high level skill ofEKG interpretation(+90%), Meanwhile 2/3 of the subjects (68%) had a very weak skill (0-20%) in the field of ABGtest interpretation. One half of them had a medium skill for administration ofthe IV drugtherapy and all of them were at very weak levelforpatienteducation skills. More than one halfof these nurses had a good skill about nursing care of the patients under cardiaccatheterization. Finally, the last objective (Cardiac resuscitation skill) was not analysed due to afew cases.
Z Rahnavard, S Ahmadnejad, A Mehran,
Volume 15, Issue 1 (8-2009)
Abstract

Background & Aim: The Clinical Teaching Partner model (CTP) integrates theoretical knowledge with professional skills and brings the reality to workplaces. Closing educational and practical aspects in nursing discipline has been a challenging goal for nursing which requires cooperation between faculty instructors with nurse practitioners such collaboration will led to development and promotion of nursing discipline. Therefore selecting an effective and efficient approach in order to integrate theoretical knowledge with practical experiences would be crucial for nursing profession. This study was conducted in order to investigate the effect of CTP on nursing students&apos clinical skills outcome.

Methods & Materials: A quasi experimental, only post test design was applied. Study sample consisted of 1) three faculty instructors, 2) seven registered nurse practitioners who were staff nurses in three pediatric wards and voluntarily participated in the study and 3) fifty two nursing students which were in the 5th semester of nursing BSc. program and had eligible criteria to enter the study. Students were allocated randomly to the intervention (n=28) and control (n=24) groups. Participants in the control group, initially started their internship period in 3 pediatric wards and were evaluated by faculty instructors regarding their clinical skills at the end students in the intervention group, then started their clinical training course in the same ward as control group, but their clinical education was conducted by the nurse practitioners who voluntarily participated in the study and trained initially in the nursing faculties&apos skill lab. Students&apos clinical skills were evaluated by nursing mentors via some instruments at the end of the educational period in addition, clinical education outcomes and nursing students&apos satisfaction of achievement to apprenticeship goals were assessed at the end of the training period. Data were analyzed using the statistical tests including Chi square, Fisher exact test, Mann-Whiney U, and t-test in SPSS.

Results: Considering students demographic characteristics, both groups were homogenous. There was a significant difference in the students&apos clinical skills between two groups (P<0.001). A significant difference was shown in the nursing mentors and faculty instructors&apos satisfaction of application of cooperative education method between both groups (P=0.004). No significant differences were found between students&apos satisfaction of reaching to educational outcomes between both groups (P=0.058). There were also no statistical differences between nursing mentors and faculty instructors&apos satisfaction of achieving to clinical education outcomes (P=0.109).

Conclusion: According to this study, CTP is an effective approach in clinical education and development of clinical skills for nursing students therefore,

application of this method is recommended in clinical nursing education.

 


Sh Davoodvand, N Elahi, M Haghighizadeh,
Volume 15, Issue 3 (12-2009)
Abstract

Background & Aim: Cardiac rehabilitation is one of the most effective ways of secondary prevention in patients with myocardial infarction manifestations. This study aimed to assess the effectiveness of cardiac rehabilitation on clinical manifestations of myocardial infarction in post-MI patients.

Methods & Materials: In this interventional study, 66 patients (58 males and eight females) with myocardial infarction who were hospitalized in public hospitals of Ahwaz were selected using purposeful sampling. The participants were randomly allocated into intervention and control groups. Data was collected using a self-structured valid and reliable instrument. The intervention group participated in an 8-week cardiac rehabilitation program. Data on the clinical manifestations were collected eight weeks later. Data were analyzed in SPSS.

Results: The results showed that there was significant differences between two groups in hypertension crisis (P=0.03), chest pain, dyspnea, fatigue and palpitation after the cardiac rehabilitation (P<0.001).

Conclusion: Cardiac rehabilitation program decreased the clinical manifestations of myocardial infarction in post-MI patients. It is recommended to perform this procedure in the post-MI patients.

 


N Dehghan Nayeri, R Negarandeh, N Bahrani, A Sadoghi Asl,
Volume 16, Issue 2 (7-2010)
Abstract

Background & Objective: Conflict occurs more frequently in health care organizations than the other settings due to complexity, frequent interaction between personnel, variations in specialties, roles, and hierarchy. Although conflict is not harmful and destructive in its nature and some degrees of conflict can help to improve health care services, high levels of conflict or its continuity may be harmful. Therefore, it is necessary to manage and control conflict. This study was carried out to assess the relationship between components of the conflict control model.

Methods & Materials: In this cross-sectional study, we developed a questionnaire that probed the relationships between components of conflict control model. A total of 290 nurses were recruited to the study using multi-stage sampling procedure from general educational hospitals in Tehran. Data were gathered using a questionnaire. Content validity of the questionnaire was examined by the expert panel. The internal consistency of the questionnaire was 0.81. Data were analyzed in the SPSS using descriptive statistics and spearman statistical test.

Results: The range of age was 22-53 (34.5±8.2). The majority of the respondents (88.6%) were female, 57.6% were married and 84.8% were staff nurses. From the majority of nurses&apos perspective, the meaning of conflict was discoordination, disagreement and disparity. However, some of the nurses meant it as violence, and difficult issues. About 41.4% of the respondents used negotiation, when they faced up to conflict. Other strategies were aggression, disagreement, avoidance, forgiveness, ignorance, and imposing own ideas to the others. From the respondents&apos point of view, factors that might cause or control the conflict were "mutual understanding and interaction" (32.4%), personality of nurses and their individual characteristics (26.6%), and conditions of the job (21.7%). Interaction was recognized to be the core strategy in conflict control model. Interaction had also significant associations with the five main variables in this study.

Conclusion: Lack of appropriate and efficient communication was an important factor in occurrence of conflict from the nurses&apos point of view. It is essential to improve nurses&apos and managers&apos communication channels by helping personnel to use effective communication skills. This measurement can be helpful for staff in understanding each other and reducing misconceptions. In addition, recognizing additional factors and variables that increases the occurrence of conflict can help to modify effective approaches.


Reza Negarandeh, Shadan Pedram Razi, Mohammad Khosravinezhad,
Volume 19, Issue 1 (7-2013)
Abstract

  Background & Aim: Access to quality care is important in delivering health services. Patients' safety and satisfaction are indicators of quality of care evaluation. Competent nurses may deliver quality care . This study aimed to investigate the impact of using competent nurses on patients’ safety and satisfaction .

  Methods & Materials: In t his interventional study with non-equivalent control group, we selected 120 patients admitted to the emergency department of Imam Khomeini hospital in 2012 using convenience sampling method . Nursing care for the experimental group (n=40 ) was provided by nurses who had high competency scores and in the control group ( n=80), nursing care was provided by usual emergency department nurses . Data were collected using the patient satisfaction with nursing care quality (PSNCQ), and patient safety inventory. Data were analyzed in the SPSS v.16 using descriptive and inferential statistics . The significance level for all statistical tests was considered at P<0.05 .

  Results: Mean age of the intervention and control groups were 48.1 ( ±12.5) and 40.5 ( ±16.7), respectively (P<0.018). There was a significant difference between the two groups in terms of employment (P<0.009). The two groups were similar in terms of other variables such as gender, marital status, level of education, having health insurance , and the reasons for seeking admission . The results showed that there were significant differences between the two groups in patients’ safety and satisfaction with nursing care (P<0.001). Regression test was used to eliminate the effects of age and job satisfaction the results showed effect of intervention on the patients’ safety and satisfaction with nursing care .

  Conclusion: These findings indicated that using competent nurses in providing nursing care promotes patients’ safety and satisfaction with nursing care. Training nurses focusing on the level of competency is required in scheduling, staffing, and implementing nursing care to enhance safety, patient satisfaction , and quality of care.


Seyed Mohammad Mirkamali, Mandana Javanak Liavali, Mohammad Reza Yeganeh,
Volume 20, Issue 1 (4-2014)
Abstract

  Background & Aim: The quality of clinical services is a major concern for healthcare systems throughout the world. Clinical Governance, a relatively new approach to improve quality of healthcare systems, plays a fundamental role in the establishment of primary healthcare strategies to provide high quality services. Moreover, regarding the importance of organizational culture as a powerful lever to improve organizational behavior, success of organizations in implementing strategies largely depends on the support receiving from organization. Accordingly the aim of this study was to examine the correlation between organizational culture with establishment of clinical governance in public hospitals in Rasht .

  Methods & Materials: A cross-sectional correlation study with structural equation modeling was used. All 152 nurses working in managerial positions participated in the study. Data were collected using Denison Organizational Culture questionnaire, and research-made questionnaire on clinical governance. Validity and reliability of questionnaire were confirmed. Data were analyzed using the Pearson correlation coefficient test and confirmatory factor analysis in the SPSS and LISREL . 

  Results: There was a significant positive relationship between clinical governance and all components of organizational culture (P< 120.01' type="#_x0000_t75"> ). Factor analysis showed the impactof organizational culture on successful establishment of clinical governance .

  Conclusion: Improvement of organizational culture leads to sustainable establishment of clinical governance through which quality of healthcare services improves. Managers of hospitals should pay attention to instituting appropriate organizational culture in order to establish clinical governance .

  


Jamal Seidi, Fatemeh Alhani, - Mahvash Salsali,
Volume 20, Issue 2 (8-2014)
Abstract

  Background & Aim: Nurses’ clinical judgment is an evolving complex concept. In order to understand the concept, clarification is needed. This study aimed to conduct the concept analysis of clinical judgment in nursing .

  Methods & Materials: Based on the Rodgers’s evolutionary method, evolving concept of clinical judgment in nursing was analyzed. Literature was retrieved from scientific databases during 1980 to 2013. Based on the inclusion criteria, 42 articles, three books and one dissertation were analyzed using thematic analysis method . 

  Results: The results showed that clinical judgment in nursing was a complicated process with attributes including intention, observation, data collection and information process, interpretation, prioritization and inference. Antecedents included knowledge, experience, evidences, clinical reasoning, intuition, critical thinking and consequences included nursing diagnosis and clinical decision making .

  Conclusion: Clinical judgment in nursing is a critical thinking process, situational based and beyond observation and assessment. This concept analysis could distinct the transposition concept of clinical judgment and other related concepts. The results of this study would help to develop theories and clinical judgment measurement instruments in practice, research and educational settings .

  


Gholamhossein Falahinia, Maryam Razeh, Mahnaz Khatiban, Mahbobeh Rashidi, Alireza Soltanian,
Volume 21, Issue 4 (3-2016)
Abstract

Background & Aim: Poor oral care for the ventilated patients in intensive care units (ICU) can result in the accumulation of pathogens and respiratory infections. In this regard, in addition to the chemical methods, a mechanical method has been recommended to be added. However, concerning its effect on pneumonia, different findings have been reported. Therefore, this study was conducted to compare the effects of chlorhexidine solution with or without toothbrushing on the development of ventilator-associated pneumonia among patients in ICUs.

Methods & Materials: This was a single-blind, randomized controlled clinical trial conducted in two selected hospitals of Ahvaz city in 2014. A convenience sample of 68 ventilated patients was randomly allocated to the toothbrush group (34 patients) or the gauze swab group (34 patients) using R software. Both groups received 0.2% Chlorhexidine solution. The intervention was performed in both groups for 3 minutes twice a day for five days. At the end of the fifth day, the development of pneumonia was assessed using the Clinical Pulmonary Infection Score (CPIS). Data were analyzed by Chi-square and t-independent test through SPSS v.16.

Results: The two groups were similar for age, sex, cause of admission, level of consciousness, medication and tobacco use. The majority of patients (58.8%) were diagnosed with pneumonia (Group A: 55.9% and Group B: 61.8%). The Chi-square test showed no significant difference between the two groups for the development of pneumonia (P>0.05).

Conclusion: The use of Chlorhexidine solution with toothbrushing compared to using Chlorhexidine with swab could not reduce the development of pneumonia. However, due to its importance, further research is needed in this regard.


Mina Mohammady, Leila Janani,
Volume 22, Issue 2 (7-2016)
Abstract

Background & Aim: Randomized clinical trials (RCTs) are studies which are able to provide the most valid evidence to compare various interventions in health research. Biases can affect the quality of research and ultimately make the results of a study invalid. One of the most important biases is selection bias. The best way to reduce selection bias is the use of random allocation. The aim of this study is to provide comprehensive, practical and simple information regarding proper implementation of the random allocation process in randomized clinical trials.

Methods & Materials: A review study was performed using available resources and comprehensive analysis. For this purpose, we searched the relevant books & articles in databases including Medline, Scopus, Science Direct, Google Scholar and Magiran. Key words were randomization, random sequence, allocation concealment, randomized controlled trial, randomized clinical trial, and bias.

Results: From the literature review, we obtained 39 articles and one relevant book that their findings were presented in a simple language with practical examples in three parts including random sequences generation, random allocation concealment and implementation.

Conclusion: Selection bias in clinical trials has an adverse effect on the accuracy of results. In order to avoid it, researchers should employ proper methods in randomization and random allocation concealment, and report it in their articles properly. Therefore, researchers can obtain valid results through a better understanding of randomization and its proper implementation.


Ali Mohammad Pour, Siamak Zarei Ghanavati, Mojtaba Kian Mehr, Abolfazl Rahmaninezhad,
Volume 22, Issue 3 (10-2016)
Abstract

Background & Aim: Ultraviolet (UV) keratitis is an inflammation of the corneal epithelium and conjunctiva caused by UV radiation and is associated with the symptoms including severe eye pain, decreased visual acuity, severe tearing and red eye. The use of primary patching in the patients is doubtful. Therefore, this study aimed to determine the effect of eye patching on the improvement of clinical symptoms in patients with UV keratitis.

Methods & Materials: In this clinical trial, 120 patients with UV keratitis referred to the emergency department of Khatam Al Anbia center affiliated to Mashhad University of medical sciences, were randomly assigned into two groups (each group contains 60 patients) with patching and non-patching in 2015 (IRCT2015092124124N1). In one group, both eyes were patched and the other group was not patched. All other care was similar in both groups. Clinical symptoms were checked and compared between two groups before and after 12 hours. Data were analyzed by descriptive statistics, independent t-test, paired t-test, Chi-square and Wilcoxon using SPSS software version 23. A p-value less than 0.05 was considered significant.

Results: The results showed that redness (P<0.001) and tearing (P<0.001) were more improved in the non-patched group but there was no statistically significant difference between the two groups in visual acuity (P>0.05).

Conclusion: Eye patch does not have effect on the improvement of clinical symptoms such as tearing and redness, and these symptoms are more improved without patching.


Mina Mohammady, Masoumeh Sadeghi, Leila Janani,
Volume 23, Issue 2 (7-2017)
Abstract

Background & Aim: Randomized controlled trials often suffer from two major problems, i.e., noncompliance and missing outcomes. One potential solution to this problem is using the intention-to-treat (ITT) analysis approach. Therefore, the aim of this study was to review the concept of ITT and the most important issues related to it in practice since RCT researchers utilize it as a guide in order to improve the quality of RCT studies.

Methods & Materials: A review study was performed using available resources and comprehensive analysis. For this purpose, we searched the relevant articles in databases including Ovid/Medline, SCOPUS, Web of Science, Google scholar and Magiran. The key words that were used included randomized clinical trials, randomized controlled trials, intention-to-treat analysis, per-protocol analysis, ITT, as-treated.

Results: The advantages of ITT, the critique of ITT, the alternatives of ITT and their limitations, missing data and their management in clinical trial studies were discussed in this paper.

Conclusion: ITT approach, due to its adherence to the principles of randomization, protects clinical trials from confounding and bias and therefore leads to the generation of the highest quality scientific evidence in the clinical research field. ITT should be considered a strategy at all stages of research, including the design of study, implementation and data analysis, and it should not be considered only a statistical approach.


Mohammad Hossein Esmaeilzadeh, Marzieh Mogharab, Seyyed Mohammad Reza Hosseini, Javad Bazeli, Amin Zamani,
Volume 25, Issue 2 (7-2019)
Abstract

Background & Aim: Improving clinical decision-making is one of the challenges of the pre-hospital emergency system. Therefore, the aim of this study was to determine the effect of pre-hospital trauma management training program on the capability of clinical decision- making in emergency medical technicians.
Methods & Materials: In a randomized controlled field trial study, 64 pre-hospital emergency technicians from Gonabad University of Medical Sciences, were randomly assigned to either intervention or control groups by the stratified sampling method in 2018. For the intervention group, a pre-hospital trauma management training program was administered based on existing domestic and global standards in a two-day crash course with a combination of learning techniques including lecture and simulation. The research instruments were a demographic questionnaire and a researcher-made questionnaire on clinical decision-making, completed before the course, immediately and one month after the completion of the course. Data were analyzed by the SPSS software version 19 using independent t-test, the repeated analysis of variance and Bonferroni's post-test.
Results: The mean changes in clinical decision-making scores before and immediately after the intervention (9.31 vs. 0.3), before and one month after the intervention (7.86 vs. 1.1) and immediately after the intervention and follow-up one month after the intervention (1.62 in. vs. 1.39) were significantly higher in the intervention group than in the control group (P<0.001).
Conclusion: The pre-hospital trauma management training program can improve clinical decision-making in pre-hospital emergency medical technicians. Therefore, this program can be integrated into the technicians’ training programs.
Clinical trial registry: IRCT20180802040677N1
 
Rahele Ezzati, Mahin Tafazoli, Seyed Reza Mazlom, Negar Asghari Pour,
Volume 26, Issue 3 (9-2020)
Abstract

Background & Aim: Clinical competence is the ability to perform professional tasks and coordinate cognitive, communication and psycho-motion skills in patient care, and empathy is one of the factors influencing clinical competence. Given the role of clinical competence in the quality of midwifery care, this study aimed to determine the effect of empathy skill training on clinical competence in midwifery students.
Methods & Materials: This randomized clinical trial study was conducted on 73 midwifery students and 438 pregnant women in 2015. A clinical competence questionnaire was used to assess the clinical competence of the students, which was completed in two ways by self-assessment and researcher assessment (after reviewing the student's performance for 3 times). Data were analyzed by chi-square test, independent t-test and paired t-test using the SPSS software version 16.
Results: There was no significant difference between the two groups in the mean score of clinical competence in the ways of self-assessment and assessment by the researcher before the intervention (P>0.05). Results from the post-intervention showed that there was significant difference between the two groups. However, the clinical competence score by the researcher assessment in the intervention group was significantly higher than in the control group (P<0.05). Also, the difference in the mean scores of the self-assessment of clinical competence before and after the intervention between the two groups was not significant (P>0.05), but the difference in the mean scores of the researcher assessment of clinical competence before and after the intervention between the two groups was significant (P<0.05).
Conclusion: Empathy skill training is an effective way to increase the clinical competence of students.
Clinical trial registry: IRCT 2016051127855N1
 
Marzieh Ziaeirad, Nasrollah Alimohammadi, Alireza Irajpour, Bahram Aminmansour,
Volume 27, Issue 1 (4-2021)
Abstract

Background & Aim: Traumatic brain injury management focuses on the prevention and treatment of secondary brain injuries. The aim of this study was to adapt a clinical guideline (CG) for nursing care of secondary brain injuries in adults.
Methods & Materials: This study was carried out through a multi-stage evolutionary study at Isfahan University of Medical Sciences in 2017. Based on the opinions of experts using AGREE tool, the quality of 8 out of 13 CGs for the treatment and care of head injuries was assessed as optimal. These were used in drafting the adaptive CG. In addition, 12 CGs, 13 articles and 5 books were used to complete the recommendations of the mentioned guideline. The CG draft was evaluated using the Delphi method and the panel of experts. Finally, it was presented as an adaptive CG.
Results: The adaptive CG for nursing care of secondary brain injuries was developed in 158 recommendations and five sections; nursing care to prevent and manage the increased intracranial pressure, nursing care to maintain and increase cerebral blood pressure, nursing care to prevent and control seizures, nursing care to prevent and control brain infections, and nursing care to prevent and control secondary extracranial injuries.
Conclusion: The nursing staff of emergency and neurological wards and intensive care units can apply the recommendations of this clinical guideline to address some of the care needs of the injured patients and improve their health conditions.
 
Sara Sharafieh, Shiva Khaleghparast, Fatemeh Ghani Dehkordi, Saeideh Mazloomzadeh,
Volume 27, Issue 3 (10-2021)
Abstract

Background & Aim: Clinical decision-making is an essential part of the nursing profession. The nursing profession is based on ethical principles. Due to their commitment to patients, morally courageous nurses ignore occupational risks threatening their own lives.  The aim of this study was to investigate the relationship between moral courage of nurses and their participation in clinical decision-making.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2019. The study population was nurses working in the CCU and ICU of Shahid Rajaie Cardiovascular Medical and Research Center. The sample size was 195 people. The data was collected using the Sekerka’s Moral Courage Scale, and the Participation in Decision Activities Questionnaire (PDAQ). Data was analyzed using descriptive statistics, independent t-test and Pearson correlation coefficient through the SPSS software version 19.
Results: The mean scores of moral courage and PDAQ in nurses were 90.38 ± 11.48 and 117.24±39.42, respectively. A positive correlation was found between moral courage and participation in clinical decision-makings (r=0.397, P<0.001).
Conclusion: The results showed that moral courage has pride of place in the nursing profession that can encourage nurses to actively participate in clinical decision making. Therefore, professional ethics courses are suggested to be organized to improve decision-making and clinical ethical performance of nursing students and nurses.
 
Mina Hashemiparast, Ebrahim Aliafsari Mamaghani, Farzaneh Soleimani,
Volume 28, Issue 2 (6-2022)
Abstract

Background & Aim: The Covid19 pandemic has posed numerous ethical challenges to nurses and has exacerbated moral distress in clinical settings. Hence, due to the important role of nurses in pandemics, this study was conducted to investigate the severity and frequency of moral distress among nurses working in clinical settings at Maragheh teaching hospitals during the outbreak of COVID-19.
Methods & Materials: This was a cross-sectional study conducted on 174 nurses working in surgical-medical, intensive care, pediatric and emergency wards of Maragheh hospitals in 2020-2021. Data were collected using a demographic form and the Corley’s Moral Distress Scale.
Results: The median (Interquartile Range (IQR) = Q3 − Q1) of the severity and frequency of moral distress experienced were 54 (44-59) and 52 (43-58), respectively. The median of moral distress experienced in the intensive care and emergency wards were 56 (51-59) and 46 (43-51), which was more severe than that of in other wards. The median of frequency and severity of moral distress in men were 48 (41-59) and in women 50 (43-59), respectively, which was significantly higher than that of in women (P<0.001). The severity and frequency of moral distress had a statistically significant relationship with age, and work experience (P>0.05) so that with increasing age and work experience, the severity and frequency of moral distress decreased.
Conclusion: Given the high frequency of moral distress among nurses during the COVID-19 pandemic in specific clinical settings, the use of management strategies in order to improve working conditions and create a positive setting can be helpful. It seems that holding courses on coping with moral distress in nurses in the context of the COVID-19 pandemic is an appropriate practical solution.

 
Soolmaz Moosavi, Mehrzad Solooki, Ehsan Shamsi Gooshki, Alireza Parsapoor,
Volume 28, Issue 3 (10-2022)
Abstract

Background & Aim: Accreditation of hospitals plays an important role in promoting the quality, safety and effectiveness of medical services, and increasing the efficiency of hospitals. The effectiveness of the accreditation system depends on the quality of the accreditation standards, the comprehensiveness of the accreditation method, and the quantity and quality of the accreditation appraiser. There is a need for appropriate metrics to review and evaluate the implementation of the charter of patients’ rights in the accreditation of hospitals. The aim of this study was to explain the challenges of patients’ rights in the Iranian hospitals accreditation system.
Methods & Materials: This qualitative study was conducted using a conventional content analysis approach with the participation of 13 key informants. In parallel with the interviews, with the aim of assessing the comprehensiveness, the coverage of the patients’ rights components was assessed by accreditation metrics in four sessions. Data analysis was conducted using the Graneheim and Lundman method.
Results: The challenges of the accreditation system were explained by two categories "Content deficiencies of hospitals accreditation standards", "Managerial challenges of accreditation system".
Conclusion: Accreditation has an effective and serious role in the improvement of hospital services and can be a good monitor for observing the rights of service recipients and the charter of patients’ rights. This study provides useful information on the content deficiencies of the country's accreditation standards in terms of service recipients’ rights and its implementation challenges that can be used by policy makers.

 
Monir Nobahar, Raheb Ghorbani, Fateme Aleboye,
Volume 28, Issue 4 (1-2023)
Abstract

Background & Aim: Chest pain is one of the main symptoms of acute coronary syndrome, and sleep disorders are among common problems in these patients. The aim of this study was to determine the effect of Curcuma Longa on chest pain and sleep quality in patients with acute coronary syndrome.
Methods & Materials: This triple-blind clinical trial was conducted on 270 patients in the Coronary Care Unit of Kowsar Hospital in Semnan, with random allocation to three groups (intervention, placebo and control) in 2020-2021. The intervention group received 500 mg of Curcuma Longa tablets and the placebo group received 500 mg of starch, Oisel and lactose tablets at 9 a.m. after breakfast once a day for 3 days. The control group received daily interventions. Chest pain was assessed using the pain assessment tool before the intervention and half an hour after the intervention for 3 consecutive days. Sleep quality was evaluated by the standardized sleep quality questionnaire of Saint Mary's Hospital in the morning of the first day before the intervention and in the morning of the second and third days after the intervention.
Results: There was no significant difference in the average reduction of chest pain intensity from the first to the third day between the groups (P>0.05). But there was a significant difference in the chest pain intensity within the intervention, placebo and control groups (P<0.001), and the average chest pain intensity on the second day compared to the first day of hospitalization decreased in three groups (P<0.001). However, the decrease in chest pain intensity on the third day compared to the second day of hospitalization was not significant in the three groups (P>0.05). The average score of sleep quality before the intervention in the intervention group was higher than that of in the placebo group (P=0.021), but on the second and third days of the intervention, it was lower in the intervention group compared to the placebo (P<0.001) and control groups (P<0.001).
Conclusion: The results showed that Curcuma Longa did not have a significant effect on chest pain in the patients with acute coronary syndrome, but it improved the quality of sleep. Therefore, Curcuma Longa can be used to improve the sleep quality of these patients.
Clinical trial registry: IRCT20110427006318N14

 
Zohreh Parsaeian, Nasrin Nikpeyma, Mohammad Salehpoor Emran, Farshad Sharifi, Shahzad Pashaeypoor,
Volume 29, Issue 4 (1-2024)
Abstract

Background & Aim: The main care need of patients with myocardial infarction (MI) is continuous care, presenting an important challenge in the field of nursing care. Therefore, This study aimed to evaluate the effect of nurse-led home-based cardiac rehabilitation on adherence to therapeutic regimens in patients with MI.
Methods & Materials: In this randomized clinical trial study, 80 eligible patients were selected through convenience sampling from selected hospitals affiliated with Tehran University of Medical Sciences in 2020-2021. Subsequently, they were randomly allocated to either the intervention or control groups. The control group received routine education upon hospital discharge, whereas the intervention group participated in a nurse-led cardiac rehabilitation program conducted both in-person at home and online, comprising four 90-minute sessions once a week, and were monitored for two months. Participants completed socio-demographic and treatment compliance questionnaires before and three months after the intervention. The collected data was analyzed using descriptive and inferential statistics with SPSS software version 20.
Results: Both groups were homogeneous in most demographic variables (P>0.05). The mean and standard deviation of treatment adherence scores before the intervention in the intervention and control groups were 70.82±7.91 and 67.94±11.20, respectively (P=0.015). After the intervention, these values changed to 75.10±6.13 and 68.77±10.12, respectively, with a statistically significant difference observed between the two groups (P<0.001).
Conclusion: The results revealed that nurse-led home-based cardiac rehabilitation was effective in enhancing treatment adherence. Therefore, it is suggested that cardiac rehabilitation care be consistently extended to the home setting.
Clinical trial registry: IRCT20201006048953N

 

Page 1 from 1     

© 2025 , Tehran University of Medical Sciences, CC BY-NC 4.0

Designed & Developed by : Yektaweb