Nursing And Midwifery Journal
Year:2019 | Volume:17 | Issue:7 (120)|Papers Count:8

Background & Aims: The number of survivors of breast cancer is increasing due to improvements in early detection and treatment. However, after treatment, the survivors often experience Unpleasant symptoms such as pain, sleep disorders, anxiety, and fatigue, which are referred to as cluster symptoms. These symptoms influence the patient's functional status and self-efficacy. Peer education can use to improve of well-being and self-efficacy, as well as to reduce the unpleasant physical and psychological symptoms of breast cancer patients. The purpose of this study was to determine the effect of peer education on cluster symptoms and self-efficacy in breast cancer patients in the experimental and control groups with a comparison design before and after. Materials & Methods: This study was a randomized clinical trial. The sample was 100 women with breast cancer. That were selected randomly and assigned to two groups of test and control. Before and after the intervention, demographic questionnaires, Sherer self-efficacy, Scherer self-efficacy, McGill Pain Questionnaire, Beck Anxiety Measurement, Piper Fatigue scale, Pittsburgh Sleep Quality Index were completed for both groups. The training was carried out by a peer group during 8 sessions. The data analysis was done with descriptive and inferential statistics in SPSS software. Results: Findings showed that 50 patients in each group did not have a significant difference in age and family history of cancer. The mean score of cluster symptoms in post-test in control group and test group respectively were the pain severity 49. 89 ± 5. 31 & 41. 9 ± 5. 68, the anxiety 34. 34 ± 9. 62 &27. 82± 10. 06 and the fatigue123. 15± 16. 72 & 96. 18± 48. 51. The sleep quality was 10. 46 ± 1. 71 & 7. 01 ± 1. 47. The mean score of self-efficacy in post-test in control group and test group was 61. 32 ± 12. 26 & 61. 38± 12. 26, which was significantly different in all cases (P <0. 05). Conclusion: Based on the results of peer education, it has improved the cluster symptoms and selfefficacy in patients with breast cancer. Therefore, it is recommended that nurses and others health professionals, create the formation of support groups and training by peers. Peer education Use it as a complementary method along with other care interventions.

Background & Aims: Delirium is a disorder in the ICU and sleep disorder can be a risk factor for it. Therefore, it is important to take non-pharmacological measures that are within the scope of the nurse's authority and that can promote sleep as a potential strategy to reduce delirium. The aim of this study was to determine the effect of using earplugs and eye mask during sleep on the delirium of patients in the intensive care unit. Materials & Methods: This experimental study was conducted on 73 patients hospitalized in ICU that they were selected by available method for 6 months randomly then allocated in two groups of control (37 patients) and mirror therapy (36 patients). In the intervention group, earplugs and eye mask was used for 3 consecutive days at 22 to 6. Patients before and after intervention were evaluated using NeeCham Delirium scale, a valid and reliable instrument. Delirium score and its domains in different stages in two groups were compared by repeated masseur ANOVA. Results: The results showed that the use of earplugs and eye mask and time both had a significant effect on total score of delirium (p<0. 05). In the process and behavior domain of the effect of time, group and interaction, there was a statistically significant difference (p<0. 05). However, in the physiologic domain, the effect of group and total effect did not show a significant relationship (p>0. 05). Conclusion: Earplugs and eye mask as a non-pharmaceutical and independent nursing care can be a useful, inexpensive and affordable tool to prevent confusion or delirium. But the relationship between sleep, sound and light and delirium requires more research.

Background & Aim: Patient safety is a serious global challenge and a very important aspect of health care quality. In addition to inflict pain on humans, unsafe care, also brings heavy economic costs. Our study aimed to evaluate the Establishment of Patient-Friendly Safety Standards in Urmia University of Medical Sciences Methods & Materials: This is a descriptive-analytic cross-sectional study that was conducted in hospitals affiliated to Urmia University of Medical Sciences in 1397. Data were collected using compulsory standards checklist that is used by World Health Organization (WHO) to assess patient safety in hospitals through observation, interviews and reviewing documents in selected hospitals of Urmia. Data were analyzed by descriptive and analytical tests (one way ANOVA) using SPSS-22 software. Then, based on the Compliance level with infrastructures of patient safety, hospitals were classified into three levels of poor (lower than 50%), medium (5o-75%), and good (higher than75%). Results: The overall compliance level of patient safety infrastructure mean with (61. 42 ± 3. 75%) was evaluated intermediate in studied hospital. The leadership and management with the highest mean (66. 29± 2. 3%) was evaluated average and the patient and public involvement domain with the lowest mean (49. 17± 2. 38%) was evaluated weak. Conclusion: In total, the overall compliance level of patient safety infrastructure was evaluated intermediate in studied hospital. Given that acquiring hundred percent of critical standards in in the four domains are essential to be considered at the basic level of patient safety friendly hospital. Therefore, Necessary investments in strategic and operational planning must be considered in order to achieve 100% standards in the four domains.

Background& Aims: Depression is the fourth most common disease in the world. It also remarkably affects the quality of life. The purpose of this study was to determine the effect of group psychological training of family on the severity and relapse of the disease in patients with major depressive disorder. Materials & methods: This randomized controlled clinical trial was conducted on 70 patients with major depressive disorder, randomly divided into two groups of 35 subjects. The treatment group received family group psychological training in addition to receiving drug therapy. The control group did not receive any psychological treatment. Depression severity of the patients was evaluated using Beck Depression Questionnaire and the relapse rate and severity of the disease in both groups were evaluated and compared after 2 and 6 months follow-up. The collected data were analyzed SPSS 24 software. The significance level of P <0. 05 was considered. Results: The mean of depression severity in the experimental group was 62. 34 ± 7. 13 at the beginning of the study and in control group was 60. 54 ± 6. 06, and using independent t-test, there was not statistically significant difference between the two groups. The mean of depression severity of patients’ in the experimental group was 22. 93 ± 1. 45 in the sixth month while the mean of depression severity in the control group was 40. 74 ± 12. 16, and therefore, there was a statistically significant difference between the two groups using independent t-test. Conclusion: empowering the patients’ family should be conducted in addition to medication.

Background & Aim: Nowadays, medication errors as the most common medical error are among the most important health and safety issues for patient safety. The aim of this study was Assessing and Management of Clinical Risk in medication Process of CCU in Mashhad teaching hospitals by HFMEA Method. Materials & Methods: The present study is a combination (qualitative – quantitative, cross sectional-descriptive) method. Data was collected through direct observation, review of documents, FGD technique by Non-probabilistic sampling based on purpose and by HFMEA standard work-sheet to risk analysis, decision tree analysis, identifying the root causes of failure states and suggestion of Improvement measures. In this study Fuzzy AHP (Analytical hierarchy process) Technique for selecting Priority Process, the Eindhoven model (ECM) was used and the Idea Generation Method was used to suggestion Improvement measures. Finally, data was analyzed using Excel software by descriptive statistics. Results: A total of 50 failure states in the 5-step medication process were identified, so that failure states were identified as unacceptable risk. so that from the total root causes of erorrs were categorized based on the ECM model, 62. 7% of latent errors and 37. 3% of obvious errors and Improving measures were suggested., if these strategies are implemented, in the re-evaluated Controlled Risk The ratio of unacceptable risks will decrease from 56. 9% to 21. 6%. Conclusion: The essential medication process due to Medicinal errors in some cases instead of treatment may increased costs, injury and prolonged hospital stay. The HFMEA Method with preventive approach and the focusing of systems rather than individual errors, in order to identify and resolve increases the agreement on process and organizational weakness and can play an Effectiveness role in eliminate the root causes of errors, especially in the sensitive and complex of the CCU ward.

Background & Aims: Childhood cancer as a life-threatening illness has negative consequences for both the patients and their family. Parents of children with cancer are experiencing high levels of psychological stress, and it affect many aspects of parents’ health. The aim of this study was to determine the depression and optimism among parents of children with cancer and relationship between these variables. Methods & Materials: This is a descriptive‐ correlational study on 148 parents of children with cancer admitted to a pediatric hospital affiliated to Tabriz University of Medical Sciences, Tabriz/Iran. Participants were selected using convenience sampling method. “ Life Orientation Test-Revised” and depression section of ‘ Hospital Anxiety and Depression Scale” were used to evaluate participants’ levels of optimism and depression. The data were analyzed using SPSS version 16. 0. Results: The mean rank for optimism and depression was 16 (IQR: 4) and 8 (IQR: 7) respectively. Also, there was a negative, significant correlation between parents optimism and depression (P<0. 001, R=-0. 439). Conclusion: Considering the rate of depression in parents of children with cancer, more attention is needed to the factors affecting this. In addition, due to the significant relationship between optimism and depression, incorporating optimism-promoting strategies into caring planes is recommended.

Background & Aims: Moral courage is a virtue that is essential for the Conscientious functioning of all healthcare providers, especially nurses and having a high level of virtue is very important Because in service provider organizations, with increasing roles and number of clients, increasing the awareness of clients, Changes in people's health needs, social justice and access to health services, moral distress has increased. Therefore, this study was conducted to determine the moral courage of nurses. Materials & Methods: This cross-sectional descriptive study was conducted in Urmia in 2018. The statistical population of this study was nurses working in different parts of educational and therapeutic centers of Urmia University of Medical Sciences. The sample size was 305 people who were selected by Simple random method and in the form of proportion. The data were collected by using of the ethical courage questionnaire of sekerka and et al and by using of SPSS v. 16, descriptive statistics and Pearson correlation, independent t-test, one-way ANOVA were analyzed. Results: The mean moral courage score was 86/09± 15/62 (range 21-105). The ethical factor dimension (17/81 ± 3/51) and the multiple values dimension (16/80 ± 3/71) respectively, had the highest and lowest average. There was a positive and significant relationship between age and work history and marital status with moral courage (p <0/05). Conclusion: According to the results of this study, the average ethical courage of nurses and also the ethical factor dimension were at the desirable level. Therefore, this important moral virtue can be promoted through effective planning and education and organizational support, and subsequently, we will see an increase in the quality of care.

Background & Aims: Substance dependence among children is recognized as one of the main sources of stress for mothers. The current study aims to investigate the association between personal actions, caring abilities, and perceived stress of mothers of children who are under substance-abuse treatment. Materials & Methods: The current study uses a quantitative method. The population of the current study was all mothers with children who were under substance-abuse treatment at Shahid Modarres Hospital, Isfahan, Iran in 2018. The study measures were perceived stress, two researcher-made questionnaires of personal actions and caring empowerments. Convergent and divergent validities and construct reliability of both questionnaires were first assessed using AMOS-20. Then, data were analyzed via Pearson correlation and hierarchical multiple regression analysis using SPSS-20. Results: After confirming the convergent and divergent validities and construction reliability of both questionnaires, Pearson correlation coefficient showed 1) negative relationship between personal actions, caring abilities, and perceived stress (r =-0. 47, r =-0. 43, p <0. 001, respectively), and 2) a significant association between some demographic characteristics (including, age, economic status, and number of children) and perceived stress among these mothers. In addition, after controlling the effect of these demographic variables, the results of hierarchical multiple regression showed that both mothers' personal actions and caring abilities negatively predicted perceived stress. Conclusion: Empowering the personal actions and caring abilities of mothers with children who are under drug-abuse treatment could lead to the reduction of perceived stress levels among mothers with different economic and social status.