Practicing patients’ rights in Iran: a review of evidence

Protection of patients' rights is critical in improving healthcare quality, and hence this study aimed at reviewing patient rights’ practices in healthcare organizations of Iran. Using systematic search, this review was conducted based on Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Several keywords, including "patient rights", "patient bills of rights" and "patients rights’ charter" were searched bilingually in the databases of SID, Magiran, PubMed, Scopus, and Web of Science from 2010 to 2021, and then, following a three-tier screening using the Critical Appraisal Skills Program (CASP) checklists, 76 articles were extracted. The degree of compliance with the Patients' Rights Charter (PRC) in healthcare organizations was 60.88% on average. As to the observance of the PRC dimensions, respectively, the highest and lowest scores were related to the "right to privacy and confidentiality" (70.16%) and "right to access an efficient complaining system" (53.01 %). Respect for patients' rights in organizations was assessed at a moderate level, and some aspects of patients' rights should be attended to immediately. Therefore, discrepancies in the dimensions of patients' rights and their implementation by organizations should be on the agenda of healthcare managers and policymakers.

Mindfulness-Based Group Therapy as Support for Mental Health Concerns in Pregnancy: A Systematic Review

Background Perinatal mental illness is prevalent and can be associated with poorer health outcomes for mother and fetus if untreated. Mindfulness is a contemporary approach to managing mental health concerns; however, little is known about the effectiveness of Mindfulness-based Interventions during pregnancy, especially within the context of peer support. Methods A systematic review was undertaken. Randomised controlled trials and quasi-experimental studies were included. All articles were critically appraised using the Critical Appraisal Skills Program checklist. Results Of the 2053 records initially identified, 21 studies met inclusion criteria. Studies demonstrated modest improvements in perinatal mental illness, particularly when interventions were adapted to meet the unique needs of women in the prenatal period. Comparison was difficult, due to high heterogeneity and methodological limitations. No studies explored peer support as a therapeutic mechanism and maternal-fetal bonding was not a measured in any studies. Conclusion Mindfulness-based group interventions designed to meet the needs of perinatal women require further research, with larger sample sizes, more rigorous methodology and greater demographic diversity required. Additionally, value could be afforded in exploration of how group support affects any change mechanisms within the participants and include maternal fetal bonding as a measured outcome.

A Qualitative Systematic Review of Family Support for a Successful Breastfeeding Experience among Adolescent Mothers

BACKGROUND: Family support for adolescent mothers is vital in making breastfeeding decisions and sustaining the feeding since many of these women struggle with identity crises. Therefore, it is essential to synthesize qualitative evidence about the types of family support provided to these young women. AIM: This study aims to identify, synthesize, and recognize the qualitative evidence of family support for successful breastfeeding among teen mothers. METHODS: A systematic review of qualitative studies was identified in six electronic databases published from 2000 to 2020. The quality of the reviewed studies was checked using The Critical Appraisal Skills Programs. The data were extracted by two investigators and analyzed using thematic analysis with three steps: coding the text line-by-line, developing the descriptive themes, and generating the analytical themes. RESULTS: This review includes eight eligible studies. The review founds that family significantly affect the success of breastfeeding practices among adolescent mothers through their appraisal, instrumental, emotional, and informational support. The family strengthens the adolescence’s breastfeeding decisions and confidence, provide financial assistance, share positive breastfeeding information and experience, encourage them to continue the feeding and motivate theme to pursue their study. CONCLUSION: Breastfeeding a baby and becoming a mother at a young age is not an easy process and need family support for a successful feeding. Health care professionals should actively involve the family in supporting adolescent mothers to breastfeed their babies optimally.

Tehnični dejavniki aplikacije intramuskularne injekcije

Uvod: Aplikacija intramuskularne injekcije predstavlja najpogosteje uporabljen način aplikacije injekcij. Namen raziskave je bil preučiti najnovejše ugotovitve s področja priprave vbodnega mesta in aplikacije intramuskularne injekcije.Metode: Izveden je bil sistematični pregled znanstvene in strokovne literature v mednarodnih podatkovnih bazah CINAHL, PubMed, The Cochrane Library ter ScienceDirect. Uporabili smo naslednje ključne besede: intramuscular injection, instramuscular vaccination, injection site, skin disinfection, injection technique. Pri iskanju smo uporabili tudi Boolove operatorje AND (IN) in OR (ALI). Iskanje literature je potekalo marca in aprila 2021. Za oceno kakovosti posameznih raziskav smo uporabili orodje Critical Appraisal Skills Programme.Rezultati: Izmed 4.208 identificiranih zadetkov je bilo v končno analizo vključenih 13 člankov. Ugotovitve smo združili v štiri vsebinske kategorije: (1) izbira vbodnega mesta, (2) tehnike intramuskularne injekcije, (3) razkuževanje vbodnega mesta, (4) aspiracija.Diskusija in zaključek: Med zaključki raziskav ni enotnega mnenja glede varne in strokovne aplikacije intramuskularne injekcije. Kot kažejo raziskave, je najprimernejše mesto aplikacije ventroglutealno področje. Razkuževanje vbodnega mesta pred aplikacijo v izvenbolnišničnem okolju ni potrebno, medtem ko je aspiracija priporočljiva zgolj na dorzoglutelnem mestu. Priporoča se aplikacija s tehniko trakcija kože – pritisk – hitro sproščanje mišic, z izbiro igle ob upoštevanju debeline podkožnega maščevja, mesta za aplikacijo in gostote zdravila. Potrebna bi bila izvedba dodatnih raziskav, s katerimi bi lahko oblikovali priporočila za optimalno tehniko intramuskularne injekcije.

Mental health and nursing based on Viktor Frankl’s theory: an integrative review

Objetivo: analisar a produção cientifica de enfermagem em saúde mental fundamentada na teoria de Viktor Frankl no período de 2011 a 2021. Método: revisão integrativa desenvolvida com seis artigos que abordam enfermagem em saúde mental com uso da teoria de Viktor Frankl. Para a busca, utilizou-se portal Capes, Biblioteca Virtual de Saúde, PubMed e Biblioteca do Conhecimento online. O estudos foram avaliados a partir do checklist proposto pelo Critical Appraisal Skills Programme, e descritos suas principais características, resultados, conclusões, convergências. Resultados: dos estudos fenomenológicos analisados, cinco obtiveram classificação alta conforme checklist Casp, e tiveram abordagens como o cuidado a pessoa idosa, àquelas com doenças crônicas hospitalizadas, cuidado paliativo e o processo de ajuda ao familiar destas pessoas. Houve convergências entre os estudos de aspectos de espiritualidade, sentido de vida, sacralidade, fé, adoecimento, diagnóstico, sofrimento possiblidades de cura, família e resiliência. Conclusão: o enfermeiro tem produzido conhecimento na perspectiva do referencial frankliano, fundamentado sua prática em teoria e contribuído com a saúde mental das pessoas sob sua responsabilidade, contudo, evidencia-se a necessidade de capacitação deste profissional quanto a espiritualidade e saúde mental para assistir as pessoas em contexto variados de cuidado.

Support needs of carers making proxy healthcare decisions for people with dementia: a systematic review based on the Noblit and Hare meta-ethnographic synthesis of qualitative studies

BackgroundThere are 50 million dementia sufferers worldwide. Decisions about healthcare often need to be made when the person with dementia lacks capacity to do so.Understanding the support needs of carers acting as proxy healthcare decision-makers will be vital in improving the decision-making process for people with dementia and addressing the holistic needs of carers.ObjectiveThe objective of this study was to review the existing literature on the support needs of carers acting as proxy healthcare decision-makers for people with dementia.DesignA qualitative systematic review protocol was published on PROSPERO. The Critical Appraisal Skills Programme checklist was used to appraise study quality. A meta-ethnographic synthesis was performed to develop third-order constructs.Data sourcesA search was conducted using three online databases (MEDLINE, CINAHL and PsycINFO).Eligibility criteriaFifteen studies met the inclusion criteria: primary qualitative research involving carers of people with dementia who had been involved in making proxy healthcare decisions.Data extraction and synthesisTwo independent researchers conducted validity assessments for each paper selected for inclusion, and discrepancies were resolved by discussions with a third reviewer. Nvivo software was used and conceptual findings from study papers lead to interpretations of findings by the team.ResultsFrom the 15 papers included in the study, three main domains arose from the meta-ethnography; informational, practical and emotional. Informational support needs included information about dementia itself and the anticipated disease trajectory. Practical needs included continuity of care, person-centred care and the use of legal frameworks.Emotional support included recognising the guilt that healthcare decisions can provoke and the importance of providing guidance in an empathic manner.ConclusionsThis meta-ethnography highlights opportunities for healthcare professionals and policymakers to improve experiences of carers making proxy healthcare decisions for people with dementia.PROSPERO registration numberCRD42020124485.

Support Needs as Perceived by Grandparent-Caregivers: A Qualitative Systematic Review

Caregiving can have adverse mental and physical health outcomes. Older grandparents who are primary caregivers for their grandchildren report multiple health conditions such as depression, anxiety, hypertension, cardiac disease and chronic fatigue, which are caused by or otherwise exacerbated by the caregiving demands. We conducted this qualitative systematic review to identify support needs that contribute to such poor health outcomes and as perceived by grandparent-caregivers for minor grandchildren. We searched relevant databases (PubMed, PyschINFO, CINAHL, and Social Work Abstracts) using terms such as: child rearing, parenting, child custody, grandparents, support needs, and caregiving. Studies were included for review if they were written in the English language; used only qualitative methods; and were published from January 1990 to January 2020. Included studies were critically appraised using the Critical Appraisal Skills Programme checklist. Data were extracted from these studies and synthesized using meta-ethnography. Of the 2828 studies identified, 58 studies from 12 countries met all inclusion criteria for review. Three main themes emerged from the review: 1) grandparent-caregivers’ personal needs, and 2) grandchildren needs. Both themes were further divided into subthemes of health (mental & physical), financial, social (interpersonal, cultural and environmental factors and services). Findings from this review have potential to: 1) inform design of comprehensive interventions and screening needed to address perceived support needs; and 2) identify gaps in and barriers to available support resources for older grandparent-caregivers. Further research is needed on comprehensive assessment of support needs and risk for poor health outcomes among grandparent-caregivers.

Microbial colonisation associated with conventional and self-ligating brackets: a systematic review

Background: Decalcification and gingivitis caused by plaque accumulation around brackets are common iatrogenic effects of fixed appliances. The influence of conventional versus self-ligating bracket design on microbial colonisation is unknown. Objective: To assess the levels of microbial colonisation associated with conventional and self-ligating brackets. Search sources: Three databases were searched for publications from 2009 to 2021. Data selection: Randomised controlled trials comparing levels of microbial colonisation before and during treatment with conventional and self-ligating brackets were assessed independently and in duplicate. Data extraction: Data were extracted independently by two authors from the studies that fulfilled the inclusion criteria. Risk of bias assessments were made using the revised Cochrane risk of bias tool for randomized trials. The quality of the included studies was assessed using the Critical Appraisal Skills Programme Checklist. Results: A total of 11 randomised controlled trials were included in this systematic review. Six of the studies were found to be at low risk of bias and five presented with some concerns. The studies were considered moderate to high quality. Five trials reported no statistically significant difference in microbial colonisation between bracket types. The remaining studies showed mixed results, with some reporting increased colonisation of conventional brackets and others increased colonisation of self-ligating brackets. The heterogeneity of study methods and outcomes precluded meta-analysis. Conclusion: Of the 11 studies included in this systematic review, five found no differences in colonisation between conventional and self-ligating brackets. The remaining studies showed mixed results. The evidence is inconclusive regarding the association between bracket design and levels of microbial colonisation.

Warm Compress on Lowering Body Temperature Among Hyperthermia Patients: A Literature Review

Hyperthermia increased the core human body temperature above normal 36.7-37.5 °C, usually caused by infection, resulting in fever, and was the most common manifestation. One of the efforts that could be done to overcome the symptoms of hyperthermia was the application of warm compresses to the frontal, axillary, and dorsalis pedis. The study aimed to describe body temperature changes in hyperthermic patients after warm compress was applied. This study used a descriptive design with a literature review approach. Twelve articles were included in this review by six journal databases: PubMed, JSTOR, Wiley Online Library, Sage Journal, Taylor and Francis Online, and Google Scholar. The selection was carried out by assessing articles that met the inclusion criteria, including the publication range for 2008-2021, English and Indonesian languages ??, and open access to full-text pdf. The critical assessment was carried out by using the Critical Appraisal Skills Programmed instrument. The review results showed that the warm compress method had a positive effect in lowering body temperature in the nursing process in patients with hyperthermia. Based on the literature from the reviewed articles, it could be concluded that a warm compress intervention needed to be given to hyperthermic patients to lower the patient's body temperature whether they were undergoing treatment or not

Challenges to Internationalisation of University Programmes: A Systematic Thematic Synthesis of Qualitative Research on Learner-Centred English Medium Instruction (EMI) Pedagogy

As many universities in non-Anglophone countries have committed to internationalising their academic programmes, more content courses in Arts and Sciences are being taught in English. When content courses are taught in English in a country where English is not the first language, this is called English Medium Instruction (EMI). Using specific country cases, previous studies have confirmed that an EMI course can pose many challenges to the learning of course content by students. To date, there have been few attempts to examine these challenges through a large-scale qualitative prism, which would be useful for gaining new insights in order to inform policy as well as classroom interventions. In this systematic thematic synthesis we have aimed to identify the obstacles to implementing learner-centred pedagogy in EMI tertiary programmes, focusing on student perspectives. The Critical Appraisal Skills Programme (CASP) and Consolidated Criteria for Reporting Qualitative Studies (COREQ) were used to appraise and synthesise 40 empirical articles. The articles included 1769 participants in 20 non-Anglophone countries and jurisdictions. The participants were both local and international non-native English-speaking students enrolled in EMI courses. The synthesis yielded 46 descriptive themes stratified into six analytical domains. The suggested domains are meta/linguistic, instructional, meta/cognitive, socio-cultural, affective, and institutional obstacles. They suggest that students in different regions faced quite similar challenges in their EMI courses. The challenges consist of inadequate use of English by students and lecturers, and a lack of student-centred pedagogy, particularly in teacher–student and student–student interactions. The findings of most learner-centred EMI studies revealed that the main challenges came from English comprehension (the first three suggested domains); fewer studies included factors related to the learning environment (the last three domains). This review can inform university administrators, teaching staff and researchers engaged in internationalising higher education and aid in designing appropriate EMI programmes that offer better learner-centred educational experiences.