Co-creation: Advancing the objectives of health care organizations during the COVID-19 pandemic

The article's abstract is not available.

Psychometric evaluation of the nine-item heart failure self-care behavior scale (9-EHFScBS)

Background & Aim: Self-care in patients with heart failure can improve multiple outcomes and reduce mortality. Measuring self-care requires valid and reliable tools. This study aimed to determine the psychometric properties of the 9-items European Heart Failure Self-Care Behavior Scale. Methods & Materials: The present study is a psychometric evaluation. The original version of the tool was translated from English to Persian using the standard Backward-Forward method. The questionnaire's validity was assessed using face, content, criterion (the Self-Care of Heart Failure Index v.6 as a criterion), and construct validity. An exploratory factor analysis approach was used to construct validity with a sample of 216 patients with chronic heart failure referred to Dr. Shariati and Imam Khomeini Hospital's heart clinics in Tehran; and Ayatollah Mousavi Hospital in Zanjan. The reliability of the questionnaire was evaluated by internal consistency and stability methods. Results: After the validation process (validity and reliability), all 9 items of the questionnaire were approved and remained. The content validity index of the total content of the questionnaire was calculated to be 0.96. Based on factor analysis, only one factor was confirmed for the questionnaire. The correlation between the present questionnaire and the Self-Care of Heart Failure Index v.6 was positive and significant (p<0.001, r=0.753). Internal consistency (α=0.728) and stability (0.897) of the questionnaire were also confirmed. Conclusion: The European Heart Failure Self-Care Behavior Scale is valid and reliable for measuring Iranian patients' self-care behaviors with heart failure.

Experts' views on the implementation of the prenatal screening decision aid in Iran: A qualitative study

Background & Aim: Patient decision aids are detailed and personalized health education materials that assist patients in decision making. According to expert viewpoints, this study aimed to determine important factors in implementing the prenatal screening decision aid in Iran. Methods & Materials: In this qualitative study, 24 experts, including seven obstetricians, four information scientists, five managers or policymakers, and eight midwives, were selected using purposive and snowball sampling approaches. Semi-structured interviews were conducted to collect the data between January 2020 and June 2020 in Tehran, Iran. A prenatal screening decision aid was presented to the participants, and we asked them to raise their concerns and thoughts regarding the factors influencing the implementation of patient decision aids. We used MAXQDA 10 and applied conventional content analysis for data analysis. Results: Two organizational and personal factors themes were identified to implement Iran's prenatal screening decision aids. Conclusion: We identified the viewpoints of experts regarding major factors in patient decision aids implementation for prenatal screening. Before implementing prenatal screening decision aids in Iran, it would be helpful to consider these organizational and personal factors. Prenatal screening decision aids can provide better information for pregnant women and strengthen their decision-making ability.

COVID-19 anxiety and organizational commitment among front-line nurses: Perceived role of nurse managers' caring behavior

Background & Aim: Anxiety related to the COVID-19 is prevalent amongst the nursing workforce potentially affecting nurses’ well-being and their organizational commitment. The nurse manager’s caring behavior has been recognized as a crucial indicator of nurses' resilience with the COVID-19 pandemic. This study aimed to investigate the effect of COVID-19 anxiety on front-line nurses’ organizational commitment and their perception of nurse managers' caring behavior. Methods & Materials: This study utilized an explanatory research design; hence, a convenient sample consisted of 60 registered nurses working at three selected medical intensive care units located in one of the Cairo University Teaching hospitals, Egypt was selected. Data were collected using the Coronavirus Anxiety Scale, Nursing Staff Organizational Commitment Questionnaire, and Nurse Managers' Caring Behavior Questionnaire. Statistical Package for the Social Sciences (SPSS) version 20 was used for the data analysis where the descriptive statistics, Simple Linear, and Stepwise multiple regression analysis were applied. Results: The highest-rated anxiety problem of COVID-19 was appetite loss (x ̅=3.03, SD = ±0.88). Human respect as one of the perceived nurse managers caring behaviors emerged as a strong predictor (Partial R2 = 0.104, p= .017) in increasing the front-line nurses’ organizational commitment, while COVID-19 anxiety has a significant decreasing effect (Partial R2 = 0.435, p<0.001) on it. Conclusion: COVID-19 anxiety has affected the front-line nurses’ organizational commitment and their perceived nurse managers' caring behavior. COVID-19 anxiety should be addressed and rectified by providing appropriate managerial caring behavior and support to boost nurses ‘organizational commitment.

Comparison of the effectiveness of Aloe Vera gel with 2% Nitrofurazone ointment on the healing of superficial partial-thickness burns: A randomized clinical trial study

Background & Aim: Routine treatment of burn injuries is dressing with Nitrofurazone ointment. It has several complications, including sensitivity. Aloe Vera is a traditional treatment for wound healing. This study aimed to compare the effectiveness of Aloe Vera gel with Nitrofurazone ointment in the healing of superficial partial-thickness burns. Methods & Materials: The present study was a split body controlled clinical trial which was carried out on 30 patients with superficial partial-thickness burns. The study was conducted in the Shafa Hospital in Kerman, Iran, in 2016. The sample was recruited from patients who had at least two burns, each burn on an alternate side of the body. On their burns, samples were allocated to two groups that received Aloe Vera gel or 2% Nitrofurazone ointment. Bates-Jensen Wound assessment tool was used to evaluate the healing of burns. Statistical analysis was conducted by SPSS-16 and using the repeated measure ANOVA. Results: The repeated measure ANOVA showed that there was a significant change in the score of BWAT in all areas during the intervention period (p=0.001), but the trend of healing in the two groups during the intervention period was not significantly different (p=0.098). Conclusion: Based on this study, it looks like Aloe vera gel is as effective as 2% Nitrofurazone ointment in healing wounds.

Nurses' exposure to verbal abuse at a university hospital in Crete, Greece

Background & Aim: The current study aimed to investigate workplace bullying, specifically verbal abuse of working nurses, and its consequences on the physical and psychological levels. Methods & Materials: A cross-sectional study was designed and implemented in 151 nurses working at a university hospital. The survey was conducted in 2018 at a university hospital in Greece, and the Verbal Abuse Scale (G-AVQ v.0/2015) was used to assess the verbal abuse level. Multiple linear regression analysis was applied, and distributions were tested for their symmetry using Blom's method (QQ plot). Results: 88.1% were women as the mean age of all was 41.7 years and 16.1 years the mean length of employment. Almost all nurses (94.7%) reported experiencing verbal abuse, as 77.6% reported that the perpetrator was a patient's relative (p<0.05). Among cognitive assessment, coping, severity of effects, and strength of feeling, coping had the highest mean value the highest mean value, while severity of effects had the lowest (2.52 vs. 1.83, p<0.05). Multiple linear regression analysis showed that frequency of verbal abuse type has a significant correlation with higher coping (β=0.28, p=0.007) and strength of feeling values (β=0.29, p=0.010). Similarly, the severity of verbal abuse type has a significant correlation with higher strength of feeling values (β=0.30, p=0.014). Conclusion: Almost all the nurses reported experiencing verbal abuse as the 'patients' relatives were the main perpetrators. Although the nurses seem to cope with verbal abuse successfully, this fact is described as stressful. Moreover, the frequency, severity of verbal abuse, and consequences are correlated to the emotions that arise from it.

The effect of a comprehensive support program on the stress level of mothers in a neonatal intensive care unit

Background & Aim: Parents of neonates hospitalized in the neonatal intensive care unit may experience a high level of stress. Although many approaches were applied to reduce stress, little is known about the effect of a comprehensive support program. This study aims to investigate the effect of a comprehensive supportive program on maternal stress levels in a NICU. Methods & Materials: This is a quasi-experimental study that lasted for about eleven months, 62 mothers whose premature neonates were hospitalized in a NICU in Edirne, Turkey, were selected and assigned into intervention and control groups non-randomly. A comprehensive support program was applied for the mothers in the intervention group, whereas the mothers in the control group received the standard routine care. Data were collected using the Parental Information Form, Newborn Information Form, and Parent Stress Scale in NICU and analyzed using SPSS software. Results: The maternal stress level of the mothers in the intervention group (mean=2.95±.72) was found significantly lower than the control group (mean=3.74±.82) (p≤001) in the post-test. Similarly, the average scores obtained by the mothers in the intervention group in the Parent Stress Scale’s subcategories of images and sounds, neonates’ appearance, and change in parental roles were also found to be significantly lower than that obtained by the mother’s in the control group (p≤001). Conclusion: A comprehensive support program is significantly effective in reducing maternal stress levels. So, it is highly recommended that nurses use these comprehensive approaches in practice and especially support mothers by facilitating interaction between parents experiencing similar problems.

The effect of rosemary ointment on the pressure ulcer healing in patients admitted to the intensive care unit: A randomized clinical trial

Background & Aim: Pressure ulcers have been identified as one of the most important and challenging issues in patient’s well-being. Based on the evidence, rosemary extract compounds can affect wound healing. The aim of this study was to determine the effect of rosemary ointment on pressure ulcer healing in patients admitted to the intensive care unit. Methods & Materials: In this single-blind randomized parallel clinical trial, 70 patients who met the inclusion criteria were selected purposefully and assigned to the groups by stratified randomization method. In the intervention group, rosemary ointment was applied once a day for seven days. The control group received routine care. Data were collected using the Pressure Ulcer Scale for Healing before the intervention and on the third and seventh days after the intervention. Data were analyzed using independent t-test, chi-square test, and two-way repeated measurements ANOVA with SPSS 18 software. Results: The mean scores of Pressure Ulcer Scale for Healing decreased significantly in the intervention group while remained unchanged in the control group (P=0.001) one week after the intervention. The effect of time and interaction effect was also significant (P=0.001). Comparison of the ratio of complete ulcer healing in the two groups showed a significant difference between the two groups (p=0.004). Conclusion: Rosemary ointment facilitated healing and prevented the progression of grade І pressure ulcers in the Intensive Care Unit. Therefore, the use of this ointment as a low-risk, uncomplicated, available, and inexpensive intervention, is recommended in such patients.

A quantifiable nursing evaluation: The need within a forensic mental health setting

The article's abstract is not available.

The effect of cognitive-behavioral group training of self-care skills on self-care in patients with schizophrenia

Background & Aim: Self-care is one of the challenges of the health care system in patients with schizophrenia. It has been less studied due to these patients have no insight into the symptoms. This study aimed to determine the effect of cognitive-behavioral group training on self-care skills in patients with schizophrenia. Methods & Materials: This single-blind randomized controlled clinical trial (blinding of data analysts) was performed on 50 hospitalized schizophrenia patients by convenience sampling method and random block allocation to the intervention (n=26) and control (n=24) groups in Ebn-Sina Psychiatric Hospital of Mashhad, Iran from late July 2020 to mid-January 2021. The intervention group received cognitive-behavioral group training of self-care skills based on Kashani Lotfabadi et al. (2020) protocol in 10 sessions (two sessions per week). The control group was placed on a waiting list. Data collection tools included the Self-Care Requisites Scale (SCRS-H) and the Positive and Negative Syndrome Scale (PANSS). The data were analyzed by SPSS 25 version, repeated measures of ANOVA test. Results: 60 % (n=30) of participants were female, and 40% (n=20) were male with a mean age of 32.98±8.35 years. The results of repeated measures of ANOVA indicated a significant difference between the intervention and control groups in terms of descending mean score of total self-care during the test stages (p=0.001). Conclusion: Cognitive-behavioral group training of self-care skills could promote self-care behaviors in patients with schizophrenia. Therefore, we suggest using this intervention to strengthen self-care skills in patients with schizophrenia.