Iran Journal of Nursing
Year:2018 | Volume:31 | Issue:115 |Papers Count:9

Through the current century, cancer has been one of the most challenging diseases worldwide(1). According to the latest statistical and epidemiological surveys, cancer is the third leading cause of mortality in Iran following cardiovascular diseases and traffic accidents(2). It is expected to witness the emergence of 130 new cases of cancer in Iran by 2025, which is at least 35% higher than the current statistics. Maintaining the current situation and providing essential services to Iranian cancer patients require an increase in resources. Therefore, it is significantly crucial to focus on this issue in the country(3). The World Health Organization (WHO) has introduced palliative care as a solution for improving the life quality of patients with refractory diseases and their families. According to this organization, 34% of patients requiring palliative care are cancer patients, only14% of whom receive palliative care. It is notable that about 78% of these patients live in the low or middle-income countries(4). Caring for cancer patients includes all stages of the disease, from diagnosis to the end of patients’ life. Therefore, palliative care which provides comprehensive care for the patient and his/her family is emphasized for these patients(5). Review of the literature on this topic showed strong and definite evidence that confirmed the positive effect of palliative care services on the reduction of the symptoms of disease and improvement of satisfaction and the quality of life of patients(6). Almost all studies examining health care costs have found palliative care cost-effective for the health system and the patient, which is more evident for cancer patients due to causing a reduction in the cost of care and hospitalization(7). According to a study by the International Observatory on End of Life Care (IOELOC) in the UK in 2011 on the overall condition of providing palliative care in the world, Iran was in the group 2 based on 2006 annual report, which indicated the lack of formation of any structural activity regarding palliative care in this country. However, based on the 2011 annual report, Iran has been upgraded to the group 3a, which means providing palliative care in a limited and separate form. The approach to the integration of care in developed countries is such that palliative care is provided globally and systematically and is accessible to all people in the community(8). Evaluation of advanced health systems demonstrated that various models of palliative care are applied for cancer patients, including Hospice, home-based palliative care, hospital-based palliative care, ambulatory-based palliative care clinics, pediatric palliative care, palliative care consultation services, spirituality palliative care model, community-based palliative care model, and early based palliative care(9). For instance, as the leading country in terms of palliative care, England provides 1139 palliative cares for adults (including 356 home-based care, 305 hospital counseling teams, 257 daily clinics, 158 Hospice, and 63 hospital beds) and 258 pediatric palliative cares (including 112 hospital counseling teams, 112 home-care teams, and 34 Hospice). In Iran, palliative care is not provided coherently for cancer patients, and no fundamental measures have been taken to establish such models. Despite the importance of this topic, palliative care has become a major challenge for the health system(8). In general, palliative care is often provided by a team as it is an interdisciplinary work, wherein nurses play an important role in helping the palliative care team improve the patient’ s condition(10). Nonetheless, most nurses, especially in the underdeveloped countries, provide care to cancer patients through the typical means as they lack a thorough knowledge of different palliative care models(1). On the other hand, palliative care is a highly complex issue and a multi-dimensional concept. In Iran, the existing knowledge on palliative care has not been well-defined and has not been seriously addressed in the education curriculum of nurses(11). Considering the effectiveness of palliative care in improving the quality of life of patients at the end of life and reducing the treatment costs in long-term, paying attention to the contexts and providing funding for establishing various palliative care models in the country are essential and inevitable. In order to provide highquality services to cancer patients in end stages, increase the familiarity of nurses with various palliative care models in the nursing field, and use such models in care planning, it is necessary to put attention to this issue on the agenda of health policymakers at various levels. In the end, it is recommended that comprehensive reviews and operational studies be carried out with quantitative and qualitative approaches to lay the foundation for this field.

Background & Aims: Cardiac arrest outside of a hospital is a major public health concern. Cardiopulmonary resuscitation (CPR) is an effort to protect the vital body organs (e. g., heart and lungs), which is performed based on a specific protocol. A proper CPR process depends on the acquisition of the required knowledge and skills by the resuscitator. The present study aimed to assess the effects of peer education based on the jigsaw puzzle method on the knowledge and performance of nursing students regarding basic CPR on adults. Materials & Methods: This quasi-experimental study was conducted in 2017 with a pretest-posttest design and a control group on 72 undergraduate nursing students, who were selected via census sampling from Tehran University of Medical Sciences and Iran University of Medical Sciences, Iran. The participants were divided into two groups of intervention and control (36 per each). Both groups received training on basic life support (BLS) skills conventionally, and peer-assisted education was provided to the intervention group based on the jigsaw puzzle method. The students were evaluated before, immediately after, and three months after the intervention using the modified questionnaire of knowledge and modified checklist of performance for adult BLS skills. Data analysis was performed in SPSS version 22 using descriptive and inferential statistics. Results: Compared to the control group, a statistically significant difference was observed in the knowledge of the students in the intervention and control groups immediately after (P<0. 001) and three months after the intervention (P<0. 001). In addition, significant differences were observed in the knowledge scores of the participants at the three intervals (P<0. 001). Compared to the control group, the performance of the students in the intervention group significantly increased immediately after (P<0. 001) and three months after the intervention (P<0. 001). Moreover, significant differences were observed in the performance scores of the participants at the three intervals (P<0. 001). Conclusion: According to the results, peer-assisted CPR training could enhance the knowledge and performance of nursing students regarding CPR. This study emphasizes on the importance of implementing peer-assisted education based on the jigsaw puzzle for all students.

Background & Aims: High-intensity circuit training (HICT) combines aerobic and resistance training into a single exercise bout as a less time-consuming approach compared to traditional training protocols. The present study aimed to investigate the effects of HICT on the serum levels of lipids and glucose in the elderly women with metabolic syndrome in Khorramabad city, Iran. Materials & Methods: This quasi-experimental study was conducted on 18 women with metabolic syndrome, who voluntarily participated in the research in 2017. During their daily routine, the subjects participated in an eight-week HICT protocol, which was performed in three sessions per week. Fasting blood samples were obtained from the subjects by a laboratory expert at 7: 30-8 AM 24 hours before and 48 hours after the training protocol. In addition, serum levels of cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride, and glucose, and body weight were measured. Data analysis was performed in SPSS version 18 using paired ttest at the significance level of P<0. 05. Results: The results indicated a significant reduction in the serum levels of glucose (P=0. 018), cholesterol (P=0. 033), body weight (P=0. 001), HDL (P=0. 05), triglyceride (P=0. 015), and LDL (P=0. 043). Conclusion: According to the results, it seems that HICT with body weight are easily performed and have beneficial effects on serum lipids and glucose and body weight in the elderly women with metabolic syndrome and could be considered an influential factor in the improvement of their health.

Background & Aims: Patient education is one of the main standards of quality of nursing care. Educational programs play a pivotal role in enhancing the knowledge of nursing students in this regard. The present study aimed to assess the effect of role-play training on the knowledge of nursing students regarding patient education. Materials & Methods: This quasi-experimental study was conducted on 74 nursing students at Iran University of Medical Sciences in Tehran, Iran. The participants were selected via census sampling and randomly divided into the experimental and control groups. Patient education contents were introduced in the control group based on routine university methods, while in the experimental group, the intervention was performed based on roleplaying. The knowledge of students regarding patient education was evaluated using a researcher-made knowledge measurement questionnaire in the experimental and control groups. Results: The results indicated that role-play training improved the knowledge of the students regarding patient education. Moreover, the mean score of the knowledge of the students in the experimental group (63. 85%) was higher compared to the control group (46. 41%), and the difference in this regard was considered statistically significant (P<0. 001). Conclusion: According to the results, role-play training could influence the knowledge of nursing students regarding patient education. Therefore, it is recommended that role-playing be used in more than one semester using other active teaching methods in student educational programs.

Background & Aims: Nurses play a key role in the pain management of patients and must have adequate knowledge in this regard. The present study aimed to assess the knowledge of nurses regarding pain management in the patients referring to the emergency departments of the hospitals affiliated to Iran University of Medical Sciences. Materials & Methods: This descriptive, cross-sectional study was conducted on 150 emergency department nurses who were selected via census sampling in the hospitals affiliated to Iran University of Medical Sciences in 2018. The inclusion criteria were the minimum education level of master's degree and six months of work experience in the emergency department. Data were collected using the demographic questionnaire and the questionnaire of knowledge of pain management. Data analysis was performed in SPSS version 16 using descriptive statistics (frequency tables, mean, and standard deviation) and inferential statistics (Pearson's correlation-coefficient). Results: Mean age of the participants was 31. 98± 5. 52 years. The majority of the nurses (82. 9%) had no prior experience of pain management training. Regarding pain management in the emergency department, the mean score of knowledge was 37. 055± 11. 53 out of 100. Conclusion: According to the results, the emergency department nurses had a low knowledge level regarding pain management. Therefore, provision of periodic training and pain assessment facilities and implementation of proper policies and methods for pain assessment could be effective in this regard. Moreover, our findings highlighted the need for training programs and retraining courses for the staff.

Background & Aims: Abortion is a medico-social phenomenon, which is correlated with maternal health. The present study aimed to investigate the prevalence and influential factors of abortion (induced and spontaneous) in the women in the rural areas of Fars province, Iran. Materials & Methods: This cross-sectional study was conducted on 1, 247 women living in the rural areas in Fars province, Iran, who were selected via cluster sampling and surveyed in October 2015. Data were collected using a researcher-made questionnaire, which consisted of three sections on demographic characteristics, history of fertility, and ideals and perceptions toward fertility. Data analysis was performed in SPSS version 22 using Chisquare, Pearson's correlation-coefficient, and logistic regression analysis. Results: Approximately 22% of the surveyed women experienced abortion at least once. The analysis of the two variables indicated that the education level of the women and their spouses and religion had significant correlations with experiencing abortion (P<0. 05). In addition, logistic regression analysis showed that the risk of abortion was lower in the women with academic education compared to those with secondary education (or lower) and high school education (or diploma) in rural areas. Conclusion: According to the results, the prevalence of abortion was relatively high in the women in the studied rural areas. Considering that the socioeconomic features of rural women differ from other women, this population requires special attention in terms of the new demographic policies for the women living in rural areas. The empowerment and training of these women on modern contraceptive techniques could reduce the prevalence of abortion.

Background & Aims: Nursing managers play a key role in the improvement of the quality of work life, job satisfaction, and organizational commitment in nurses, as well as patient satisfaction. The present study aimed to evaluate the performance of nursing managers in the hospitals in Sari, Iran. Materials & Methods: This cross-sectional, descriptive-analytical study was conducted in 2017 on 108 nursing managers employed in the hospitals in Sari, who were selected via census sampling. Data were collected using a researcher-made questionnaire to assess the nursing performance in eight domains of decision-making, planning, organization, coordination, leadership, communication, budgeting, and control. Data analysis was performed in SPSS version 21. Results: The mean score of nursing management performance was estimated at 3. 84 out of five (favorable). The highest scores achieved by the nursing managers were in the domains of organization (4. 12), leadership (3. 95), and decisionmaking (3. 94), whereas the lowest scores belonged to the domains of budgeting (3. 26), coordination (3. 79), and planning (3. 81). In addition, 71% of the success of the nursing managers in managerial functions was associated with their controlling tasks. A significant correlation was observed between the performance of the nursing managers and receiving management training (P=0. 01). Conclusion: According to the results, the nursing managers in the hospitals in Sari viewed their performance to be favorable. Evaluation of nursing management performance, identifying the strengths and weaknesses, and providing feedback to nurses play a pivotal role in improving performance in the clinical sections of hospitals.

Background & Aims: Pharmacovigilance is an integral part of patient care. Medication side-effects in the elderly and the key role of nurses and healthcare team in the safety of these patients are of utmost importance. The present study aimed to investigate the effects of pharmacovigilance training on the knowledge, attitude, and performance of geriatric nurses in the health centers affiliated to Iran University of Medical Sciences in 2017. Materials & Methods: This experimental study was conducted on 100 nurses employed in two teaching hospitals affiliated to Iran University of Medical Sciences, who were selected via convenience sampling. After the pretest, the nurses were non-randomly divided into two groups of intervention and control using the demographic and principles of drug safety questionnaires. The nurses in the intervention group received training on the principles of drug safety for the elderly for two weeks using a web-based program obtained from the website of the hospital, and the control group received no intervention. Two weeks after the intervention, posttest was performed on both groups. Data analysis was performed using the analysis of variance (ANOVA), independent t-test, and paired t-test at the significance level of P<0. 05. Results: The intervention and control groups were completely homogenous in terms of the demographic characteristics. Before the intervention, no significant differences were observed in the knowledge, attitude, and performance between the groups (P>0. 05). After training on the principles of drug safety, significant differences were observed between the intervention and control groups regarding the level of knowledge (P=0. 33), attitude (P=0. 003), and performance (P=0. 027). In addition, the scores of knowledge (P<0. 001) and attitude (P<0. 001) significantly increased in the intervention group after the training, while the improvement in the performance was not considered significant (P=0. 34). Conclusion: Considering the positive effects of web-based training on the principles of drug safety on improving the knowledge and attitude of nurses and since skilled performance is essential to the recognition of concepts and situations, it is recommended that novel educational methods for the care of elderly patients be incorporated into the curriculum of nursing education.