The effect of bio ethical principles education on ethical attitude of prehospital paramedic personnel

The effect of psychological first-aid virtual education on the communication skills of nurses in disasters: a randomized controlled trial

BACKGROUND

Disasters have affected the physical and mental health of people around the world. Since nurses are frontlines in disasters, it seems necessary to prepare for this responsibility. This study investigates the effect of psychological first-aid virtual education on the communication skills of nurses in disasters such as COVID pandemic.

METHODS

In a randomized controlled trial, 55 nurses were selected by purposive sampling method from two hospitals in Isfahan and Tehran, Iran in December-November 2022 and randomly replaced in the intervention group who participated in psychological first aid virtual training and control group. The data were collected through the personal information form and Communication Skills -Test-Revised (CSTR).

RESULTS

Two groups were homogeneous in terms of communication skills (p = 0.177), the total score of communication skills was significant between the two groups after the intervention (p < 0.0001). Regarding communication skills, in the pre-intervention phase, the subscale of "the ability to receive and send messages" and "insight into the communication process" the difference before the intervention was not significant between the two groups (p > 0.05). However, it was significant between the two groups after the intervention (p < 0.05), and regarding "emotional control", "listening skills", and "communication along with assertiveness" the difference before and after the intervention was not significant between the two groups (p > 0.05).

CONCLUSION

Pre-disaster training and virtual education can increase nurses' communication skills in their ability to handle a disaster such as COVID pandemic. Virtual education of post-disaster psychological interventions is suggested.

TRIAL REGISTRATION

IRCT20220923056023N1; date: 2023-01-31.

Navigating into the unknown: exploring the experience of exposure to prehospital emergency stressors: a sequential explanatory mixed-methods

INTRODUCTION

The unpredictability of prehospital emergencies combined with constantly changing circumstances can lead to increased stress and mental health issues among Emergency Medical Technicians (EMTs). To accurately determine the stress-inducing factors in the prehospital environment, it is important to first identify the stressful events that occur in this environment. Therefore, this study strives to provide a thorough analysis of the stressors in the prehospital environment.

METHODS

Sequential explanatory mixed methods were conducted in Hamadan prehospital emergency centers in 2022. The study included 251 EMTs, who were selected through a method in the quantitative phase. The quantitative part used a questionnaire consisting of basic information and the Posttraumatic Stress Questionnaire (PCL-5). In the qualitative phase, 17 with extensive experience in dealing with prehospital stressors were selected based on their PCL-5 scores (above 33). The qualitative phase analysis was carried out using the contractual content method using the Graneheim and Ladman's approach. Statistical analyzes for the quantitative and qualitative phases were performed using SPSS 21 and maxqda 10, respectively.

RESULTS

The study revealed that the EMTs had an average PTSD score of 21. 60 ± 11. 45. Multivariate linear regression analysis showed that the number of shifts had a statistically significant relationship with PTSD scores (t = 26.38, P < 0.001). The qualitative phase of the study included 17 interviews, resulting in 14 subcategories, which consisted of four categories: "the overall impact of the stress crisis on technicians," "missing links in the communication network in incident management," "professional shortcomings in pre-hospital care," and "the complex and multifaceted context of stressful pre-hospital emergencies." Additionally, the study's theme was centered around "surveying the experiences of EMTs in stressful environments."

CONCLUSION

As the number of shifts increased, the primary cause of the high prevalence of PTSD in EMTs was revealed. Prehospital emergency stress can be reduced and managed more skillfully by adjusting various factors such as shortening workdays, offering continuous training, augmenting workforce, supplying ambulance equipment insurance, refraining from hiring personnel devoid of clinical training, hiring psychologists, hiring midwives in an emergency, updating prehospital protocols and guidelines, encouraging cooperation between EMTs and other relief groups, and utilizing cutting-edge technologies.

Explaining the challenges of resources management and its underlying factors in COVID-19 era in Iran: a qualitative study

BACKGROUND

Identifying factors affecting health costs can contribute to formulating the best policies for controlling and managing health costs. To this end, the present study aimed to analyze resource wastage and identify the factors underlying it in COVID-19 management in Iran's health sector.

METHOD

This qualitative content analysis study was conducted in Iran's health sector. The participants were 23 senior, middle, and operational managers in the health sector. The data were collected through semistructured interviews with the managers. The participants were selected using purposive, quota, and snowball sampling techniques. The interviews continued until the data were saturated. The collected data were analyzed using MAXQDA software (version 10).

RESULTS

Following the data analysis, the factors affecting the wastage of health resources were divided into 4 themes and 13 main themes. Vaccines, diagnostic kits, medicines, and human resources were the main factors underlying resource wastage. The identified main themes were open and unused vials, nonuse of distributed vaccines and their expiration, excess supply and decreased demand for vaccines, expiration of diagnostic and laboratory kits and their quantitative and qualitative defects, and the large number of tests. Inefficiency and the expiration of COVID-19 drugs, poor drug supply and consumption chain management, inaccuracy in inventory control and expiration dates, disorganization and inconsistency in the distribution of healthcare staff, low productivity of the staff, and failure to match the staff's skills with assigned tasks in selected centers were identified as the most important causes of resource wastage.

CONCLUSION

Given the limited health funds and the increased healthcare costs, effective preparation and planning and making reasonable decisions for unexpected events can minimize unnecessary costs and resource wastage, which requires some revisions in attitudes toward COVID-19 management in the healthcare sector.

Role of demographic variables in investigating occupational stress of disaster and emergency medical management center

BACKGROUND

Emergency medical services face stressful environments such as departments dealing with injuries and sick patients that pose challenging situations for the healthcare staff. This present study investigates the role of demographic variables in investigating occupational stress of disaster and emergency medical management center in 2021.

MATERIALS AND METHODS

This present descriptive study selected a sample size of 200 medical personnel associated with disaster and emergency medical management center in Iran, according to the inclusion chosen criteria. The study used a tool consisting of two parts, including demographic information and a job stress Health and Safety Executive (HSE) standard questionnaire. The study selected respondents through Cochran's sample size formula using stratified random sampling with a cross-sectional research design for data collection. This present study has analyzed received data using performed the descriptive and inferential information (t-test and one-way ANOVA) at a significance level P < 0.05. The participants of the survey were males only.

RESULTS

The study results specified that the mean age of respondents was 30.14 ± 5.96. The study results exhibited that the mean score of total occupational stress was 3.41 ± 0.26. The results showed the highest (4.34 ± 0.35) and the lowest (2.72 ± 0.86) stress levels were related to role dimensions.

CONCLUSIONS

The study findings revealed a significant relationship between stress level and participants' age, marital status, educational level, type of base, workplace, and the number of work hours per month. Emergency medical personnel experience a high level of occupational stress. Senior managers can use similar studies to implement measures to reduce the experience of employees' stress.

Nursing students and faculty perception of academic incivility: A descriptive qualitative study

BACKGROUND

Incivility is one of the significant challenges that affect nursing education. Uncivil behaviors have a significant upward trend compared to the past in nursing education. This study was conducted to explore academic incivility from the perspective of nursing students and faculty.

MATERIALS AND METHODS

This study was conducted in 2021 using a descriptive qualitative method. Fifteen baccalaureate nursing students and six faculty were selected using purposeful sampling method. Data was collected through in-depth semi-structured interviews, and a qualitative content analysis was applied for data analysis.

RESULTS

Data analysis revealed four categories, namely, ineffective teaching-learning, inapposite/unreasonable requests, behaviors disrupting mutually respectful environment, and academic dishonesty, and 14 subcategories.

CONCLUSION

To reduce incivility, closer attention needs to be paid to the admission of faculty as well as training them to use effective communication techniques and interactive teaching methods. In addition, nursing students must be provided with the training about uncivil behaviors. Furthermore, clear and precise rules and regulations concerning incivility incidence should be developed and implemented in the universities.

Knowledge, attitude, and practice of medical interns and postgraduate residents on American Geriatric Society updated Beers criteria

BACKGROUND

Potentially inappropriate medication (PIM) prevalence in older adults is increasing day by day due to lack of knowledge among medical students and professionals.

OBJECTIVE

To determine the knowledge of medical students toward American Geriatric Society (AGS) Beers criteria for PIM prescribing.

MATERIALS AND METHODS

This cross-sectional study employed a self-administered questionnaire which was validated and designed to assess the knowledge, attitude, and practice of medical interns and postgraduate residents on Beers criteria for PIMs in older adults. The study was conducted in Faridkot region of Punjab in 2019. This study will utilize a purposive sampling strategy and a convenience sampling of up to 183 participants. Mann-Whitney U or Kruskal-Wallis tests were used to compare different issues as appropriate. P values of <0.05 were considered significant.

RESULTS

Out of 183 questionnaires distributed, only 155 participants (response rate 84.6%) had filled the survey and were included in the study. 61.3% (n = 95) of the respondents were males. The mean knowledge score of 155 participants was (5.16 ± 1.56), where the highest score was 9 and the lowest score was 2 out of 10. 15.5% (n = 24) of the participant strongly agreed that Beers criteria use is necessary in clinical setting and would be very helpful. While 22.5% (n = 35) of the participants strongly agreed that PIMs cause adverse drug event (ADE) and drug-related problems (DRPs) in older adults. Age of the participant had a significant effect on the knowledge score (p = 0.009), and participant aged between 31 and 40 years had significantly higher knowledge scores compared with participants falls under 20-30 years.

CONCLUSION

Medical students and postgraduate residents had average knowledge of PIMs and are unaware of the standard guidelines in older adults such as the Beers criteria. Lack of formal education or training about Beers guidelines was the main reason responsible for average knowledge among participants.

Heroism and paramedic practice: A constructivist metasynthesis of qualitative research

Objectives

We aimed to identify, appraise, and synthesise the qualitative literature to develop theory on heroism and paramedic practice.

Hypothesis/research question

What does published literature tell us about heroism and paramedic practice?

Setting

Paramedics and other healthcare workers (HCWs) faced an outpouring of public support for them early in the COVID-19 pandemic which brought into focus the relationship between them and society, where they are portrayed as heroes.

Participants

We conducted a metasynthesis using Evolved Grounded Theory and procedural guidelines of Noblit and Hare to guide analysis. Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P) guidelines were also applied.

Results

151 papers were retrieved and eleven included in the final sample. Studies were moderate to very low quality, involving a wide range of methodologies and settings; none specifically explored heroism and paramedic practice. The following interrelated themes were constructed on heroism and paramedic practice: (a) Myth, Folk law, and storytelling in heroism and paramedic practice (b) The epic journey of heroism and paramedic practice (c) Heroes and Zeroes: The fluctuating Societal Value in heroism and paramedic practice (d) Politicisation, and objectification in Heroism and Paramedic practice.

Conclusion

Paramedics have long been characterised as heroes, but this may not reflect their everyday experiences. Heroism in paramedic practice can provide scripts for prosocial action, inspiring others, and leading to more social heroic actions. Paramedics may however be ambivalent to such heroism narratives, due to politicisation, and objectification in the media and society. This metasynthesis is only one of many possible constructions of heroism and paramedic practice and is the first point in making sense of and developing theory on heroism and paramedic practice.

Study registration

PROSPERO: CRD42021234851.

Knowledge Mapping of Articles on Application of the Quran and Hadiths in Health Care: VOSviewer Visualization Techniques

This study sought to conduct a knowledge mapping of articles to shed light on the application of the Quran and Hadiths in health care. The study is applied in terms of purpose and scientometrics in terms of type, which has been carried out using retrospective bibliometric analysis methods and visualization through knowledge mapping. In order to do so, the PubMed database with related keywords was thoroughly searched. Then, 302 relevant articles were reviewed in terms of the author, the year of publication, the journal, and the subject. In addition, VOSviewer software was employed to analyze and visualize keywords and maps of the articles. The findings showed that 302 articles were published between 1972 and 2021 in 190 journals, among which the Journal of Religion and Health was ranked first with 43 articles. Word co-occurrence map of scientific products of the Quran and Hadith in health care were categorized into six clusters, namely: "complementary and alternative medicine," "ethics," "the effectiveness of spirituality on the treatment and control of mental illness," "women's rights and status," "family planning, infertility treatment and abortion," and "the views of the Quran and Hadiths on sexual issues." Adopting a holistic approach toward the application of various aspects of the Quran and Hadiths on health care, the present study can be considered as a pioneering research whose results can account for determining relevant applied research projects.

Effect of educational intervention on improving nurse's general health in military hospitals of Iran: a quasi-experimental study

Background

Nursing in military hospitals affects their general health. Educational interventions can help to maintain the general health of nurses. This study aimed to evaluate the effect of an educational intervention to improve the general health of nurses in military hospitals.

Methods

In this quasi-experimental study, 146 nurses working in military hospitals in Tehran, Iran in 2021 were included in the study. The one-month educational intervention included videos, pamphlets, and motivational messages about promoting general health. General health questionnaire with 28 items (GHQ28) was study tool. The allocation of nurses to groups was not random, it was based on personal interest. Frequency (percentage), and mean (standard deviation) were used to describe, and the chi-square test, Fisher’s exact test, independent and paired t-test were used for data analysis. All analyzes were performed in SPSS 24 software with a significance level of 5%.

Results

A total of 146 nurses participated in the study, most of them were in the age group of 30 to 40 years (64 people, 43.8%), and 76.7% (112 people) of them were women. The results of the independent sample t-test showed after the intervention, general health scores in the intervention group had a significant decrease compared to the control (p < 0.001) (change in intervention group = -31.1, V.S change in control = 0.55). The results of paired t-test showed that only in the intervention group, the value of the general health score and its dimensions were significantly different (p < 0.001).

Conclusions

The educational intervention performed well and decreased the score of the general health of military nurses. Given that these positive effects may be temporary, it is necessary to design and perform educational interventions over a longer period.

The impact of violence on women’s health. The present as a reflection of the past: A qualitative study

The objective of the study is to analyze the impact of violence on women’s health and the feelings generated during the period of exposure to violence. This is a qualitative study with an interpretative phenomenological design in which 16 women participated—4 through interviews and 12 through stories. The data obtained were analyzed using the Colaizzi approach. The results were structured into 3 themes according to how the women interpreted their experiences. The themes were physical consequences: visible traces; psychological consequences: stormy days and sunny days; and social consequences: from loneliness to a new world. In conclusion, the women in this study considered all those (very diverse) physical pathologies to be important. They encompassed a series of psychological disorders that lasted over time, causing considerable suffering and complicating the participants’ ability to relate to the rest of society, especially men. Similarly, the participants identified a series of positive consequences when they left the traumatic situation empowered after overcoming gender-based violence.

Ethics education to support ethical competence learning in healthcare: an integrative systematic review

Background

Ethical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.

Methods

In this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.

Results

The review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.

Conclusions

The review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations.