Journal of Caring Sciences最新文献

Introduction: In recent years, health care has faced many changes. Thereupon, it would be beneficial to investigate the quality of midwifery care and its related factors. Many factors contribute to the provision of quality care, and recognizing factors to ensure the quality of midwifery care. This qualitative study was conducted to explain the factors that affect the provision and quality of midwifery care. Methods: This qualitative study with content analysis approach was conducted between June 2017 and February 2018 on 15 midwives working in private and public maternity hospitals in the city of Qom. The participants were selected by purposeful sampling. Semi-structured and in-depth interviews were performed with open ended questions to find out how midwives describe high quality midwifery care. Data were analyzed by conventional content analysis method through MAXQDA-11 software. Results: The findings of this study revealed two main themes, including individual factors (personal efficiency, staffs' psychological status, value-centeredness, cultural-educational issues, and professional attachment), and professional-organizational factors (professional characteristics, patient characteristics, personal-professional welfare, professional empowerment system, value-centered culture of organization, and organizational monitoring and evaluation). Conclusion: The results of this study showed that individual and professional factors are associated with the quality of midwifery care. Midwives who participated in this study believed that providing high quality midwifery care requires a broad range of prerequisites. Since high quality midwifery care decreases maternal and infant mortality and morbidity, it is imperative for policymakers to pay attention to all the factors that contribute to the quality of midwifery care.

Introduction: The congenital cardiac diseases (CHDs) are the leading cause of death in children. The CHDs detection and management have greatly improved over the past few decades. This review aimed to assess the effectiveness of early enteral nutrition (EEN) on postoperative outcomes in infants undergoing congenital cardiac surgery. Methods: Electronic databases PubMed, Clinical Key, UpToDate, the Cochrane Library, and Google Scholar were searched for studies published in the English language, between 2004 and 2021. This review carried out based on PRISMA statement and studies qualities assessed using "Downs and Black score". Hospital stay, intensive care unit (ICU) stay, mechanical ventilation support, aortic cross clamping and cardiopulmonary bypass were as primary outcomes. Similarly infections, vomiting and mortality were as secondary outcomes of included studies. Results: This review consists of 887 infants from 10 studies. Of these, 470 infants were assigned to the intervention group and 417 to the control group. The post-operative hospital stay shorted in the EEN group than the control group (SMD=-0.63, 95% CI: -1.03 to -0.22, P=0.0, I²=87%). Similarly, EEN group lessen the ICU stay (SMD=-0.15, 95% CI: -0.42, 0.11, P=0.0, I²=71%), mechanical ventilation support (SMD=-0.31, 95% CI: -0.51, -08, P=0.08, I²=47%), aortic cross clamping (SMD=-0.92, 95% CI: -0.31, 2.4, P=0.00, I²=96%), and cardiopulmonary bypass (SMD=-0.0, 95% CI: -0.42 to 43, P=0.00, I²=71%). Secondary postoperative complications such as infections (RR=0.68, 95% CI: 0.43 to 1.08, P=0.40, I²=3%). vomiting (RR=1.47, 95% CI: 0.80 to 2.69, P=0.90, I²=0%) and postoperative mortality (RR=0.42, 95% CI: 0.03 to 5.82, P=0.00: I²=80%) significantly reduced. Conclusion: Postoperative outcomes were improved in the intervention group compared to the control group, including shorter hospital stays, ICU stays, mechanical ventilation, and less postoperative complications.

Introduction: Traditional medicine are popular treatments among families of children with cancer. This study was designed to identify the behaviors, beliefs, and values of families and health care providers for the use of traditional medicine in pediatric oncology. Methods: This study was conducted with a focus on ethnography approach in the oncology department of a pediatric subspecialty hospital in northeastern of Iran from September 2021 to June 2022. A total of 20 key informants were observed and interviewed formally and informally. The Miles and Huberman (1994) approach was used for data analysis. Results: Finally, two main cultural themes were emerged, including the blame of traditional herbal medicine and the synergy of rituals with modern therapies. Families use traditional medicine based on values passed down from generation to generation, while health care providers make evidence-based decisions. Conclusion: The results of the present study represent the conflict between health care providers and families in the use of medicinal herbs. The findings allow care providers to be aware of the beliefs and values of children caregivers to make the right decision about traditional medicine use.

Introduction: Arterial hypoxia is one of the most common findings in critically ill patients. Inhaled medications in ventilated patients can reduce airway resistance, facilitate dilution, and prevent airway infections. This study aimed to examine the effects of nebulized Eucalyptus (NE) on arterial blood gases (ABG) and physiologic indexes of patients receiving mechanical ventilation (MV). Methods: The current randomized clinical trial was performed in three intensive care units (ICUs) of Al-Zahra Hospital in Isfahan, Iran. Using purposive sampling method, 70 intubated patients were selected and randomly divided into NE (n=35) and control (n=35) groups. NE group received 4 ml (5%) Eucalyptus in 6 mL normal saline (NS) every 8 hours since intubation to 3 days by a nebulizer. Control group received 10 mL NS in the same way. Glasgow Coma Scale (GCS) and ABG parameters (pH, BE, HCO3, PCO2, SaO2, and PaO2), and the peak inspiratory pressure (PIP) and tidal volume (TV) were equally assessed in both intervention and control groups. Data were analyzed using SPSS software version 13. Results: There was no significant difference between the patients of both groups in terms of vital signs (blood pressure, temperature, respiratory rate, and pulse rate), GCS, pH, BE, HCO3, PCO2, SaO2, PaO2, PIP, and TV before the study. Amongst the parameters of ABG, there was a significant difference between PaO2 and SaO2 and PIP in the intervention and control groups 3 days after intervention. Conclusion: Inhaled Eucalyptus can improve oxygenation and reduce airway pressure in patients undergoing MV.

Introduction: Neonates are prone for sepsis due to their immature immune system. Sepsis is preventable if we aware of the maternal and neonatal risk factors. This study aimed to identify the incidence of sepsis and its risk factors. Methods: A prospective observational study was carried out among 288 neonates in level III Neonatal unit. Convenience sampling technique was used to enroll the neonates who met the inclusion criteria. Data pertaining to neonatal and maternal demographic and clinical characteristics, incidence of sepsis, risk factors of sepsis were collected by direct observation and from medical record. Data regarding number of skin pricks for blood sample and intravenous cannulation and number of handling of the baby were collected from Tally counters. Data were analysed using chi square test, t-test and logistic regression with SPSS software version 25. Results: The incidence of sepsis was 34.7% in level III neonatal unit. Culture positive sepsis constituted 7.3%, urinary tract infection 0.3%, meningitis 7 % and probable sepsis 26.4%. Neonatal factors like extreme preterm, extreme low birth weight, gestational age, birth weight, duration of stay in level III neonatal unit, number of handling, number of skin pricks, duration of intravenous line, duration of tube feeds, mechanical ventilation and maternal premature rupture of membrane were associated with neonatal sepsis significantly. Conclusion: Incidence of neonatal sepsis can be minimized by concentrating on modifiable risk factors and implementing the protocol of minimum handling and minimal skin pricks for the neonates.

Introduction: Nurses are the frontline workers who had to play multiple functions like in acute care, community, etc. but, it was stated that COVID-19 has caused immense trauma to nurses globally. Methods: A descriptive phenomenological study to explore the lived experience of nurses working in COVID-19 units was conducted among nine senior nursing officers recruited by purposive homogenous sampling and interviewed with an open-ended interview guide by ensuring data saturation. COREQ guideline were adopted for this qualitative study. Results: Qualitative data were analysed using Giorgi's framework, and themes and sub-themes were derived. The major themes that emerged in the present study were "Reactions and preparation", "Feelings and satisfaction in active duty", "Role of a helping hand", "Working experience in PPE", and "Pandemic and socialization". Each theme had further sub-themes to classify the verbatims. Conclusion: Most of the nurses had anxiety and prepared themselves to play with fire, had unrealistic hope, and mixed emotions, kept their family away and intentionally concealed information to reduce family's fear, were satisfied with training and preparation, and had unpleasant experiences with PPE, had to restrict their social activities and felt social stigma. It also concludes with the recommendation that warrants the need to improve their professional quality of life and working conditions by safeguarding nurses' physical and mental health.

Introduction: Having a child with cancer impacts the family members and reduces their quality of life. Considering the fact that spirituality creates tranquility, hope for the future, and acceptance of the disease, this study aimed to explain the process of spiritual care in parents of a child with cancer. Methods: This study was carried out using a qualitative method and grounded theory approach. The setting of this research was oncology and radiotherapy wards, governmental oncology clinics and pediatric hospitals. Using purposive and theoretical sampling method, 22 participants (eight mothers, three fathers with childhood cancer experience and 11 individuals working in oncology departments of different Iranian pediatric hospitals) were selected and individual and semi-structured interviews were conducted. Results: The data analysis led to the creation of a core variable of "bridge towards spirituality" which included five main categories of "unstable situation", "spirituality," "crossing rocky path", "multi-dimensional support", and "rethink". Conclusion: Due to the significant impacts of a child's cancer on parents and the fact that people's spiritual needs increase in critical and stressful situations, paying attention to the spirituality process is essential for managing the conditions created by the child's disease and help parents through developing a comprehensive program of spiritual care in health care centers. Spiritual care is currently absent in the health care system of Iran, which necessitates attention to this issue in the parents of children with cancer.

Introduction: Hypertension is one of the most common diseases in all populations. Since people with hypertension have a lower quality of life (QoL) compared to healthy people, it is necessary to follow up these patients according to their conditions. This study aimed to investigate the impact of a continuous care model on blood pressure and QoL in hypertensive patients. Methods: Using a random sampling method, this randomized clinical trial (RCT) included 66 patients with hypertension referring to the clinic of Shahid Madani hospital in Tabriz, Iran in 2019. Data collection tools in this research were demographic information questionnaire, sphygmomanometer control device and stethoscope and Quality of Life questionnaire (The Short Form Health Survey-12, SF-12). The patients were randomly assigned into two groups of control and experimental. After the pre-test, the patients' needs in the experimental group were assessed and the problems were resolved. Then, the post-test was performed one month and two months after the intervention. Data analysis was performed using SPSS software version 13. Results: After the intervention, there was a significant difference in the QoL score and blood pressure in the experimental group. However, this difference was not significant in the control group. Conclusion: Results indicated that using a follow-up care model had a positive effect on the blood pressure and QoL of patients with hypertension. It is recommended that further studies examine the impact of the integrated care model on QoL in other chronic diseases.

Introduction: Human caring combines science, art, and humanity. Humanity is the heart of care and interpersonal interactions. Despite the critical emphasis on human caring and concern for nursing care without humanity, there is no clear definition for human caring in nursing. This study aimed to analyze the concept of human caring. Methods: Walker and Avant's strategy for concept analysis was used. Electronic databases such as PubMed, Scopus, Ovid, Google Scholar, Magiran, Iran Doc, SID, and a number of dictionaries were searched without any limitation in date. Search keywords were "care", "caring", "human caring", "humanization", "patient care", "comprehensive care" and "nursing care". We searched all documents published before September 2020. In the initial search, 1637 articles were found but finally, 39 relevant articles remained in the study. Results: The nine defining attributes of human caring were establishing therapeutic communication, presence at the patient bedside, empathy, providing scientific care, subjectivity, dynamicity, respecting the patient's rights and ethics of care, helping the patient achieve a feeling of well-being, and art and creativity. Antecedents of human caring were categorized into three categories namely, human, personal, and organizational factors. The consequences were also categorized into consequences related to nurse, profession, patient, and organization. Conclusion: A theoretical definition and a conceptual model of human caring were developed. This concept should be included in the nursing curricula at all undergraduate and graduate levels and even in nurses' in-service training programs.