JOURNAL OF NURSING AND MIDWIFERY SCIENCES
Year:2023 | Volume:10 | Issue:1|Papers Count:11

Background: Nurses are the fi, rst point of contact in hospitals and play a signifi, cant role in providing high-quality care. Missed nursing care has been shown to be associated with poorer patient outcomes, increased mortality, medication errors, falls, and hospitalacquired infections. Objectives: This study aimed to investigate missed nursing care and its causes and related factors in the north of Iran. Methods: This cross-sectional study was conducted during the COVID-19 pandemic in Rasht, Iran, from January to March 2021. A total of 326 nurses from non-emergency wards of 7 medical centers were enrolled using a simple random sampling method. The data on demographic characteristics, occupational stress (using the expanded nursing stress scale [ENSS]), and missed nursing care and its causes (using the MISSCARE questionnaire) were collected. Data were analyzed by descriptive statistics and multiple logistic regression analyses. Results: Sixty-nine percent of nurses reported that at least 1 aspect of nursing care was missed occasionally, often, or frequently. Also, the median number of missed care items reported on each shift was 4 out of 25. Attending interdisciplinary care conferences (46%), interventions for basic care (45%), and psychological supports for patients (42%) were the most omitted items. The most stated reason was human resources (53%). Also, the occurrence of occasionally, often, or frequently missed care was signifi, cantly related to a higher level of nursing occupational stress (adjusted odds ratio [OR], 2. 12,95% CI, 1. 28-3. 52,P < 0. 001) and rotating shift work compared to day shift work (adjusted OR, 4. 54,95% CI, 2. 38-9. 10,P = 0. 003). Conclusions: Nursing missed care is relatively prevalent in the north of Iran. Human resources, work shift schedules, and occupational stress play an important role in missed nursing care during the COVID-19 pandemic. It is necessary for policymakers and nursing managers to use strategies to optimize manpower and equipment, develop a standard work shift, and reduce stress in the workplace to improve the quality of patient care.

Background: Chronic endometritis (CE) can contribute to infertility and reproductive outcome. Currently there is a lack of information about the prevalence of CE and diagnostic value of hysteroscopy in the CE in infertile women in Iran. Objectives: To determine the CE prevalence in female candidates for in-vitro fertilization (IVF) and evaluate hysteroscopy’, s sensitivity, specifi, city, and accuracy in diagnosing CE. Methods: This cross-sectional study enrolled 90 women candidates for IVF undergoing hysteroscopy by consecutive sampling in the infertility clinic of Vali-e-Asr Hospital, Tehran, Iran from October 2019 to February 2020. Hysteroscopic features of CE were recorded, and endometrial specimens were taken for histological study. Data analysis was done using descriptive and chi-square tests and specifi, city, sensitivity, negative and positive predictive value were calculated. Results: Chronic endometritis prevalence was identifi, ed in 19 (21. 1%) women by histology. A signifi, cant relationship was found between CE and vaginal discharge (P = 0. 03), pelvic infl, ammatory disease (PID) (P = 0. 01), and abnormal uterine bleeding (AUB) (P = 0. 001). Sensitivity, specifi, city, negative and positive predictive value (NPV and PPV), and accuracy of hysteroscopy for diagnosis of CE were 68. 4%, 87. 3%, 91. 17%, 59. 1%, and 83. 3%, respectively. Conclusions: Considering the good specifi, city, NPV, and accuracy of hysteroscopy in diagnosing CE, an endometrial biopsy can be avoided in infertile women without risk factors for CE and with normal hysteroscopy. However, it should be considered for CE diagnosis in patients with vaginal discharge, dyspareunia, PID, and positive hysteroscopy fi, ndings.

Background: Studies often focus on assessing PPCI-related outcomes such as mortality and major adverse events. But, few studies have been conducted to assess the psychological aspect, including quality of life (QOL). Cognitive behavioral therapy (CBT) is a nonpharmacological therapy guided by an experimental orientation to human behavior. Objectives: The present study aimed to determine the eff, ect of CBT on quality of life in patients with coronary artery disease. Methods: This randomized experimental study was conducted on 30 CAD patients who underwent primary percutaneous coronary intervention (PPCI) in a cardiac clinic affi, liated with Mazandaran University of Medical Science, Iran. The participants were selected using the convenience sampling method. Then, they were randomly allocated to two groups. The data collection tools included demographic information and the short form-36 health survey (SF-36). The data were analyzed using the statistical package IBM SPSS version 24. 0. Descriptive statistics and chi-square tests, independent t-tests, and paired t-tests were done. Results: The present study showed that most patients were at least 35 years old, male, married, BSc, living in the city, and had no previous disease history and surgery. The independent sample t-test showed two groups had no signifi, cant diff, erence before the intervention regarding the QOL score (P = 0. 385). But, after CBT, the QOL score revealed signifi, cant diff, erences between the two groups (P < 0. 001). Conclusions: The PPCI patients experienced sudden events without a previous mentality that helped them to cope with changed conditions. The results showed that CBT could be considered a non-pharmacological intervention necessary for PPCI patients.

Background: One of the major concerns of the healthcare system managers is the excessive increase in cesarean sections in Iran which led to the implementation of the physiological childbirth program. The promotion of physiological childbirth by the participation of husbands is facing barriers. Objectives: The present study aimed to explore the husbands’,viewpoints on the barriers against their participation in the physiological childbirth of the wives. Methods: The present qualitative study was carried out with Granheim and Landman’, s content analysis approach. A total of 13 husbands whose wives had physiological childbirth were purposively included in the study. The data were collected from the husbands through semi-structured and in-depth interviews and continued until data saturation. The data were analyzed using MAXQDA software (version 2020). Results: The participants’,age range was 25-50 years, and their level of education varied from diploma to doctorate. The data analysis resulted in 3 main categories and 12 subcategories, including sociocultural (i. e., uncommon husband’, s presence, parturient’, s shame, established female caregiving role, husband’, s shyness, and scorn by others), structural (i. e., imperfect maternity ward physical structure, words and actions contradiction, and non-acceptance of the husband), and individual (i. e., occupational problems, lack of information, psychological unpreparedness, and fear of harming the mother and neonate) barriers. Conclusions: According to husbands’,viewpoints, there are social, cultural, structural, and individual barriers to participating in the childbirth of their wives. Therefore, managers of healthcare services need to plan evidence-based measures to remove the husbands’,participation barriers against the physiological childbirth of their wives.

Background: Patients with diabetes-related visual impairment (DRVI) have expectations of the health system and nurses, which can have positive consequences if met. Objectives: This study aimed to investigate the consequences of meeting the health expectations of patients with DRVI. Methods: This qualitative study was conducted using the content analysis approach from November 2020-May 2021. The participants were ten patients with DRVI, two nurses, and one member of the patient’, s family. Data collection was done using semistructured, in-depth, and face-to-face interviews. Purposive sampling was done until data saturation. A total of 23 interviews were conducted with 13 participants. The conventional content analysis proposed by Graneheim and Lundman was used for data analysis. Microsoft Word 2016 and MAXQDA 2010 software were used to transcribe the interviews and manage and analyze the data. Results: Data analysis led to the extraction of the main category of "improving access to comprehensive care" and four categories, including "receiving preventive care, " "access to home care, " "safety promotion, " and "increasing health literacy. " Conclusions: The results of this study showed that including patients’,views can eff, ectively improve the healthcare process. In order to ensure the satisfaction of patients with DRVI, healthcare professionals, particularly nurses, should examine the expectations of patients with DRVI to provide quality and patient-centered care that is based on their individual needs.

Background: Organ donation is one of the main medical advances in treating patients with organ failure. However, the supply of transplant members is much below such patients’,demands, thereby arousing a serious challenge to governments. Organ donation is a sacrifi, cial and altruistic behavior, and altruism is recognized as an eff, ective factor in making decisions for organ donation. Objectives: This study aimed to investigate the relationship between altruism and attitudes toward organ donation in society. Methods: The present research was a cross-sectional descriptive study conducted in Iran during 2020-2021. The research sample encompassed328 individuals selected using the simple random sampling method. Data collection tools included a demographic information form, the standard Self-Report Altruism Scale, and the Attitude Toward Organ Donation Questionnaire. Linear regression controlling the intervening variables was used to investigate the relationship between altruism and attitudes toward organ donation. Results: The univariate analysis results showed that gender, occupation, age, and marital status were not signifi, cantly correlated with attitudes toward organ donation. In the multivariate model controlling the intervening variables, altruism increased attitudes toward organ donation (beta-standardized = 0. 17,P < 0. 001). Conclusions: The fi, ndings highlighted the signifi, cance of altruism in attitudes toward organ donation. Accordingly, intervention programs promoting altruism can be helpful in diff, erent groups.

Background: Poor sleep quality leads to interventions during labor, more fatigue during labor, decreased tolerance to pain, prolonged duration of delivery, and impaired quality of life and health. Objectives: The purpose of this study was to examine the eff, ect of sleep quality during pregnancy on labor pain and duration of delivery. Methods: This study is descriptive based on repeated measurements. The sample consisted of 75 pregnant women. A personal information form, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Visual Analog Scale-Pain were used to collect the data. Medians, standard deviations, frequency, percentages, minimum, maximum, Fisher’, s exact test, Kruskal-Wallis test, and MannWhitney U test were used for data analysis. Cronbach’, s alpha reliability coeffi, cient was used to assess the reliability of the scales. Results: Sleep quality was poor in 89. 3% of the women. Back, waist, and leg pain during pregnancy negatively aff, ected sleep quality. The duration of the second stage of labor was shorter in pregnant women who had poor sleep quality. It was seen that daytime sleepiness and sleep duration did not aff, ect the length of labor. No signifi, cant diff, erence was found between labor pain and daytime sleepiness, and sleep quality. Conclusions: Sleep quality deteriorated during pregnancy. Sleep quality aff, ected the duration of the second stage of labor. Sleep quality and daytime sleepiness did not aff, ect labor pain.

Background: Coronary artery bypass graft (CABG) is associated with death anxiety and endangers the feeling of well-being. Objectives: This study was designed to examine the impact of foot refl, exology massage on well-being and death anxiety in patients undergoing CABG surgery. Methods: This randomized controlled clinical trial was conducted on 66 patients undergoing CABG hospitalized in Fatemeh Zahra Hospital in Sari, Iran, in 2021. The patients were assigned to control (receiving routine care) and intervention (receiving refl, exology massage of the foot sole) groups by permuted-block randomization. Massage therapy was conducted after the surgery for half an hour for each foot during 3 sequential days (from the second to the fourth day after surgery) for patients of the intervention group. A sociodemographic and medical information questionnaire, Templer Death Anxiety Scale, Subjective Well-being Scale, and Hospital Anxiety and Depression Scale were completed for the patients. The data were analyzed by descriptive and analytical statistics, including the Mann-Whitney U test, chi-square test, Fisher’, s exact test, Friedman’, s test, and generalized estimating equations (GEE). Results: The study results revealed a signifi, cant diff, erence in the level of death anxiety of the intervention group (before: 52. 57 ±,3. 97, second day: 50. 07 ±,3. 38, 4th day: 36. 61 ±,5. 25) compared to the control group (before: 51. 25 ±,3. 06, second day: 49. 57 ±,3. 83, fourth day: 47. 71 ±,3. 01) (P < 0. 001). Additionally, comparing the well-being mean of the group undergoing refl, exology massage of the foot sole (before: 52. 57 ±,3. 97, second day: 50. 07 ±,3. 38, fourth day: 36. 61 ±,5. 25) and the control group (before: 52. 57 ±,3. 97, second day: 50. 07 ±,3. 38, fourth day: 36. 61 ±, 5. 25) during the 3 days by GEE showed a signifi, cant diff, erence between the two groups (P = 0. 001). Conclusions: According to the fi, ndings, refl, exology foot massage reduced death anxiety and increased feeling of well-being. Due to low costs, no complications, and ease of performance, this method is recommended to reduce death anxiety and promote wellbeing in patients after CABG.

Background: Lack of social support may lead to destructive eff, ects on pregnancy outcomes, especially for women with gestational diabetes. Objectives: This study aimed to examine the eff, ect of spouse participation in gestational diabetes care on pregnant women’, s perceived social support. Methods: This quasi-experimental study was carried out in one of the health centers affi, liated with Shahroud University of Medical Science, Shahroud, Iran, during 2018-19. A total of 80 pregnant women with gestational diabetes were non-randomly allocated to two groups of 40 members. The control group received the standard care, whereas the experiment group received, in addition to the standard care, gestational diabetes care as well as face-to-face and online education with their spouses. Demographic and Diabetes Social Support Questionnaire-Family Version was fi, lled by the two groups before and fi, ve weeks after the intervention. Data analyses were performed using descriptive statistics, independent t-test, paired t-test, and chi-squared test with SPSS (V16). Results: The total score of social support in the experiment group had a signifi, cant increase compared to that in the control group (3. 42 ±,1. 16, 3. 06 ±,1. 14, and P < 0. 001). In addition, the three aspects of social support (i. e., taking blood sugar test, adhering to diet, and receiving social support) in the experiment group had a signifi, cant increase compared to those in the control group (P < 0. 05). Conclusions: Considering the positive eff, ect of spouse participation on the perceived social support of pregnant women with gestational diabetes and on their healthy pregnancy, it was recommended that health policymakers should codify pregnancy cares, despite the cultural limitations, in order to facilitate maximum participation of spouses.

Background: Traumatic brain injury (TBI) causes disability and death in many patients. Objectives: We investigated the eff, ect of memantine on the Glasgow Coma Scale (GCS), serum levels of neuron-specifi, c enolase (NSE), and its eff, ect on sequential organ failure assessment (SOFA) score in TBI patients with GCS 6-12 on days 1, 3, and 7. Methods: Fifty-nine patients were randomly divided into intervention (n = 29) and control (n = 30) groups who received 30mg drug/placebo every 12 hours for seven days with standard treatment, respectively. The acute physiology and chronic health evaluation II and head CT scan fi, ndings were collected on the fi, rst day, and the Glasgow Outcome Scale Extended 90 was collected three months later. Results: Considering patients with GCS 6-12, the SOFA and NSE decreased from day 1-7 in both memantine and control groups, about NSE by 21% and 12. 6%, respectively. In GCS6-8 subgroup, the NSE decreased by 19. 1% in the memantine group and increased by 8. 45%, in the control group. In GCS 9-12 subgroup, the NSE decreased by 52. 6% and 24. 43% in the memantine and control groups, respectively. The SOFA changes were signifi, cant between memantine and control groups on day 3 in GCS 9-12 subgroup (P = 0. 01). In the memantine group with GCS 6-12, the increase of GCS from day 1-7 was signifi, cant (29. 6%, P = 0. 002), and also in both GCS subgroups. Comparing memantine and control groups, the improvement of GCS was signifi, cant on days 3 and 7 in GCS 9-12 subgroup. Conclusions: This trial showed that memantine improved the neurohormonal and clinical status of TBI patients with GCS 6-12.

Background: Medication adherence is one of the most signifi, cant factors in optimally controlling cardiovascular disease. Objectives: The aim of this study was to determine the eff, ect of Health Belief Model (HBM)-based education on medication adherence of cardiovascular patients. Methods: In this quasi-experimental study, participants were 45 patients discharged from CCU ward of Ali Ibn Abitalib Hospital in 2020, Rafsanjan, Iran. Participants allocated into intervention or control group by simple randomization. For fi, ve weeks, the intervention group received weekly medication adherence educational package using a mobile phone application, through the WhatsApp messenger. The control group received routine care. Data collected using demographic questionnaire and Morisky Drug Adherence scale as well as the researcher-made HBM questionnaire, before and three months after the intervention. The data were analyzed by descriptive and inferential statistics and independent samples t-test, chi-square test and repeated measures ANOVA. Results: The drug adherence scores of the patients in the intervention group (6. 63 ±,1. 71) signifi, cantly increased than control group (5. 29 ±,1. 85) three months later (P = 0. 006). Moreover, the mean score of the components of the HBM included perceived benefi, ts, perceived self-effi, cacy and perceived barriers were signifi, cantly increased in the intervention group (P < 0. 001) Conclusions: Health Belief Model-based education through WhatsApp Messenger promote the drug adherence of cardiovascular patients, through improving self-effi, cacy, improving the understanding of the benefi, ts as well as reducing perceived barriers. Therefore, utilizing this method may be a practical solution toward enhancing the drug adherence of cardiovascular patients.