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   2020| July-September  | Volume 9 | Issue 3  
    Online since July 17, 2020

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The effect of aromatherapy with rosa damascena essence on postoperative pain in inguinal hernia repair: A randomized clinical trial
Abolfazl Amini, Nasrin Bahraminejad, Samineh Jafari, Koorosh Kamali
July-September 2020, 9(3):117-123
Background: Despite therapeutic interventions, patients are still dissatisfied with the treatment of postoperative pain. Objectives: The aim of this study was to examine the effect of Rosa damascena essential oil on postoperative pain in patients undergoing inguinal hernia repair surgery. Methods: In a double-blind, randomized trial, 60 patients undergoing inguinal hernia repair surgery were selected consecutively and equally assigned to two groups of experimental and placebo. In both groups, the pain intensity was measured by a visual analog scale in 4, 8, and 12 h after the surgery. Patients in the experimental group received aromatherapy with R. damascena essential oil and those in the placebo group treated with almond oil. In both groups, pain intensity was measured before and 20 min after aromatherapy. Data analysis was performed using the repeated-measures analysis, analysis of covariance, independent-samples t- test, Chi-square, and Fisher's exact tests. Results: The mean pain intensity in the experimental and the placebo groups was 7.10 ± 1.24 versus 7.20 ± 1.10, 4.56 ± 1.04 versus 4.90 ± 0.84, and 1.30 ± 0.79 versus 2.46 ± 0.68 after the 4th, 8th, and 12th postsurgical hours, respectively. The repeated-measures analysis showed that the intervention was effective on pain reduction, especially in the 8th and 12th postoperative hours when the pain was at moderate-to-mild levels (P < 0.001). Conclusion: Aromatherapy with R. damascena essential oil was effective in relieving mild to moderated postoperative pain. Yet, further studies are needed to confirm this finding.
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COVID-19-Related anxiety in nurses working on front lines in Turkey
Murat Saricam
July-September 2020, 9(3):178-181
Background: The novel coronavirus (COVID-19) pandemic constituted serious impacts globally. Objectives: The aim of this study was to investigate the pandemic related anxiety in nurses working in a university hospital in Turkey. Methods: A questionnaire-based study was conducted to include 123 nurses working in the wards and intensive care units (ICUs). Data concerning age, gender, marital status, having a child, duration of employment, workplace, and state anxiety score were collected for every participant. Turkish version of Spielberg's State-Trait Anxiety Inventory (Form TX-1) was applied to calculate the anxiety scores. Independent samples t- test and Chi-squared test were used for the statistical analysis. Results: Fifty-seven (46.3%) nurses demonstrated an elevated level of anxiety. COVID-19-related anxiety was closely associated with advancing age and years of experience, having a child and working in the wards rather than ICUs (P < 0.05). However, gender and marital status did not affect significantly on the development of higher anxiety (P > 0.05). Conclusions: Alleviation of worries of health-care providers is crucial in addition to the prevention of self-contamination to provide the continuation of medical services.
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Comparing the effects of muscle relaxation and music therapy on anxiety among candidates for coronary angiography: A randomized clinical trial
Farzaneh Mozaffari, Hossein Tavangar, Zahra Pourmovahed
July-September 2020, 9(3):124-129
Background: Coronary angiography is associated with some levels of anxiety. Anxiety in turn can cause different complications, and hence, interventions are needed for its management. Recently, nonpharmacological therapies for anxiety management have gained great attention. Objectives: This study aimed to evaluate the effects of muscle relaxation and music therapy on anxiety among candidates for coronary angiography. Methods: This randomized controlled trial was conducted on 105 candidates for coronary angiography. Participants were consecutively recruited from the cardiology wards of Namazi hospital, Shiraz, Iran, and were randomly assigned to three 35-person groups, namely music, relaxation, and control groups. Participants in the music and the relaxation groups received 20-min music therapy and were performed 20-min muscle relaxation. Anxiety level was assessed both before and after the interventions using the Spielberger State Anxiety Inventory. Data were analyzed through the Chi-square test, the paired-sample t-test, and the one-way analysis of variance. Results: The mean score of anxiety in the relaxation and the music groups significantly reduced from 51.08 ± 6.98 and 49.02 ± 7.74 at the baseline to 41.88 ± 5.16 and 44.28 ± 5.21 at posttest (P < 0.01); however, it did not significantly change in the control group (P = 0.081). Conclusion: Both muscle relaxation and music therapy are effective in significantly reducing anxiety among candidates for angiography.
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Protective disciplinary exchange: A qualitative study into nurse managers' supportive strategies for nursing error management
Esfandyar Baljani, Robabeh Memarian, Zohreh Vanaki
July-September 2020, 9(3):135-141
Background: Understanding nurse managers' supportive strategies for managing nursing errors can facilitate the improvement of nursing care quality and patient safety. Objectives: This study aimed to explore nurse managers' supportive strategies for nursing error management (NEM). Methods: This descriptive qualitative study was conducted on twenty nurse managers and two nurses purposively recruited from teaching hospitals affiliated to Urmia University of Medical Sciences, Urmia, Iran. The data were collected via in-depth semistructured interviews and concurrently analyzed via conventional content analysis. Results: Nurse managers' supportive strategies for NEM were overlooking nurses' errors to promote their obedience, prioritizing nursing care measures to reduce errors, error prevention training rounds during shift handover instead of error reporting, and alternative disciplinary measures instead of error reporting. These strategies were conceptualized as protective disciplinary exchange. Conclusion: Protective disciplinary exchange denotes that nurse managers prefer to manage nursing errors with flexibility. This situational communicative strategy helps nurse managers protect their staff resources and maintain their positions.
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The effects of guided imagery on test anxiety among the 1st-year nursing students: A randomized clinical trial
Farzaneh Maghaminejad, Mohsen Adib-Hajbaghery, Fatemeh Nematian, Mojtaba Akhavan Armaki
July-September 2020, 9(3):130-134
Background: Many students suffer from test anxiety (TA). Some nonpharmacological therapies, such as cognitive behavioral therapy, have been proposed for TA management. Objectives: The aim of this study was to investigate the effects of guided imagery (GI) on TA among the 1st year nursing students. Methods: This randomized controlled trial was conducted on forty nursing students conveniently recruited from the Kashan University of Medical Sciences, Kashan, Iran. Participants were randomly allocated to either a control (n = 20) or an intervention (n = 20) group. In the intervention group, participants were provided with a 30-min GI audio file to listen to once daily in the evening for 1 week. Students' TA was measured both before and after the intervention, i.e., before their physiology midterm examination and before their physiology final examination. The data were analyzed through the Chi-square, paired-sample t, and independent sample t-tests. Results: The study was completed with 38 students. The intervention and the control groups did not differ significantly from each other respecting the pretest mean score of TA (50.50 ± 13.90 vs. 44.94 ± 7.34; P= 0.13). However, the posttest mean score of TA in the intervention group was significantly less than the control group (33.90 ± 14.39 vs. 42.83 ± 13.56; P= 0.05). Although the mean score of TA did not significantly change in the control group (P = 0.55), it significantly reduced in the intervention group (P = 0.003). Conclusion: Thirty-minute GI performed once daily for 1 week is effective in reducing TA among nursing students.
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Development and psychometric evaluation of the police quality of work–Life questionnaire
Zeinab Tabanejad, Fatemeh Oskouie, Abbas Ebadi, Morteza Mesri
July-September 2020, 9(3):142-148
Background: Police staff have difficult work conditions, are prone to physical damages, and experience high levels of occupational stress. Their work-related problems may affect their quality of work life (QWL). Meanwhile, there is no appropriate instrument for assessing their WLQ. Objectives: This study was conducted to develop the police quality of work–life questionnaire (PQWLQ) and evaluate its psychometric properties. Methods: This methodological study was conducted in 2018–2019 in two phases. In the first phase, literature review and semi-structured interviews with 13 police staff were conducted and the results were used for item generation. In the second phase, the face, content, and construct validity and reliability of the questionnaire were assessed. For construct validity assessment through exploratory factor analysis, 234 police staff were purposefully recruited to fill out PQWLQ. Results: In the first phase, 57 items were produced. In the second phase, item number reduced to 38 after face and content validity assessment. In exploratory factor analysis for construct validity assessment, 14 more items were deleted and the remaining 24 items were loaded on two factors. The Cronbach's alpha and the test–retest intraclass correlation coefficient of PQWLQ were 0.947 and 0.931, respectively. Conclusion: The 24-item PQWLQ has acceptable validity and reliability and can be used for QWL assessment among police staff. The use of this scale can help police and health managers develop their understanding about police staff's QWL and develop strategies for its improvement.
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Caregiver burden and related factors in Iranian mothers of children with attention-deficit hyperactivity disorder
Mina Mostafavi, Hossein Namdar Areshtanab, Hossein Ebrahimi, Maryam Vahidi, Shahrokh Amiri, Sanaz Norouzi
July-September 2020, 9(3):149-156
Background: Literature indicates high levels of burden in primary caregivers of children with attention-deficit hyperactivity disorder (ADHD). Identifying the related factors might help in planning the interventions to reduce it. Objective: This study aimed to identify the caregiver burden and its related factors in Iranian mothers with children suffering from ADHD. Methods: In this correlational study, 246 mothers with children and adolescents suffering from ADHD referred to psychiatric clinics of Tabriz University of Medical Sciences were included through a convenient sampling method. Data were collected using a demographic information form, Zarit Burden Interview, Swanson Nolan and Pelham Parent Rating Scale-IV, and the Kiddie Schedule for Affective Disorders and Schizophrenia-present and lifetime version. Data were analyzed using descriptive statistics, t-test, Pearson's correlation coefficient, analysis of variance, and multiple linear regression analysis. Results: A majority of children (66%) were in the combined subtype. The mean of the disorder severity was 1.91 ± 0.79, 1.76 ± 0.70, and 1.81 ± 0.61 in impulsive, inattentive, and combined subtypes, respectively. The mean of mothers' caregiver burden was 40.43 ± 1.38. A significant relationship was found between the mean severity of the disorder subtypes and caregiver burden. The correlation coefficient was 0.36, 0.29, and 0.29 for the impulsive, inattentive, and combined subtypes, respectively. The mother's age, existence of ADHD in the child's brother, family member's cooperation in caregiving, and the child's birth rank could significantly predict the caregiver burden. Conclusion: Given the role of family-related factors in the burden of care in mothers of children with ADHD, family-centered care and home visits are recommended to assist mothers of these children.
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The association between fear of falling and functional tests in older adults with diabetes mellitus
Sakineh Jaddi Arani, Mahboubeh Rezaei, Mansour Dianati, Fatemeh Atoof
July-September 2020, 9(3):163-170
Background: The number of older adults with diabetes mellitus (DM) is increasing. Falling during walking and the fear of it are prevalent in older adults with DM. Objective: This study aimed to examine the association between fear of falling (FoF) and functional tests in older adults with DM and to determine other factors affecting functional tests in these people. Methods: A cross-sectional study was conducted on 134 older adults with DM who had referred to the diabetes clinic of Matini Hospital in Kashan, Iran. The participants were selected through sequential sampling and then were categorized into two groups of “with” and “without FoF.” In addition to responding to a demographic questionnaire, the participants were assessed by the Mini-Mental State Examination, Diabetic Neuropathy Symptom Score, and Falls Efficacy Scale-International version. Walking performance of the participants was also measured using the Timed Up-and-Go, 5-Sit-to-Stand, and 50-Foot Timed Walk tests. Data were analyzed using the Chi-square, t-, and Mann–Whitney U-tests and linear regressions analysis. Results: Significant associations were found between FoF and education level, body mass index, waist-to-hip ratio, and having neuropathy (P < 0.05). In addition to FoF, a number of demographic, anthropometric, and clinical variables affected the patients' performance in all functional tests; however, gender was the variable that affected the results of all three tests (P < 0.05). Conclusion: FoF is associated with the performance of older adults with DM in functional tests. Thus, the FoF should be assessed in older adults with DM in order to provide better health care for them.
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Determining nursing research priorities in lao people's democratic republic: A modified delphi study
Yupin Aungsuroch, Chanheme Songnavong, Pachanat Tantikosoom, Souksavanh Phanpaseuth, Anousone Sisoulath, Joko Gunawan, Virya Koy, Dalasouk Khamlunvilaivong
July-September 2020, 9(3):157-162
Background: Determining research priorities is important not only to support evidence-based nursing practice, but also to direct nursing research based on the needs of each country. However, there is no single study identified in Lao People's Democratic Republic that sets research priorities in nursing. Objective: This study was to gain consensus from experts on the priorities of nursing research in Lao People's Democratic Republic. Methods: A modified Delphi study was used, which consisted of three rounds. A focus group discussion was used in round I. In round II, the results of content analysis in round I were electronically presented to all participants and asked them to rate the importance of each topic using a 5-point Likert scale. In round III, the results of round II were presented using mean score, and the participants were again asked to rate each topic using the same scale. Results: The top five priorities include: (i) evaluation of the implementation of nursing documentation based on nursing process, (ii) developing and updating standard of nursing practice for typical diseases, (iii) development of professional nurses and preceptor competency, (iv) motivational system and nurse satisfaction and their effects on nurse performance, and (v) utilization of evidence-based practice to improve nursing practice. Conclusion: The results of this study serve as an input for developing nursing research agenda in Lao and enhancing international research collaboration that focuses on health system and nursing management.
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Development and validation of the social responsibility questionnaire for Iranian nurses
Mohsen Faseleh Jahromi, Ali Dehghani
July-September 2020, 9(3):171-177
Background: Assessment of nurses' social responsibility is necessary for improving their social responsibility and accountability. Valid and reliable culturally appropriate instruments are needed for such an assessment. Objectives: This study aimed to develop and validate the Nurse Social Responsibility Questionnaire (NSRQ) for Iranian nurses. Methods: This methodological study was conducted in a qualitative and a quantitative phase. In the qualitative phase, the concept of social responsibility was explored using a grounded theory study and the item pool of NSRQ was generated. In the quantitative phase, the psychometric properties of the questionnaire (namely face, content, and construct validity and reliability) were evaluated. Results: Exploratory factor analysis revealed that NSRQ consisted of four factors which were labeled ethical commitment, clinical care management, professional competence, and divine satisfaction. The Cronbach's alpha and the test–retest intraclass correlation coefficients of NSRQ were 0.92 and 0.95, respectively. Conclusion: The 27-item NSRQ is a valid and reliable instrument for social responsibility measurement among nurses.
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