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   Table of Contents - Current issue
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January-March 2021
Volume 10 | Issue 1
Page Nos. 1-64

Online since Thursday, January 14, 2021

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ORIGINAL ARTICLES  

The Effects of Role Play Simulation and Demonstration on Pediatric Peripheral Venous Catheter Insertion Skill among Nursing Students: A Three Group Experimental Study Highly accessed article p. 1
Leila Valizadeh, Bahareh Akbarzadeh, Shahrzad Ghiyasvandiyan, Zahra KuchakiNejad, Vahid Zamanzadeh, Parvaneh Aghajari, Faranak Jabbarzadeh, Maureen Crowley
DOI:10.4103/nms.nms_94_18  
Background: The short course of baccalaureate nursing program and overcrowding of clinical settings restrict the development of pediatric peripheral venous catheter (PVC) insertion skill among nursing students. Therefore, better teaching strategies are needed. Objectives: The aim of this study was to compare the effects of role play simulation and demonstration on pediatric PVC insertion skill among nursing students. Methods: In this three-group experimental study, 46 nursing students were selected from Tabriz University of Medical Sciences, Tabriz, Iran, randomly allocated to a control, a role play simulation, or a demonstration group. Initially, all students received information about pediatric PVC insertion through lecture. Then, their skill was assessed using a child mannequin in a skill lab by a thirty-item rating scale. Then, participants in the simulation and the demonstration groups received training about this skill through simulation or demonstration teaching methods. After 3 weeks, their skill was reassessed. Data were analyzed using the Wilcoxon and Kruskal–Wallis tests. Results: The baseline total scores of PVC insertion skill were 17.66 ± 7.46, 14.93 ± 6.64, and 16.92 ± 10.38 and after intervention changed to 20.66 ± 5.65, 33.81 ± 6.86, and 41.14 ± 7.67 in the control, role play simulation, and demonstration groups, respectively. There was a statistically significant increase of skill in simulation and demonstration groups (P < 0.001), whereas the increase in the control group was insignificant (P = 0.09). There was no significant difference between role play simulation and demonstration groups (P > 0.05). Conclusion: Both role play simulation and demonstration significantly improve pediatric PVC insertion skill among nursing students. These teaching methods are recommended for developing nursing skills.
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The Effects of Education through Role-Playing on Self-Concept among Older Adults p. 7
Fatemeh Mansouri, Parand Pourghane, Roya Mansour-Ghanaei, Zahra Atrkar Roushan
DOI:10.4103/nms.nms_5_20  
Background: Self-concept (SC) is one the psychological characteristics affected by aging. Objectives: This study aimed to assess the effects of education through role-playing on SC among elderly people. Methods: This quasi-experimental study was conducted in 2018 using a two-group pre- and posttest design. Participants were 72 older adults randomly recruited from retirement centers in the East of Guilan province, Iran, and randomly allocated into control group and intervention group. Participants in the intervention group received education through role-playing in six-weekly sessions. Participants' SC was assessed before the intervention onset and 1.5 months after its end using the Rogers Self-concept Questionnaire. The independent sample t-test, the Mann–Whitney U test, and the Chi-square test were used for the data analysis. Results: There was no statistically significant difference between the intervention and the control groups respecting the pretest mean score of SC (10.69 ± 2.21 vs. 9.77 ± 2.59; P = 0.11). However, the posttest mean score of SC in the intervention group was significantly less than the control group (8.44 ± 2.70 vs. 9.69 ± 2.40; P = 0.046). The pre- and posttest mean difference of SC in the intervention group was also significantly greater than the control group (2.25 ± 2.43 vs. 0.10 ± 1.58; P < 0.001). Conclusion: Education through role-playing is effective in significantly improving older adults' SC. Therefore, health-care providers can use this method for SC improvement among older adults.
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The Effect of Motivational Interview on Puberty Knowledge and Practice among Adolescent Girls p. 13
Sarah Mohamadi, Omid Garkaz, Seyed Abbas Mousavi, Afsaneh Keramat, Shahrbanoo Goli, Zahra Motaghi
DOI:10.4103/nms.nms_4_20  
Background: Adolescence is a critical stage of life with a significant role in reproduction and fertility. Interventions are needed to promote the health of adolescent girls as prospective mothers. Objectives: This study aimed to investigate the effects of motivational interviewing on adolescent girls' puberty knowledge and practice. Methods: This quasi-experimental study was conducted in 2018 on 240 eighth-grade female students recruited through multistage sampling from ten high schools in Shahroud, Iran. Schools were allocated into an intervention group and a control group through simple randomization. Participants in the intervention group received a five-session puberty-related motivational interviewing intervention. Puberty knowledge and practice in both groups were assessed before, immediately after, and 1 month after the intervention. Data were analyzed through the Chi-square and the independent-samples t-tests and the repeated-measures analysis of variance. Results: Participants' age was 14.47 ± 0.51 years, on average. About 70% of them had poor or moderate puberty knowledge. Although there was no statistically significant between-group difference respecting the mean scores of puberty knowledge and practice at pretest (P > 0.05), the mean scores of puberty knowledge and practice in the intervention group were significantly higher than the control group at both posttests (P = 0.001). Conclusion: Motivational interviewing is effective in improving adolescent girls' puberty knowledge and practice.
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The Effects of Thai Massage on Comfort and Symptoms among Female Cancer Patients Receiving Chemotherapy p. 20
Narges Mardaneh, Arash Jenabian, Ladan Fattah Moghaddam
DOI:10.4103/nms.nms_110_19  
Background: Chemotherapy is the most common modality for cancer management, but it is associated with many side effects. Objectives: This study evaluated the effects of Thai massage on comfort and symptoms among female cancer patients receiving chemotherapy. Methods: This randomized clinical trial was conducted in 2017–2018 with a two-group pre-posttest design. Participants were sixty female patients with cancer selected from Bu-Ali Hospital in Tehran, Iran, and randomly allocated to a control and an intervention group. Participants in the control group received routine care, while their counterparts in the intervention group received both routine care and ten-session massage therapy. A demographic questionnaire, the Kolcaba's General Comfort Questionnaire, and the Edmonton Symptom Assessment Scale were used for data collection. Data were analyzed using the Chi-square, Fisher's exact, independent-samples t, and paired-samples t-tests. Results: There was no statistically significant difference between the groups respecting the pretest mean scores of comfort and symptoms (P > 0.05). After the intervention, the mean score of comfort in the control group was statistically significantly greater than the intervention group (137.4 ± 6.8 vs. 131.53 ± 9.61; P = 0.008). Moreover, the posttest mean scores of pain, fatigue, nausea, depression, anxiety, and drowsiness in the intervention group were significantly less than the control group (P < 0.05). Conclusion: Massage therapy is effective in significantly reducing symptoms among female cancer patients receiving chemotherapy.
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Iranian Nurses' Experiences of their Roles in Care Provision to the Victims of Child Violence: A Qualitative Study p. 27
Nazila Vosoghi, Masoud Fallahi-Khoshknab, Mohammadali Hosseini, Fazlollah Ahmadi
DOI:10.4103/nms.nms_123_19  
Background: As the largest group of healthcare providers, nurses have many different responsibilities in care provision to child violence victims (CVVs). Yet, their roles in care provision to these victims are poorly known. Objectives: The aim of this study was to explore nurses' experiences of their roles in care provision to CVVs. Methods: This qualitative study was conducted in 2018–2019. Fourteen nurses were purposively recruited from two pediatric specialty hospitals in Tehran and Ardabil, Iran. In-depth semi-structured interviews were held for data collection. Data were analyzed through conventional content analysis. Results: Data analysis revealed that nurses' roles in care provision to CVVs included the four main categories of protective, diagnostic, reporting, and educational roles. Conclusions: Nurses play significant roles in care provision to CVVs through diagnosing violence, reporting it, protecting CVVs, and providing education to CVVs and their families. Nonetheless, they receive limited education, if any, in this area.
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Excruciating Care: Experiences of Care Transition from Hospital to Home among the Family Caregivers of Patients with Spinal Cord Injury p. 34
Moloud Farmahini-Farahani, Hamid Reza Khankeh, Mohammadali Hosseini, Asghar Dalvandi, Kian Norouzi Tabrizi
DOI:10.4103/nms.nms_102_19  
Background: Transition of patients with spinal cord injury (SCI) from hospital to home often involves a shift in caregiving responsibility from health-care providers to family caregivers. Poor care transition may lead to poor care-related outcomes. Objectives: The aim of this study was to explore experiences of care transition from hospital to home among the family caregivers of patients with SCI. Methods: This qualitative study was conducted in 2018–2019. Participants were 17 family caregivers of patients with SCI who were purposively recruited from two specialty SCI care centers in Iran. In-depth semi-structured interviews were held for data collection. Interviews were audio-recorded, transcribed, and analyzed using conventional content analysis. Results: The following four main categories were developed during data analysis: lack of knowledge (with two subcategories), excruciating care (with two subcategories), emotional burden of caregiving (with three subcategories), and need for support (with two subcategories). The nine subcategories of these main categories were lack of medical and care-related information, seeking for information, heavy burden of daily caregiving, need for providing professional care at home, feelings of sadness and sorrow, feeling of insufficiency, restriction of life, limited support by family members and relatives, and limited financial support by the government. Conclusion: Family caregivers of patients with SCI experience many challenges and problems during care transition from hospital to home, which can affect the quality of their care services for their patients. Therefore, they need ongoing support throughout the process of care.
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The association of Shift Work and Effort–Reward Imbalance with Gastrointestinal Symptoms among Female Nurses p. 41
Malak A Alsadah, Sultan T Al-Otaibi, Hatem K Herzallah
DOI:10.4103/nms.nms_47_20  
Background: Shift work impacts workers' health, mainly by disrupting the circadian rhythm, and gastrointestinal (GI) disturbances are among the health effects of shift work. Objectives: The objective of this study was to assess the association between shift work, work stress, and GI disturbance among nurses. Methods: In July 2018, a cross-sectional study was conducted in Dammam Medical Complex, Saudi Arabia. A total of 250 nurses were selected through convenience sampling from several departments. They completed a validated questionnaire, which included questions about their demographic data, GI symptoms, and effort–reward imbalance (ERI). Work stress was classified into two groups based on the ERI ratio. GI symptoms were categorized into three indices: total, upper, and lower GI. The sampling plan was designed to cover most of the shifts in the included departments throughout nonspecified dates. The daytime nurses' group was selected from the same hospital as a comparison group to the shift workers. Means and standard deviations were calculated for continuous variables and frequencies and percentages were calculated for categorical variables. The associations were assessed using the Chi-squares and analysis of variance. Results: Work stress among nurses, as measured by the ERI scale, was strongly associated with both upper and lower GI symptoms, with odds ratios of 5.7 (CI: 3.3–7.9) and 2.2 (CI: 1.8–4.3), respectively. The total GI symptom score of the shift workers was greater than that for the daytime workers, with means of 7.8 ± 6.9 and 5.4 ± 5.1, respectively (P = 0.005). Multivariable regression analysis showed that ERI was associated with both lower and upper GI symptoms after adjusting for shift work and years on the job. Conclusions: Shift work was associated with the high prevalence of GI symptoms. Stress (ERI) increased the risk for GI disturbance. Controlling work stress is necessary because it affects nurses' physical and social health, as well as their performances at work and the quality of care they provide.
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Clinical Belongingness and its Relationship with Clinical Self-Efficacy among Nursing Students: A Descriptive Correlational Study p. 47
Sima Pourteimour, Hossein Jamshidi, Naser Parizad
DOI:10.4103/nms.nms_34_20  
Background: Clinical self-efficacy (CSE) plays a pivotal role in safe and quality nursing care delivery. Clinical Belongingness (CB) is a major factor in the clinical practice of nursing students. Objective: This study aimed to assess CSE and CB and their relationship among nursing students. Methods: This descriptive, correlational study was conducted in 2019 in the Faculty of Nursing and Midwifery of Urmia University of Medical Sciences, Urmia, Iran. Participants were 216 eligible 3rd- and 4th-year nursing students. Data were collected using a demographic questionnaire, the Belongingness Scale-Clinical Placement Experience, and the Self-Efficacy in Clinical Performance Questionnaire. The Pearson correlation analysis, the independent-sample t-test, the one-way analysis of variance, and the linear regression analysis were performed for the data analysis. Results: The total mean scores of CSE and CB were, respectively, 134.02 ± 20.62 and 121 ± 16.79, indicating moderate CSE and high CB. CB had significant positive correlation with CSE and was a significant predictor of it (P < 0.05). Conclusion: Nursing students have high CB and moderate CSE, and their CB is a significant positive predictor of their CSE. University authorities are recommended to develop clear strategies to improve nursing students' CSE through improving their CB.
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Nursing Students' Attitude toward the Importance of Patient Privacy p. 52
SeyyedHamidReza FallahMortezaNejad, Zahra Pourhabibi, Moein Mashayekhipirbazari, Kourosh Delpasand
DOI:10.4103/nms.nms_96_19  
Background: Observing patient privacy is one of the most important nurses' ethical responsibilities. Objective: This study is aimed to investigate nursing students' attitudes toward the importance of patient privacy in nursing care. Methods: This cross-sectional study was conducted between September 2018 and April 2019 in the School of Nursing and Midwifery of Guilan University of Medical Sciences, Iran. One hundred and fifty nursing students responded to the study questionnaires. Descriptive statistics were used to analyze the data. Results: A total of 142 nursing students with a mean age of 21.91 ± 4.67 years participated in this study. A majority of the students (63.5%) were female, 82.2% were single and 31.8% had clinical experience. The mean students' attitudes scores were, respectively, 8.36 ± 1.53, 6.84 ± 2.04, 6.24 ± 2.23, and 11.42 ± 2.17 for the physical, psychological, spatial, and informational dimensions of patient privacy. Conclusion: The mean students' attitude toward patient privacy was at a moderate level. Nurse educators and all the authorities of nursing education should instruct nursing students to pay special attention to the observance of patient privacy.
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Job Stress among Iranian Nurses: A Meta-Analysis p. 57
Parvaneh Isfahani, Monireh Shamsaie, Saeid Peirovy, Rasoul Corani Bahador, Mahnaz Afshari
DOI:10.4103/nms.nms_28_20  
Background: Job stress is one of the most important factors in reducing the organizational productivity. Objective: This meta-analysis aimed to determine the prevalence of job stress among nurses in Iran. Methods: All articles published on the prevalence of job stress among Iranian nurses from January 1, 2004, to April 31, 2020, were searched in six databases. The reference lists of the articles were also checked for additional relevant studies. Finally, 25 articles were analyzed through Comprehensive Meta-Analysis software. Heterogeneity of studies was checked using the I2 index, Q-test and the possibility of publication bias by the Egger test. Metaregression was performed to assess the variables suspected to affect the heterogeneity at a significance level of 0.05. The outcomes of the study were combined using the random-effects model. Results: The overall prevalence of job stress in Iranian nurses was 37.5% (95% confidence interval [CI]: 28.5, 47.4). The highest prevalence was 96.4% in Tehran city in 2016 (95% CI: 90.3, 98.7), and the lowest prevalence was 2% in Kashan city in 2011 (95% CI: 0.7, 5.3). A significant correlation was observed between the prevalence of job stress and year (P = 0.0001), mean age (P = 0.002), and sample size (P < 0.0001). Conclusion: Job stress affects over a third of Iranian nurses. Health-care policy-makers and managers should decrease this stress by adopting appropriate strategies such as increasing welfare facilities, reconsidering job descriptions for different levels of nursing, providing support, increasing nurses' involvement in the decision-making process, improving communication between managers and nurses, and teaching problem-solving skills to them.
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