Iranian Journal of Nursing and Midwifery Research
Year:2022 | Volume:27 | Issue:1|Papers Count:15

Background: Blinding is one of the critical criteria of clinical trials that prevents probable bias. Judgment regarding results of an intervention significantly depends on the quality of such studies, one of which is blinding. This study aimed to investigate blinding and its quality in clinical trials in patients with breast cancer. Materials and Methods: A systematic review was conducted on the online databases of PubMed, ScienceDirect and ProQuest using keywords, MeSH terms and grey literature. Articles were screened by predefined inclusion and exclusion criteria. They were evaluated based on the checklists introduced by Cochrane database. Results: From 22519 articles obtained at the initial stage, 20 articles remained after screening for the inclusion and exclusion criteria. Fifteen articles had used single, five: double and none had used triple or quadruple blinding. Seventeen studies had described the details of blinding. Of the 15 single blind articles, the blinded subjects were patients in five, patients and research assistants in three, research assistants in five studies, and two had not given any details. Conclusions: The majority of researchers had used the single blind method, though using double, triple or quadruple blinding increases the trustworthiness of results and increases the quality of clinical trials. The details of blinding should be explained to other researchers and for a better understanding of the method if it is to be repeated. Thereafter, nurses can apply new interventions and earn their patients’ trust and help those with breast cancer by relieving them of their disease symptoms and its treatment complications.

Background: Timely rehabilitation in patients with Breast Cancer (BC) has a great impact on improving their physical and mental conditions. Thus, the appropriate follow‑ up method is essential especially during the Covid‑ 19 pandemic. The aim of this study was to review the different technology‑ assisted interventions for improving physical activity in BC patients. Materials And Methods: In this systematic review, the original studies were extracted from the beginning of indexing in databases including PubMed, Scopus, Google Scholar, and Web of Science until 2019. Finally, 45 papers were included in this study based on the inclusion criteria for before the Covid‑ 19 pandemic and 3 articles extracted for the Covid‑ 19 period. Results: The most widely used technologies for BC patients were in the United States (46. 67%). Telephone, mobile application, and web with 28. 89%, 15. 56%, and 8. 89% frequencies were the most common technologies, respectively. Although the majority of the participants were satisfied with the intervention method, in some cases, the patients were unsatisfied due to the complexity of the technology. These technologies were used for various purposes, such as physical activity and functions, control of pain severity, fitness, quality of life, diet behavior, fatigue, muscle strength, cardio‑ respiratory capacity, as well as arm and shoulder exercises. Conclusions: In conclusion, virtual communication can improve the health of BC patients and also increases patients’ desire and hope to continue treatment. It is worth noting that in the Covid‑ 19 pandemic, with the strengthening of virtual communication infrastructure, more attention was paid to BC patients due to their sensitive conditions.

Background: The birth of a child with an intellectual disability is a common event. The fertility desire plays an important role in healthy reproductive programs. This study was conducted to compare the fertility desire and related factors in mothers with intellectually disabled and healthy children. Materials and Methods: The present study was a descriptive, cross‑ sectional study. The sample size consisted of 348 mothers with healthy and intellectually disabled children (174 per group). Sampling was performed at normal (six schools) and special primary schools (twelve schools) in Isfahan, Iran using stratified random sampling method. Attitude, subjective norms, perceived behavior control, and gender preference were assessed using a researcher‑ made questionnaire and psychological well‑ being using Ryff questionnaire. Data were analyzed by descriptive statistics, Independent t‑ test, Mann– Whitney U test, Chi‑ square test, and Logistic regression using SPSS 24. Results: In this study, 21. 84% of mothers with healthy children and 13. 79% of mothers with intellectually disabled children were willing to have other children. The fertility desire in mothers with intellectually disabled and healthy children decreased as their numbers of children (CI 95% =0. 14‑ 0. 42) and age increased (CI 95% =0. 80‑ 0. 93) by 0. 87 and 0. 24, respectively. There was statistically significant difference in mean score of psychological well‑ being between the two groups of mothers with fertility desire (p = 0. 017). There was no statistically significant difference in mean score of attitude, subjective norms, perceived behavior control, and gender preference (p > 0. 05). Conclusions: Apparently the awareness of fertility desire and related factors in mothers with healthy and intellectually disabled children may be helpful in healthy fertility counseling.

Background: An effective interview can strengthen the clinician‑ patient relationship and improve treatment outcomes. We aimed to assess the effect of communication skills training using the Calgary‑ Cambridge model on interviewing skills among midwifery students. Materials  and  Methods  : In this randomized controlled trial, 30 midwifery students of Golestan University of Medical Sciences were selected using the convenience sampling method and randomly assigned through minimization into the intervention (n = 15) and control (n = 15) groups in 2018. The routine interventions were administered for the control group, and four sessions of communication skills training based on the Calgary‑ Cambridge model was performed in small groups for the intervention group. Evan and colleague’ s History‑ taking Rating Scale was used before and four weeks after the intervention. Data were analyzed using paired and independent‑ sample t and Mann‑ Whitney U tests at the significance level of less than 0. 05. Results: The mean (SD) scores of interviewing skill before and after the intervention was 33. 71 (7. 34) and 54. 50 (8. 16), respectively, in the intervention group (t13 = 9. 26, p < 0. 001) and 33. 64 (6. 02) and 33. 93 (5. 39) in the control group, respectively (p = 0. 85). The difference between the two groups was significant (t26 = 7. 86, p < 0. 001). Conclusions: Communication skills training based on the Calgary‑ Cambridge model can be used as an effective method to improve interviewing skills among midwifery students.

Background: The theory‑ practice gap can be described as a lack of ability to relate the knowledge acquired in academics and research work with practice. This study aims to assess the knowledge and the perception of Nigerian nurses on the theory‑ practice gap in Nursing. Materials and Methods: This cross‑ sectional correlational study was carried out with a sample of 196 nurses who were working in the Federal Medical Centre Keffi and Aminu Kano Teaching hospital in Kano, all from the northern part of Nigeria, from April to June 2019. The participants were selected using a convenient sampling technique, where a self‑ administered questionnaire was utilized to collect the data and analysis was undertaken using SPSS. Results: The results of this study showed that 83. 80% of respondents had good knowledge and 89. 10% of the respondents had good perceptions. The levels of knowledge were significantly different in correlation with the educational level of respondents (χ 2 = 13. 88, df = 6, p = 0. 022), which was determined using a Fischer exact test. Also, the level of perception was significantly different when considering the nature of work participants undertook (X 2 = 7. 65, df = 2, p = 0. 022). Conclusions: Given the participants’ awareness and perceptions in this study, it is clear that they are well informed of the theory‑ practice gap. This is a call for all professionals at an individual and organizational level to work, as it will translate into gap minimization, thereby increasing the quality of health care delivery as nurses constitute the largest part of the health care team in Nigeria.

Background: Nurses play a very important role in caring for patients with coronavirus disease‑ 19 (COVID‑ 19). They are on the frontline fighting COVID‑ 19. The objective was to explore the experiences of nurses in the surgical and infectious wards about caring for patients with COVID‑ 19 in a large and tertiary care hospital in Iran. Materials  and  Methods  : This was a qualitative study. Semi‑ structured qualitative interviews were conducted with 18 nurses in the Imam Reza Hospital Complex from April to May 2020, Mashhad, Iran. Data analysis was performed using the method proposed by Lundman and Granheim. The Maxqda10 software was used. Results: The experiences were summarized into three categories: (1) experiencing new feelings and relationships with colleagues and patients, (2) viewpoints about managers’ performance, and (3) concern about getting infected with COVID‑ 19. Findings reflected similar experiences on personal protective equipment between nurses in the surgical and infectious wards. Experiencing new feelings and relationships with colleagues and patients and concern about getting infected and spreading the COVID‑ 19 were mostly expressed by infectious nurses and surgical nurses, respectively. Conclusions: This research results provide evidence of the experiences of infectious and non‑ infectious disease nurses who are currently caring for COVID‑ 19 patients. Due to some differences between the experiences of these two groups in COVID‑ 19, it is suggested to pay more attention to the needs and required skills in the staff mix during a crisis.

Background: Low Back Pain (LBP) is one of the most common complaints during pregnancy, which could cause performance disability. Kinesio tape is a drug‑ free elastic therapeutic cotton tape used in treating musculoskeletal problems. This study aims to determine the effects of Kinesio tape on LBP and disability in pregnant women. Materials and Methods: A total of 80 pregnant women with LBP who were referred to the comprehensive health service centers were randomly assigned into the two groups of Kinesio tape and adhesive tape. Pain intensity was determined by the visual analog scale before and on the 1 st, 2 nd, 7 th, and 14 th day after the intervention and the disability by Roland‑ Morris disability questionnaire before and on the 7 th and 14 th day after the intervention. Data analysis was performed by, Two‑ way repeated‑ measures ANOVA, Friedman, and Wilcoxon tests. Results: The intensity of pain decreased in both groups compared to the pre‑ intervention period; Kinesio (χ 2 = 48. 94, df = 4, p < 0. 001) control (χ 2 = 22. 94, df = 4, p < 0. 001); however, the comparison results of pain intensity were not different in the two groups at different times (p ≥ 0. 05). The effects of time was significant (Two‑ way repeated‑ measures ANOVA, F1, 83 = 10. 63, p < 0. 001), but the effects of time and group were not significant (F1, 83 = 0. 31, p = 0. 722) and indicated a decreasing trend of functional disability in two groups. Conclusions: The Kinesio tape reduced the disability caused by LBP during pregnancy and had a lasting effect after the tape was removed.

Background: The need for assessing health‑ care workers’ communication skills is increasingly emphasized by researchers. Achieving such a goal requires the use of a reliable tool. The purpose of this study was to validate the Persian version of Health Professionals Communication Skills Scale (HP‑ CSS). Materials and Methods: For the present methodological study carried out from September 2016 to February 2017, 400 health workers were selected by convenience sampling from educational hospitals in Mazandaran province in Iran and they were asked to fill out the 18‑ item HP‑ CSS. All steps of the scale validity were performed. Exploratory and confirmatory factor analysis were used. The reliability of the tool was measured by internal consistency. Results: Two factors of care and verbal clarity with patients and respect for patients’ rights, extracted by exploratory factor analysis, explained 47. 38% of the variance. Content Validity Index (CVI) and Content Validity Ratio (CVR) of all items were higher than 0. 79 and 0. 49, respectively. Reliability coefficients of factors were found to be more than 0. 70. Model’ s fitness indicators confirmed the construct of HP‑ CSS. Both factors had a convergent and divergent validity. Conclusions: This study showed that the Persian version of the communication skills scale has a two‑ dimensional construct and good psychometric properties; also, this scale was found to be useful for the purpose and context in which it will be used, that is, communication skills.

Background: The effectiveness and efficacy of teaching behaviors by clinical educators need to be determined and applied in caring environments, wherein students’ seminal Professional Behaviors (PBs) are being shaped. Here, we endeavor to compare the relationship between Iranian clinical educators’ teaching behaviors and undergraduate nursing students’ PBs. Materials and Methods: This descriptive correlational study was conducted on 189 students enrolled in the second, third, and fourth academic years at Urmia University of Medical Science in 2019. The instruments were the Nursing Students’ PBs Scale (NSPBS) and the Nursing Clinical Teacher Effectiveness Inventory (NCTEI). Data were analyzed by Pearson correlations test and linear regression model. Results: A significant positive correlation between the NSPB and NCTE in the fourth year (r = 0. 42, p = 0. 001) was about twice as much as the second (r = 0. 28, p = 0. 017) and third ones (r = 0. 28, p = 0. 033). Nursing competency, teaching skills, and communication domains were respectively the most effective ones related to the second‑ (r = 0. 35, p = 0. 003), third‑ (r = 0. 32, p = 0. 015), and fourth‑ year NSPBs (r = 0. 46, p < 0. 001). Teaching skills and nursing competency domains had the lowest significant relationships with the second‑ (r = 0. 25, p = 0. 034) third‑ (r = 0. 30, p = 0. 023) and fourth‑ year NSPBs (r = 0. 35, p = 0, 006), respectively. Conclusions: The comparison between the two mentioned variables in the academic year can provide appropriate information about potential problems of clinical education to develop clinical facilitation models.

Background: Mothers with children undergoing hemodialysis play the role of primary caregivers for their child and fully sacrifice themselves for care, leading to social isolation, suffering, stress, and negative effects on their health. Therefore, this study was conducted to design a supportive program based on the real needs of mothers with children undergoing hemodialysis. Materials  and  Methods  : This qualitative study was conducted in the Hemodialysis Division of Doctor Sheikh Pediatric Hospital in Mashhad City, Iran, from September 2016 to February 2019. The research included phenomenological study, meta‑ synthesis of qualitative studies, focused group, and nominal group. Participants were selected based on purposive sampling. Eleven mothers with children undergoing hemodialysis and seven key people related to these mothers participated in the study. MaxQDA software was used to facilitate data management. Results: The six main areas including information needs, how to deal with the child, maintaining the mother’ s physical and functional health, maintaining family relationships, income earning and maintaining financial resources, and emotional‑ psychological support were extracted. Based on the needs of mothers, 28 support strategies were presented; then, 19 ideas were presented to screen the needs, and finally, the best idea was selected for each need. Conclusions: According to the findings of this study, mothers with children undergoing hemodialysis need support in various physical, psychosocial, informational, economic, and functional dimensions. The supportive program designed provides a systematic framework for screening the needs of these mothers and providing multifaceted support measures with the participation of a multidisciplinary care team.

Background: Retinopathy of Prematurity (ROP) is a preventable cause of childhood blindness. India accounts for nearly 10% of the worldwide estimate of blindness and visual impairment due to ROP. Nurses are pillars of neonatal intensive care units (NICUs) and play a critical role in the prevention and management of ROP. The primary aim of this study was to evaluate the effect of developmentally supportive education program on knowledge regarding prevention and management of ROP among nurses working in NICU. Materials and Methods: A hospital based pre‑ experimental, one group pre‑ test– post‑ test study was carried out among 32 staff nurses working in the NICU of a tertiary care center during January to February 2019. Knowledge regarding the prevention and management of ROP was assessed before and after the implementation of developmentally supportive education program using a structured knowledge questionnaire. Results: Pre‑ test knowledge score was mean (Standard Deviation [SD]) 9. 00 (3. 68) and after the educational program post‑ test knowledge score was found to be mean (SD) 14. 53 (2. 39). Paired t‑ test was used to evaluate the effect of developmentally supportive education program and was found to be statistically significant (t32 = 10. 09, p < 0. 001). Conclusions: Developmentally supportive educational program can be used as an effective intervention for improving the knowledge regarding ROP among nurses in NICU.

Background: Despite the importance of self‑ esteem in cancer patients and the potential role of spiritual care programs in its promotion, no interventional study was found in this field in Iran. The aim of this study was therefore to investigate the effect of a spiritual care program on the self‑ esteem of patients with various types of cancer. Materials and Methods: This study was quasi‑ experimental with two groups using a before and after design which was conducted in 2019 in a selected hospital in Isfahan, Iran. A convenience sample of 64 patients randomly assigned into the experimental (n = 32) and the control group (n = 32). Data collection was conducted through a two‑ part questionnaire including Demographic characteristics and the Coopersmith Self‑ Esteem Inventory (SEI). The spiritual care program consisted of six sessions based on four domains including individuals’ relationship with God, themselves, others, and with the environment. To analyze the data, Chi‑ square, Fisher’ s exact test, independent t test, and paired t test were performed. Results: The total self‑ esteem mean score and its domains were not significantly different between the two groups before the intervention (p > 0. 05). However, after conducting the intervention, the total self‑ esteem mean score and its domains were significantly higher in the intervention group compared with the control group (p < 0. 001). Conclusions: The spiritual care program used in this study was effective in promoting the self‑ esteem of patients with cancer. It is suggested that similar studies are conducted to provide fertile grounds for using such programs in the oncology clinical area.

Background: Considering the importance of report writing and its problems, different teaching methods can be used to improve nurses’ knowledge and performance, among which is peer teaching. This study aimed to determine the effect of peer teaching on the quality of report writing based on the nursing process. Materials and Methods: This quasi‑ experimental study examined 60 nurses working in the surgical and cardiac wards of Razavi Hospital in Mashhad during 2019. These wards randomly assigned to intervention (n = 30) and control (n = 30) groups. For 2 weeks, report writing teaching was implemented for the intervention group based on the nursing process through peer teaching. The control group routinely performed report writing. At the beginning and end of the study, we reviewed nursing reports of both groups using a valid and reliable checklist. Data were analyzed using two‑ way analysis of variance with repeated‑ measures analysis of variance. Results: Before the intervention, there was no significant difference between the two groups in terms of scores of report writing quality in structure, content dimensions, and the total scores (p > 0. 05). After the intervention, the mean score changes were significantly higher in the structure (Mean Difference (MD) = 4. 99, 95%CI: 1. 26– 8. 72, p < 0. 010), content (MD = 8. 11, 95%CI: 4. 91– 11. 31, p < 0. 001), and the total quality of report writing (MD = 7. 54, CI: 4. 56– 10. 53, p < 0. 010) in the intervention group than the control group. Conclusions: Peer teaching improved the nurses’ quality of report writing. The teaching planners are recommended to use this method to train nursing staff.

Dear Editor‑ in‑ Chief, Value‑ based education is known as one of the affecting factors of professional dignity of medical practitioners, as well as their informed decision‑ making in critical clinical settings. Critical situations are the best opportunities to convey professional and moral practice and also the most difficult. [1] The resuscitation or blue code involves calling in a special team to take immediate actions for a patient who has developed cardiopulmonary arrest to bring the patient back to a stable state. The important point is the speed of action that is often life‑ saving in the cooperative effort of the resuscitation team with the stake of nurses. In contrast, “ slow code” that is mainly enacted in end‑ of‑ life patients, is limited in terms of number, duration, intensity, or all three. Lantos et al. [2] have defined the slow code as a short‑ term intervention that is practically symbolic and apparently effective. In this manner, it seems that we are trying to save the patient life, but we are in fact deceiving the family. Doing cardiopulmonary resuscitation to address the interests and grief of “ other important people” is morally unfounded and deceptive. The team knows that doing everything for an end‑ of‑ life patient is futile, and interventions are not only ineffective but actually harmful. All the challenges in slow code arise due to low awareness of the patient’ s family, whereas we can prevent the futile actions by establishing a clear relationship and empathy with them. “ Tailored code” is a valuable alternative, especially in end‑ of‑ life situations, where high‑ quality resuscitation is performed within defined specific limits. In this manner, family members are clearly informed about what will and will not be done, [3] and sound communication can make hope and patience, and prevent futile care, whereas performing essential and personalized actions without family deception. [4] The review of medical sciences students’ curriculum, especially nursing ones, indicates that mentioned issues are not specifically addressed and most of the learning occurs through a hidden curriculum. Thus, the development of a value‑ based curriculum is needed to transfer both ethical values and professional teachings in critical settings, with an integrated approach of theoretical and practical education. [5] Furthermore, given the more exposure of nurses to stressful situations, ethical analysis of clinical cases, which enables nursing students to develop moral sensitivity and reasoning as essential skills to face and solve moral dilemmas, is recommended. Financial support and sponsorship: Nil. Conflicts of interest: Nothing to declare.

Dear Editor, The Human Immunodeficiency Virus (HIV) serodiscordant relationship refers to mixed‑ status and condition in which one of the partners is HIV positive, while the other is HIV negative. It is anticipated that 75% and 37% of serodiscordant couples are living in countries with low and high HIV prevalence, respectively. They play a significant role in preserving the global HIV epidemic through sexual contacts. [1] There is a strong tendency towards conducting studies on HIV prevention that address couples as a unit for changing behaviors and interventions. [2, 3] There are two general strategies of service delivery in serodiscordant couples, including biobehavioral and biomedical categories, with emphasis on couple‑ based strategies. [3] SMART Couples, which stands for Sharing Medical Adherence Responsibilities Together, is a biobehavioral and couple‑ based approach for discordant couples with inadequate medication adherence in the HIV‑ positive partner. This approach educates couples about the significance of compliance to reduce viral resistance. The intervention involves cognitive‑ behavioral elements to identify barriers, promote healthy behaviors, and employing problem‑ solving techniques to identify and address adherence barriers. [4] Training on the importance of adherence to prevent viral resistance, health maintenance, recognition of non‑ adherence patterns, and increasing mutual social support for good health outcomes are core components of it. SMART Couples sessions for partners are better provided by a certified social worker or therapist, HIV case manager, health educator, or a nurse with experience of dealing with a dyad couple. [4, 5] The couple‑ based approaches in the service delivery process that emphasize healthy lifestyles, behavioral changes, and mutual supports can have positive consequences for the individual, newborn, family, and community. These approaches provide a context for couples to recognize their mutual responsibility to protect each other from transmitting HIV and to maintain each other’ s health. It also creates a safe environment to discuss sensitive issues such as sexual relationships using negotiation skills. It should be noted that for the effective implementation of couple‑ based approaches in real‑ world contexts, a cultural shift from focusing on individuals to dyad couples is needed, as well as the emphasis on addressing existing organizational and financial barriers. Financial Support and Sponsorship: Research Deputy, Mashhad University of Medical Sciences, Mashhad, Iran. Conflicts of Interest: Nothing to declare.