A feasible approach to measure metal concentrations in drill hole waters on site for mineral exploration

The new technologies used in the green transition towards carbon-free societies typically demand extensive use of metals. This leads to a heavily growing need for exploration and extraction of ore deposits. Exploration can be facilitated by measuring metal concentrations in ground and surface waters carrying trace concentrations of metals leached from nearby deposits. Currently, measuring metal concentrations in water is slow and expensive and it cannot be done on-site, which hinders the discovery of new ore deposits. To address this challenge, we have developed a method to collect and concentrate the dissolved metals in a solid filter and measure the metal concentrations directly from the filter with a portable X-ray fluorescence spectrometer. The permeable filter is made of mesoporous silicon modified with bisphosphonates. Two types of adsorbing materials for the filters were prepared based on scalable production methods: i) regenerative etching of metallurgical grade silicon powder, and ii) magnesiothermic reduction of silica from barley husks. Empirical calibrations were prepared in a concentration range of 10-200 μg/L for Mn, Co, Ni, Cu, Zn, and Pb using water samples prepared by spiking well water with standard metal solutions. Both filter types were tested for their ability to adsorb metals from the real water samples taken from drill holes. The developed system was able to detect metal concentrations down to 12 μg/L (ppb) showing its potential for on-site measurements of dissolved metals in water samples, which could be feasible in the discovery of new mineral deposits. This innovation enables smart sampling during exploration and provides real-time information on metal concentrations in water.

Multidisciplinary analysis of cancer-related fatigue at the time of diagnosis: preliminary results of the BIOCARE FActory cohort

PURPOSE

Cancer-related fatigue (CRF) is a common side effect of cancer and cancer treatment that significantly impairs the quality of life and can persist for years after treatment completion. Although fatigue is often associated with cancer treatment, it is also a result of the disease itself, even before intervention. CRF at the time of diagnosis may affect treatment timing or completion and is a consistent predictor of post-treatment fatigue at any time. The mechanisms underlying CRF are multidimensional and not well understood, particularly at the time of diagnosis.

METHODS

Sixty-five breast cancer patients at the time of diagnosis were included. The participants completed self-assessment questionnaires about CRF, sleep disturbances, and emotional symptoms and wore an accelerometer to assess levels of spontaneous physical activity and sleep quality. During the experimental session, the participants underwent cognitive, neuromuscular, and exercise metabolism evaluations.

RESULTS

Using augmented backward elimination regression, this study found that emotional symptoms and perceived sleep disturbances were the strongest predictors of CRF (adjusted r2 = 0.51). Neuromuscular fatigability and sleep disturbance were also associated with physical dimensions, whereas cognitive performance was associated with cognitive dimensions.

CONCLUSION

At the time of diagnosis, emotional and cognitive dimensions are over-represented compared to the general population, and specific subdimensions have specific predictors that support the idea of distinct mechanisms. Evaluating CRF subdimensions and their potential mechanisms at the time of diagnosis would be particularly relevant for identifying high-risk patients and offering them appropriate interventions.

TRIAL REGISTRATION

This study was registered at ClinicalTrials.gov (NCT04391543) in May, 2020.

Comparison of neuromuscular fatigability amplitude and etiologies between fatigued and non-fatigued cancer patients

PURPOSE

Cancer-related fatigue (CRF) is the most reported side effect of cancer and its treatments. Mechanisms of CRF are multidimensional, including neuromuscular alterations leading to decreased muscle strength and endurance (i.e., fatigability). Recently, exercise fatigability and CRF have been related, while fatigability mechanisms remain unclear. Traditionally, fatigability is assessed from maximal voluntary contractions (MVC) decrease, but some authors hypothesized that the rate of force development (RFD) determined during a rapid contraction could also be an interesting indicator of functional alterations. However, to our knowledge, no study investigated RFD in cancer patients. The purpose of this study was to determine whether RFD, fatigability amplitude, and etiology are different between fatigued and non-fatigued cancer patients.

METHODS

Eighteen participants with cancer, divided in fatigued or non-fatigued groups according their CRF level, completed a 5-min all-out exercise in ankle plantar flexor muscles composed of 62 isometric MVC of 4 s with 1 s rest, to assess fatigability amplitude as the force-time relationship asymptote (FA). Before and after exercise, fatigability etiologies (i.e., voluntary activation (VA) and evoked forces by electrical stimulation (Db100)) were assessed as well as RFD in 50 and 100 ms (RFD50 and RFD100, respectively) during rapid contractions.

RESULTS

FA is significantly lower in fatigued group. Significant differences were found between pre- and post-exercise VA, Db100, RFD50, and RFD100 for both groups, with no statistical difference between groups.

CONCLUSION

During treatments, fatigability is higher in fatigued patients; however, the mechanisms of fatigability and RFD alterations are similar in both groups.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04391543, May 2020.

Critical care nurses' experiences of caring challenges during post-resuscitation period: a qualitative content analysis

BACKGROUND

Patients in the post-resuscitation period experience critical conditions and require high-quality care. Identifying the challenges that critical care nurses encounter when caring for resuscitated patients is essential for improving the quality of their care.

AIM

This study aimed to identify the challenges encountered by critical care nurses in providing care during the post-resuscitation period.

METHODS

A qualitative study was conducted using semi-structured interviews. Sixteen nurses working in the intensive care units of three teaching hospitals were selected through purposive sampling. The Data collected were analyzed using qualitative content analysis.

RESULTS

Participants experienced individual, interpersonal, and organizational challenges when providing post-resuscitation care. The most significant challenges include inadequate clinical knowledge and experience, poor management and communication skills, lack of support from nurse managers, role ambiguity, risk of violence, and inappropriate attitudes of physicians towards nurses' roles. Additionally, nurses expressed a negative attitude towards resuscitated patients.

CONCLUSION

Critical care nurses face several challenges in providing care for resuscitated patients. To enhance the quality of post-resuscitation care, address the challenges effectively and improve long-time survival it is crucial to implement interventions such as In-service education, post-resuscitation briefing, promotion of interprofessional collaboration among healthcare teams, providing sufficient human resources, clarifying nurses' roles in the post-resuscitation period and increasing support from nursing managers.

The intention to leave among academics in Iran: an examination of their work-life quality and satisfaction

BACKGROUND

Despite the importance of faculty retention, there is little understanding of how demographic variables, professional and institutional work-life issues, and satisfaction interact to explain faculty intentions to leave. This study aimed to investigate the intention to leave among academics and their Work-Life Quality and Satisfaction.

METHODS

This is a descriptive cross-sectional study conducted by 8 faculties affiliated to Urmia University of Medical Sciences located in Urmia, West Azarbaijan province, Iran. The participants in the study were 120 faculty members from Nursing and Midwifery, Medicine, Allied health professions, and Health management and medical information faculties. The Work-Life Quality and Satisfaction scale, and the intension to leave scale were used for data collection. Uni- and multivariable linear regression analyses were employed to determine predictors of the intention to leave (P-values < 0.05).

RESULTS

The mean scores of all dimensions of Work-Life Quality and Satisfaction scale, and intention to leave were in an average level. There is a negative correlation between Work-Life Quality and Satisfaction subscales, along with demographic factors, and the intention to leave (P < 0.05), while multivariate analysis showed that work experience and Discipline were significant independent predictors of intention to leave (P < 0.05).

CONCLUSIONS

In order to improve education in universities, it is necessary to pay attention to the conditions of creating job satisfaction in academics. Considering the high intention to leave among Nursing lecturers, without sufficient support of nursing schools in terms of human resources, it may suffer by the lack of academic staff; eventually the quality of education will reduce in undergraduate nursing in the long term.

Nursing core competencies for postresuscitation care in Iran: a qualitative study

OBJECTIVE

This study explored nurses' perceptions of the core competencies required for providing postresuscitation care in both in-hospital and out-of-hospital cardiac arrest.

DESIGN

Qualitative conventional content analysis.

PARTICIPANTS

17 nurses selected with purposeful sampling method.

SETTING

Three educational hospitals in northwest of Iran.

DATA COLLECTION AND ANALYSIS

Semi-structured interviews were used for data collection and they were analysed using conventional content analysis.

RESULTS

Seven main categories have emerged from the data. The core competencies for nurses providing postresuscitation were identified as: quality assurance, providing evidence-based care, monitoring and presence, situation management, professionalism, positive attitude and providing family centred care.

CONCLUSIONS

The postresuscitation period is a unique and critical time requiring highly competent nursing care. Several core competencies for providing high-quality nursing care during postresuscitation period were identified through nurses' experience in caring for patients postresuscitation.

Nurses' Perceptions Towards Resuscitated Patients: A Qualitative Study

Nurses' perceptions of resuscitated patients may affect their care, and this has not been investigated in previous literature. The aim of this study was to explore nurses' perceptions towards resuscitated patients. In this descriptive-qualitative study seventeen clinical nurses participated using purposive sampling. In-depth, semi-structured interviews were conducted and data were analyzed by conventional content analysis. Four main categories emerged: Injured, undervalued, problematic, and destroyer of resources. Participants considered resuscitated patients to have multiple physical injuries, which are an important source of legal problems and workplace violence, and they believed that these patients will eventually die. Resuscitated patients are considered forgotten and educational cases. Iranian nurses have a strong negative perception towards resuscitated patients. Improving the quality of cardiopulmonary resuscitation, improving the knowledge and skills of personnel in performing resuscitation, and supporting managers and doctors to nurses in the post-resuscitation period can change the attitude of nurses and improve post-resuscitation care.

Nurses' experiences of provision family-centred care in the postresuscitation period: A qualitative study

AIM

This study aimed to explore nurses' experiences of providing family-centred care in the postresuscitation period.

DESIGN

An exploratory-descriptive qualitative design was used.

METHODS

In this qualitative study, in-depth, semi-structured interviews were conducted with 22 nurses in three educational hospitals. There were six participants who completed follow-up interviews to resolve questions generated during initial interviews. Data were analysed using conventional content analysis.

RESULTS

Five main categories were extracted: continuous monitoring, facilitation of attendance, involvement in care, informing and emotional support. Despite the lack of organizational policies and guidelines, nurses explained how they work to provide family-centred care for families, especially those they assessed as having less possibility of aggressive behaviour and those with a better understanding of their loved one's condition. To provide postresuscitation family-centred care, nurses facilitated family attendance, involved them in some basic nursing care, and provided information and emotional support to the family members.

CONCLUSION

Nurses attempted to follow the basic principles of family-centred care in the postresuscitation period. However, to improve the provision of care by nurses, it is necessary to embed family-centred care principles in institutional policies and guidelines and to conduct training for nurses.

IMPLICATIONS FOR THE PROFESSION

Iranian nurses are interested in engaged families in the postresuscitation period. Correct implementations of such care that include all families need institutional policies and guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Potential of Marine Strains of Pseudoalteromonas to Improve Resistance of Juvenile Sea Bass to Pathogens and Limit Biofilm Development

The European sea bass (Dicentrarchus labrax), one of the most produced marine fish species in Europe, is acutely vulnerable to multiple infectious hazards. In this study, we investigated the potential probiotic effect of some marine Pseudoalteromonas bacterial strains against two major pathogens of this species, Vibrio harveyi and the nervous necrosis virus (NNV), and examined their antibiofilm effect. Impregnation phase was done by repeated immersion of juvenile's sea bass during 8 to 12 weeks in seawater containing the probiotic candidates at a concentration of 106 CFU/mL. Four candidates were tested: (1) a combination of two strains producing antimicrobial compounds, hCg-42 and hOe-125; (2) strain 3J6, with known antibiofilm properties; (3) strain RA15, from the same genus, but with no identified probiotic effect; and (4) a control group without probiotics. At the end of the impregnation phase, fish underwent an infection challenge with V. harveyi or with a pathogenic strain of NNV and mortality was monitored. For the V. harveyi challenge, improved survival rates of 10 and 25% were obtained for the RA15 and the mix hCg-42 + hOe-125-impregnated groups, respectively. For the NNV challenge, no significant benefic effect of the probiotics on infection kinetics or cumulative mortality was observed. At the end of the impregnation phase, the maximal thickness of biofilm was significantly lower in the 3J6, double strain, and RA15 groups, compared with the non-impregnated control group. This study highlights the interesting probiotic potential of marine bacteria to limit mortalities induced by bacterial pathogens as well as biofilm development.

Reasons for kidney transplant refusal among patients receiving peritoneal dialysis: A qualitative study

BACKGROUND

Even though kidney transplantation has better outcomes compared to dialysis therapies, some patients undergoing peritoneal dialysis (PD) refuse to consider kidney transplantation. Identification of the underlying reason for patient refusal may improve patients' acceptance of kidney transplantation.

AIM

The aim of this study was to describe the reasons given by Iranian PD patients for refusing kidney transplantation.

METHOD

Eighteen patients undergoing PD participated. Data were collected using semi-structured interviews and were analysed using conventional qualitative content analysis.

RESULTS

The analysis leads to the emergence of two categories and six subcategories: negative outcomes of kidney transplantation (financial burden, psychosocial problems and physical complications) and doubtful factors for kidney transplantation (negative attitudes towards kidney transplantation, long waiting time for kidney transplantation and compatibility of PD with daily life). The financial burden and long waiting time for kidney transplantation were the most important factors in the reluctance of kidney transplantation by PD patients.

IMPLICATION FOR PRACTICE

Patients undergoing PD declined kidney transplantation for several reasons, such as financial burden, fear of post-transplantation side effects, long waiting time for kidney transplantation. Reducing the time of kidney transplantation and insurance coverage of transplant costs can change the attitude of PD patients towards transplant.

Nurses' experiences of ethical and legal issues in post-resuscitation care: A qualitative content analysis

BACKGROUND

Cardiopulmonary resuscitation and subsequent care are subject to various ethical and legal issues. Few studies have addressed ethical and legal issues in post-resuscitation care.

OBJECTIVE

To explore nurses' experiences of ethical and legal issues in post-resuscitation care.

RESEARCH DESIGN

This qualitative study adopted an exploratory descriptive qualitative design using conventional content analysis.

PARTICIPANTS AND RESEARCH CONTEXT

In-depth, semi-structured interviews were conducted in three educational hospital centers in northwestern Iran. Using purposive sampling, 17 nurses participated. Data were analyzed by conventional content analysis.

ETHICAL CONSIDERATIONS

The study was approved by Research Ethics Committees at Tabriz University of Medical Sciences. Participation was voluntary and written informed consent was obtained. For each interview, the ethical principles including data confidentiality and social distance were respected.

FINDINGS

Five main categories emerged: Pressure to provide unprincipled care, unprofessional interactions, ignoring the patient, falsifying documents, and specific ethical challenges. Pressures in the post-resuscitation period can cause nurses to provide care that is not consistent with guidelines, and to avoid communicating with physicians, patients and their families. Patients can also be labeled negatively, with early judgments made about their condition. Medical records can be written in a way to indicate that all necessary care has been provided. Disclosure, withdrawing, and withholding of therapy were also specific important ethical challenges in the field of post-resuscitation care.

CONCLUSION

There are many ethical and legal issues in post-resuscitation care. Developing evidence-based guidelines and training staff to provide ethical care can help to reduce these challenges.

Pain Self-management Strategies in Patients With Cancer: A Qualitative Study

Successful pain management in patients with cancer is a significant challenge, and paying more attention to patients' experiences of pain self-management strategies has particular importance. This study aimed to explore pain self-management strategies in Iranian patients with cancer. This qualitative study was conducted on 14 patients with cancer. Data were collected using semistructured interviews and analyzed through the Graneheim and Lundman content analysis approach. Two main categories emerged from data analysis: (1) psychological pain self-management strategies, and (2) behavioral pain self-management strategies. Psychological strategies included pain distraction techniques, spiritual tendencies, increasing social interactions and support networks, pain tolerance and self-control, and resistance to pain. Behavioral strategies included massage and touch, heat and cold therapy, opium (Taryak in Persian) and tobacco use, herbal and home remedies, and proper diet.

Enhancing Cancer Pain Self-Management: A Holistic Supporting Model

Introduction

Pain self-management is crucial in reducing pain intensity and improving the quality of life for cancer patients. By acquiring self-management skills, patients can actively participate in managing their pain.

Objective

The objective of this study was to develop a grounded theory-based model to assist cancer patients in enhancing their pain self-management.

Methods

This qualitative research was conducted in two stages from 2019 to 2021. The initial phase utilized a grounded theory approach to explore the process of pain self-management in cancer patients. Following Corbin and Strauss' analytical method, a grounded theory of pain management in cancer patients was identified. Subsequently, Walker and Avant's theory synthesis strategy was employed to construct a practical model that provides support for patients in managing their pain.

Results

Within the conceptual framework, this study developed the "Holistic Supporting from Pain Self-Management" model. This supportive model consists of three main components: (1) enhancing pain self-management skills in cancer patients and their families, (2) empowering physicians and nurses in pain management for cancer patients, and (3) improving the organizational structure for pain management in cancer patients.

Conclusion

The Holistic Supporting from Pain Self-Management model emphasizes the importance of addressing all dimensions of cancer pain, including physical, functional, psychosocial, cultural, and spiritual aspects, to effectively manage pain in cancer patients. This model addresses the needs of patients, healthcare providers, and the healthcare system, aiming to enhance and support pain self-management.

Iranian nursing students' experiences of workplace violence: a qualitative study

BACKGROUND

Workplace violence against nursing students is a common phenomenon. This study aimed to investigate Iranian nursing students' experiences of workplace violence, including their reaction to violence and the consequences and the effects of such violence on the students.

METHODS

The study participants were undergraduate nursing students. The data were collected using semi-structured, in-depth face-to-face interviews. Data analysis was carried out with qualitative approach using conventional content analysis.

RESULTS

Four categories were extracted from the analysis of the interview transcriptions: vertical violence, horizontal violence, reaction to violence and consequences of violence. Nurses were the major imposers of violence against students and psychological and verbal violations were the most of used forms of violence. The students reacted to violence in the forms of counteracting, reporting, disregarding and considering as commonplace.

CONCLUSIONS

Workplace violence is a common phenomenon experienced by nursing students in this study, which causes devastating individual, educational, and professional impacts. Action plans including providing safe environment and appropriate support from nurses and educators should be developed in clinical settings to intervene and to prevent workplace violence.

Delayed cervical cancer diagnosis: a systematic review

OBJECTIVE

Cervical cancer (CC) is a preventable women's cancer. Vaccination and routine Pap smear screening have reduced cervical cancer-related mortality by 70-80% in the world. The eradication of CC depends on identifying the disease early and removing barriers to its timely detection. This review study was designed to determine diagnostic delay and factors related to delayed CC diagnosis in the world.

MATERIALS AND METHODS

A comprehensive search was carried out in databases including Medline, Web of Science, Core Collection (Indexes = SCI-EXPANDED, SSCI, A & HCI Timespan), and Scopus for articles published up to December 2021. Publications were included if they reported data on the delayed CC, and factors related to diagnosis of CC in women. There was no time restriction in this review.

RESULTS

In total, 45 articles were entered into the study. In studies, advanced stages of CC (IIB to IV) varied from 10.2% to 87.9% due to delayed diagnosis. A delayed CC diagnosis was reported in 4.3%-89.1% of patients. The median and mean days of delayed diagnosis were 59-210 days and 2.92-10.5 months, respectively. Factors related to delayed CC diagnosis were categorized into three components including patient, medical history, and health system delay. Patient delay included socio-demographic, husband/ partner, and knowledge. Medical history included medical issues, obstetrics, and family history. Health system delays included health facilities and levels of accessibility.

CONCLUSIONS

There is an urgent need to shorten the diagnostic journey of CC patients by addressing all the components of diagnostic delay and developing strategies to modify the factors associated with these delays.

The Relation of Work Ability and Return to Work Among Iranian Cancer Survivors

OBJECTIVE

Cancerous diseases are known to disrupt a person's ability and inflict physical, psychological, financial, and social complications on the person, thereby challenging an individual's returning to work. The aim of this study was to investigate the ability of cancer patients to work after returning to work.

METHODS

This descriptive-correlational study examined a total of 227 surviving cancer patients, having picked the participants through convenience sampling. Data were collected by the return to work and work ability index (WAI) questionnaires and analyzed by descriptive statistics and inferential statistics using SPSS software.

RESULTS

A total of 166 (73.2%) of the participants had returned to work after completing the basic treatment. The mean (standard deviation) of the work ability score was 29.52 (9.43), ranging from 9 to 43 while the average daily work hours dropped from 12.30 to 5.50. The chi-square test showed a significant relationship between the work ability score and the type of return to work. Moreover, the rank logistic regression analysis revealed that work ability was the most important predictor of return to work.

CONCLUSION

Survivors of cancer face reduced working hours and limited ability to work after returning to work, and it is possible to facilitate the return to work in these patients by identifying their job needs in relation to their abilities and barriers of returning to work through the appropriate interventions.

Relationships between ethical decision-making and professional behavior in Iranian nursing students

Ethical decision-making and professional behavior are essential skills in nursing profession, hence educational programs should be designed to enable future nurses to tackle problems related to ethical decision-making. This descriptive, correlational and analytical study aimed at determining the ability of Iranian nursing students to make ethical decisions as well as relationship between such decisions and professional behavior. The present study used census to select 140 freshmen from the School of Nursing and Midwifery of Tabriz University of Medical Sciences, Tabriz, Iran. Data collection tools included a demographic questionnaire, the Nursing Dilemma Test (NDT) comprising two indices of “nurse’s principled thinking” and “practical consideration”, as well as the Nursing Students Professional Behaviors Scale (NSPBS). The mean scores obtained were 41.3±5.7 for “nurse’s principled thinking”, 21.3±3.7 for “practical consideration”, and 119.07±11.79 for professional behavior. Relationships of professional behavior with “nurse’s principled thinking” and “practical consideration” were insignificant (P>0.05). According to the present study’s findings, nursing students’ weakness in applying ethical concepts to decisions and professional behaviors was due to a gap between scientific material learned and clinical practice. Hence, novel training strategies and programs should be designed to reduce such theory-practice gap.

Iranian Nurses' Attitudes and Readiness for Nurse Prescribing: A Cross Sectional Study

Introduction: Since prescribing is a new subject in the nursing profession, it is necessary to assess nurses' attitudes to and readiness for this new responsibility. Objective: This study aimed to investigate nurses' attitudes to and readiness for nurse prescribing in teaching hospitals of Tabriz City, Iran. Materials and Methods: This cross-sectional analytical study was conducted on 335 nurses working in the hospitals of Tabriz from June to October 2019. The participants were selected with a stratified random sampling method, and study data were collected using a two-part questionnaire: demographics and the nurse prescribing questionnaire.The demographics were analyzed using descriptive statistics. The Spearman rank correlation coefficient and the Mann-Whitney U tests were employed to examine the correlation and to compare the mean scores, respectively. The significance level for all tests was determined to be less than 0.05. Results: About 82.1% of participants were female, 59.7% were working in general wards, and 42.1% were in critical care units. The results showed that the mean ±SD scores of attitude and readiness were 34.79 ±8.15 and 36.99 ±6.01, respectively. Moreover, 71.6% of nurses agreed with nurse prescribing. The results showed that the score of attitudes towards prescribing the drug was significant in terms of gender (P = 0.039), employment status (P = 0.032), work experience (P =0.041), and academic degree (P = 0.028). Also, results showed readiness to implement was significant in terms of gender (P = 0.028), employment status (P = 0.049), work experience (P = 0.037), and academic degree (P = 0.042). Finally, there was a positive and significant correlation between nurses' attitudes toward and readiness for prescribing (P = 0.042, rs=0.626). Conclusion: Because nurses have a positive attitude toward and are ready for prescribing, it is possible to make them more prepared for this new role by increasing their pharmacological knowledge and improving their accountability.

Determinant factors in adopting mobile health application in healthcare by nurses

Background

Mobile applications are among effective learning tools and have a significant role in transferring information and knowledge to nurses. The current study was carried to identify the factors affecting nurses’ use of practical health related mobile applications in education and patient interaction based on the combined Technology Acceptance Model (TAM) and Diffusion of Innovation (DOI).

Method

The study is a descriptive-analytical study with a cross-sectional method. The research population includes nurses working at Tabriz University of Medical Sciences hospitals, 150 of which were selected as the research sample using simple and available sampling. The data collection instrument was a questionnaire, the validity and reliability of which were confirmed (α = 0.9). Data analysis was carried out using a correlation test and regression analysis by applying SPSS _v16 software.

Results

The findings show that perceived usefulness and perceived ease of use have a direct and significant effect on the rate of using mobile applications by nurses (P value ≤ 0.01), [(β = 0.52), (β = 0.40)]. Other findings indicate that relative advantage, compatibility, trialability and observability, have a direct and significant effect on nurses’ use of mobile applications, while complicatedness does not have a significant effect.

Conclusion

The current study identifies the effective factors in nurses’ use of health-related mobile applications based on an integrated model of TAM and DOI. Designers of mobile applications should consider these factors in designing and developing programs so that mobile applications can successfully fulfill their purpose in healthcare.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01784-y.

Compassionate Nursing Care Model: Results from a grounded theory study

Compassion, as an indicator for quality care, is highly valued by patients and healthcare professionals. Compassionate care is considered a moral dimension of nursing practice and an essential component of high quality care. This study aimed to answer these questions: (1) What are the facilitators and barriers of providing compassionate nursing care in the clinical setting? (2) Which strategies do nurses use to provide compassionate care? (3) What is the specific model of compassionate care for the nursing context? A grounded theory approach was used in this study. A total of 21 nurses working in diverse clinical settings participated in the study. Purposive and theoretical sampling was used to select the participants. Data were collected by in-depth face to face interviews and analyzed by the constant comparative method. Ethical approval was gained from the Ethical Review Board of Tabriz University of Medical sciences. The analysis resulted in the development of three main themes: (a) contextual factors affecting compassionate care, (b) the compassionate care actions, and (c) the consequences of compassionate care. The main dimensions of compassionate care are demonstrated in a Compassionate Nursing Care Model. Nurses' ability on providing compassionate care is influenced by individual and organizational factors that may facilitate or inhibit this type of care. Leadership and nurse managers should remove the barriers which diminish the nurses' ability to provide compassionate care and support them to engage in compassionate care programs. Identifying and recruiting compassionate nurses, developing their compassionate capacity, and providing role models of compassion could improve the flourishing of person-centered and compassionate care in clinical settings. The Compassionate Nursing Care Model (CNCM) provides a model to guide nursing care and research.

Caring Needs of Cancer Patients from the Perspective of Home Care Nurses: A Qualitative Study

Objective:

Cancer is the third leading cause of death in Iran. Todays, caregiving to patients with cancer is shifting towards home based care, and home care needs from a caregiver’s perspective can help improve the patient care. This qualitative study aimed to examine the home care needs of cancer patients from the perspective of home care nurses.

Methods:

This is a qualitative descriptive study carried out at home care centers in the northwest of Iran. A total of 15 participants were recruited through purposive sampling and underwent face-to-face semi-structured interviews. Data were analyzed through Conventional content analysis method in MAXQDA software. Measures of trustworthiness were established throughout the study using Lincoln and Guba’s (1985) criteria (dependability, credibility, transferability, and confirmability).

Results:

Data analysis resulted in the extraction of four main categories including physical needs (pain relief, gastrointestinal problems including nausea and anorexia and nutritional problems, lethargy, wound care), psychological support (need for hope and emotional support), educational needs (need for information and self-care) and financial support (service insurance coverage, charity support). To promote these patients home care, insurance coverage of nursing home care services was emphasized by the participants.

Conclusion:

Various aspects of cancer patients home care needs were identified. Interdisciplinary home-based palliative care collaboration is needed to address their physical, psychological, and moral needs.

Microfluidic synthesis of retinoic acid-loaded nanoparticles for neural differentiation of trabecular meshwork mesenchymal stem cell

OBJECTIVES

This study aimed to fabricate the PCL-nanoparticles (NPs) loaded retinoic acid (RA) using the microfluidic system for successful cellular uptake and induction of neuronal differentiation of trabecular meshwork mesenchymal stem cells (TMMSCs).

METHODS

A microfluidic system used to synthesize RA-loaded NPs, DLS, FTIR, TEM, and UV-spectroscopy was recruited to characterize and study the release of RA. Also, the toxicity, cellular uptake, and neuronal differential of TMMSCs have been assessed.

RESULTS

According to the obtained results, the spherical NPs (117.6±0.35 nm, ‒19.4±5.3) and RA-loaded NPs (121.6±0.75 nm, ‒23.6±1.3) were synthesized successfully by microfluidic system. 7.8±2.04 % of RA was loaded in NPs, and 25 % was released in the first four hours. Thus, the NPs have been successfully internalized into the stem cells, leading to a significant increase in neural genes and protein (β Tubulin III and Map-2) expression.

CONCLUSION

Our study's harvested results have represented valid data for practical use of microfluidic systems in the term of NPs loaded RA synthesis and its successful function to cellular internalization and euronal differentiation of TMMSCs (Tab. 2, Fig. 10, Ref. 46).

Fatigue and Its Related Factors Among Iranian Cancer Survivors

Introduction: Cancer-related fatigue (CRF) is one of the major problems experienced by cancer patients. Identifying the prevalence and factors associated with CRF may be effective in designing appropriate interventions to reduce this problem. This study aimed to examine the prevalence of CRF and its related factors among Iranian cancer survivors.

Methods: The samples of this descriptive cross-sectional study included 131 cancer survivors referred to outpatient clinic of Shahid Gazi Hospital affiliated to Tabriz University of Medical Sciences. Brief fatigue inventory (BFI) questionnaire was used for data collection. The data were analyzed using SPSS software version 13, descriptive statistics, and regression analysis.

Results: The mean (SD) fatigue score was 6.41 (1.68) and 89% of survivors reported that they had suffered from CRF. The factors affecting CRF included blood pressure, diabetes mellitus, anemia, serum levels of blood urea nitrogen (BUN), marital status, type of cancer, and physical activity.

Conclusion: High level of CRF in cancer survivors requires special attention and designing effective interventions through considering the identified factors associated with CRF.

Building a biopsychosocial model of cancer-related fatigue: the BIOCARE FActory cohort study protocol

Background

Cancer-related fatigue (CRF) is the most common side effect of cancer and cancer treatment. CRF prevalence is up to 50% in breast cancer patients and can continue several years after cancer remission. This persistent subjective sense of exhaustion is multifactorial. Numerous parameters have been evidenced to be related to CRF across biological, physical, psychological, social and/or behavioral dimensions. Although CRF has been studied for many years, the majority of previous studies focused on only one dimension, i.e., physical function. Moreover, few studies investigated CRF longitudinally with repeated measures. These are the two main obstacles that limit the understanding of CRF mechanisms. The purpose of this study is to create a biopsychosocial model of CRF with simultaneous and longitudinal anthropometric, clinical, biological, physical, psychological and sociological parameters.

Methods

BIOCARE FActory is a multicentric prospective study that will consist of an 18-month follow-up of 200 women diagnosed with breast cancer. Four visits will be scheduled at diagnosis, after treatments, and 12 and 18 months after diagnosis. The same procedure will be followed for each visit. Each session will be composed of anthropometric data collection, a semi-structured interview, cognitive tests, postural control tests, neuromuscular fatigability tests and a cardiorespiratory fitness test. Clinical and biological data will be collected during medical follow-ups. Participants will also complete questionnaires to assess psychological aspects and quality of life and wear an actigraphy device. Using a structural equation modeling analysis (SEM), collected data will build a biopsychosocial model of CRF, including the physiological, biological, psychological, behavioral and social dimensions of CRF.

Discussion

This study aims to highlight the dynamics of CRF and its correlates from diagnosis to post treatment. SEM analysis could examine some relations between potential mechanisms and CRF. Thus, the biopsychosocial model will contribute to a better understanding of CRF and its underlying mechanisms from diagnosis to the aftermaths of cancer and its treatments.

Trial registration

This study is registered at ClinicalTrials.gov (NCT04391543), May 2020.

Barriers to cancer pain management from the perspective of patients: A qualitative study

Aim

The aim of this study was to explore the barriers to effective pain management in Iranian people with cancer.

Design

A qualitative descriptive design was used.

Methods

This qualitative descriptive study was performed on 14 people with cancer. Data were collected using semi‐structured interviews and analysed by Graneheim and Lundman's content analysis method.

Results

Four main categories emerged in relation to barriers to pain management from the perspective of people with cancer. Categories included 1) accepting and enduring divine pain, 2) negative attitudes towards the effectiveness of analgesics, 3) patients’ low knowledge of pain self‐management methods and 4) neglected pain management. Barriers to pain management are multidimensional in nature consisting of patients, healthcare providers and system components. Therefore, attempts should be focused on the education of patients and healthcare providers about pain management and eliminating the shortcomings of the healthcare system.

Home Care Nurses' Attitude Towards and Knowledge of Home Palliative Care in Iran: A Cross-Sectional Study

BACKGROUND

Chronic and cancer diseases are expected to rise with the growing population of the elderly in the world. Home palliative care might be a possible solution for improving these patients' quality of life; therefore, the present study sets out to investigate home care nurses' attitude towards and knowledge of home palliative care.

MATERIALS AND METHODS

This is a descriptive cross-sectional study (2018-19), in which 168 home care nurses and nursing assistants in East Azerbaijan Province (Iran) were included (2018). The questionnaire used was specifically designed by Shimizu et al. in 2016 for determining the nurses' attitude towards and knowledge of home care. Data analysis was carried out using descriptive and inferential statistics (T-test and ANOVA).

RESULTS

In this study, 95 (56.60%) and 113 (67.90%) of the participants were found to have negative attitudes and limited knowledge, respectively. The other participants seemed to have neutral attitudes towards and average knowledge of home palliative care. The Mean (SD) attitude score on terminal home care was estimated 2.33 (0.83), and the knowledge score on dying care was calculated 41.76%, which were the lowest in comparison with the scores of other dimensions.

CONCLUSIONS

The home care nurses' attitude towards and knowledge of home palliative care were found to be negative and limited, respectively, which underscores the need to endeavor to improve the attitude towards home care and the knowledge of dying care.

Beliefs, fear and awareness of women about breast cancer: Effects on mammography screening practices

AIM

This study sought to investigate the beliefs, fear and awareness about breast cancer and mammography screening practices of women in Iran.

METHODS

This descriptive-correlational study was conducted at Tabriz, East Azerbaijan Province, northwest of Iran from February-July 2017. One hundred and fifty-two women aged 40 years and older, who were referred to 12 health centres for health services were selected via clustering sampling. Associations between variables and mammography screening practices were examined using bivariate and multivariate logistic regression analyses. Participants who had a mammogram within the last 24 months were compared with those who had none. Sociodemographic questionnaire, Champion's Breast Cancer Fear Scale, Champion's Health Belief Model Scale for Mammography Screening, Breast Cancer Awareness Scale and Powe Fatalism Inventory were the tools used for data gathering.

RESULTS

Just 38.2% of women reported having a mammogram within the last 24 months. Self-efficacy (OR = 5.36, B = 1.68, p < .001), susceptibility (OR = 2.83, B = 1.04, p < .001), motivation (OR = 2.11, B = 0.75, p = .024) and lower perceived barriers (OR = 0.25, B = -1.37, p < .001) were associated with being screened. Neither fatalistic belief nor awareness towards breast cancer was significant.

Iranian Nurses' Experiences of Workplace Violence in Prehospital Emergency Care: A Qualitative Study

Prehospital emergency care nurses experience severe workplace violence. However, despite the widespread violence they experience, this phenomenon has not been well studied among these nurses. Therefore, the purpose of this study was to explore the experiences of Iranian nurses working in prehospital setting regarding workplace violence with a focus on the factors leading to such violence. In this qualitative descriptive study, 23 prehospital nurses participated purposefully. The data were collected by individual face-to-face semistructured interviews and analyzed using content analysis methodology. Data analysis led to the identification of 4 main themes, including job competency mismatch, inadequate resources, criticality of the situation and circumstances, and inadequate awareness and misplaced expectations of society. These nurses have not completed specialized training courses, work in a system that is in a critical situation, and face many barriers and deficiencies in terms of intra- and interorganizational coordination. On the other hand, people in the community do not have sufficient awareness about the duties and services provided by prehospital nurses and thus have unrealistic expectations to receive services. The results showed that there was a deep gap between the prehospital emergency realities and public expectations, leading to workplace violence. Therefore, efforts to improve the working conditions of nurses with an emphasis on teaching specialized prehospital emergency courses, especially violence control courses, promoting intra- and interorganizational coordination, and increasing the equipment and personnel of ambulances for special missions, as well as raising the public awareness and outlining more realistic expectations, may reduce the prevalence of violence against prehospital nurses.

Nursing presence from the perspective of cancer patients: A cross-sectional study

Background & Aim: Nursing presence is an essential element of nursing care. Since the perception of nursing presence is influenced by different factors depending on the culture within which patients receive nursing care, this study aimed to investigate Iranian patients' nursing presence with cancer. Methods & Materials: In this cross-sectional study, 130 cancer patients were selected by random sampling from an oncology teaching hospital. Data was collected by the Presence of Nursing Scale and analyzed by SPSS software. Results: The results showed that the mean score of nursing presence (in a range of 0 to 125) was 101.91±16.19. According to the results, the highest and lowest scores belonged to the items "I trusted in these nurses" and "These nurses met my spiritual needs" with a mean score of 4.38±0.81 and 3.68±1.16, respectively. Data analysis by Pearson correlation coefficient showed no significant correlation between the mean score of nursing presence and quantitative variables such as patients' age, length of stay in the hospital, and the number of hospitalization (p>0.05). Conclusion: Although the total score of nursing presence was high, improvements in some items such as fulfilling the spiritual needs of cancer patients seem necessary. Evaluation of nursing presence by valid measures, encouraging nurses to spend more time and interacting with their patients, and providing special courses on nursing presence could help nurses improve and implement oncology nursing.  

The Relation of Readiness for Return to Work and Return to Work Among Iranian Cancer Survivors

Return to work after completion of cancer treatments has many benefits for patients, families, and society. Readiness for return to work (RRTW) seems to be an effective factor for return to work in cancer survivors. Therefore, the present study was to investigate return to work and its relation to RRTW among Iranian survivors of cancer. This descriptive-correlational study examined a total of 227 survived cancer patients with completed primary treatments and without active cancer symptoms. Data were collected by the return to work and RRTW questionnaires and analyzed with descriptive statistics and inferential statistics using SPSS software. Upon completion of initial treatment, 166 (73.2%) of survivor participants returned to work, of which 78 (34.4%) and 88 (38.4%) participants returned to full-time and part-time works, respectively. ANOVA test showed a significant difference between RRTW and the type of return to work. In addition, results of regression analysis revealed that there was a positive significant relationship between RRTW and the rate of return to work before and after the adjustment of variables (p ≤ 0.05). Considering the findings of the study, there is a necessary need planning for rehabilitation programs by nursing managers concerning these patients to facilitate their return to work.

The level of blood lead painter workers Rafsanjan city and its correlation with risk factors for cardiovascular disease in 2019

Introduction: Painters are exposed to various chemical harmful agents such as lead particles in paints. Some studies have suggested a possible association of occupational exposure that may cause cardiovascular effects. Lead is absorbed through the body through the skin, skin, and respiratory tract and penetrates some tissues. Considering the importance of labor health in each country's development and progress, this study was conducted to determine the amount of lead in the blood of painters in Rafsanjan in 2019. Materials and Methods: The present study is a cross-sectional study of the descriptive type conducted in 1397 on 77 painters of Rafsanjan city. Data collection was done in two stages, in the first stage, based on a checklist that included demographic information, and in the second stage by performing laboratory tests. Finally, by recording the data in SPSS software, quantitative data was reported as a "mean ± standard deviation" and qualitative information as a "number (percent)". Results: Of the 77 painter workers, the youngest is 21, and the oldest is 70 years old. A total of 20 people (26%) had a family history of heart attacks. The highest amount of lead in the blood of painters was reported to be 30.7 micrograms per deciliter, and the level of lead was most correlated with blood sugar. Sixty people (77.9%) painters used personal protective equipment. 49.4% of the study's painters wore work clothes, and 28.6% used gloves while working. Lead levels are directly related to blood sugar, cholesterol, triglyceride, LDL, age, work experience, and blood sugar levels were most correlated with the level of lead in painters' blood. Conclusion: This study's findings show that due to the increase in the work experience of painters, their blood lead level has also increased, and the blood sugar level has had the highest correlation with the lead level in the painters' blood.

External pH modulation during the growth of Vibrio tapetis, the aetiological agent of brown ring disease

AIMS

Brown ring disease (BRD) is an infection of the Manila clam Ruditapes philippinarum due to the pathogen Vibrio tapetis. During BRD, clams are facing immunodepression and shell biomineralization alteration. In this paper, we studied the role of pH on the growth of the pathogen and formulated hypothesis on the establishment of BRD by V. tapetis.

METHODS AND RESULTS

In this study, we monitored the evolution of pH during the growth of V. tapetis in a range of pH and temperatures. We also measured the pH of Manila clam haemolymph and extrapallial fluids (EPFs) during infection by V. tapetis. We highlighted that V. tapetis modulates the external pH during its growth, to a value of 7·70. During the development of BRD, V. tapetis also influences EPFs and haemolymph pH in vitro in the first hours of exposure and in vivo after 3 days of infection.

CONCLUSIONS

Our experiments have shown a close interaction between V. tapetis CECT4600, a pathogen of Manila clam that induces BRD, and the pH of different compartments of the animals during infection. These results indicate that the bacterium, through a direct mechanism or as a consequence of physiological changes encountered in the animal during infection, is able to interfere with the pH of Manila clam fluids. This pH modification might promote the infection process or at least create an imbalance within the animal that would favour its persistence. This last hypothesis should be tested in future experiment.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study is the first observation of pH modifications in the context of BRD and might orient future research on the fine mechanisms of pH modulation associated with BRD.

Barriers to home-based palliative care in people with cancer: A qualitative study of the perspective of caregivers

Aim

To investigate the barriers to home-based palliative care for cancer patients from professional caregivers' experiences.

Design

A qualitative study.

Method

This is a descriptive-qualitative study carried out in the community-based care. Twenty-three participants took part in this study. Data were collected through semi-structured interviews.

Results

Data analysis led to the identification of three category of barriers including the lack of instructions (the lack of clinical practice guidelines, the ambiguity of tariffs and the lack of insurance coverage), family desperation (family views of prognosis, distrust and poverty) and lack of professionalism (limited knowledge, the use of amateur nurses and siloed care). Developing a care protocol and providing resources support contribute to the development of home-based palliative care. Moreover, the education of families and training courses for nurses must be fostered.

Palliative Care Models for Cancer Patients: Learning for Planning in Nursing (Review)

Cancer is the second cause of mortality in the world. Increased incidence of cancer and its growing trend have drawn attention to care for these patients. Palliative care is a solution for improving the quality of cancer care. However, only 14% of cancer patients in the world are receiving palliative care and most nurses lack the adequate knowledge and education to implement different palliative care models for cancer patients. This review of the literature intended to identify the palliative care models used by nurses for cancer patients as well as the similarities and differences between these models. Databases such as PubMed, ProQuest, google scholar, and CINAHL were searched, and experimental studies that presented palliative care models for cancer patients that nurses were involved were selected. From a total of articles selected by searching the databases, 16 experimental articles were selected. These articles presented 12 palliative care models that involved nurses and participants were cancer patients. The palliative care models presented in the experimental articles were based on hospice, hospital, home care, ambulatory, community, pediatric, spirituality, early, family, telehealth, dignity, and integrated. It was found out that several palliative care nursing models for cancer patients can be employed by nurses as they are the key agents in the provision of palliative care. The collaborative nature of the models, their positive consequences for patients being common components of models, and the implementation of the models considering the disease trajectory were among their distinctions.

Effective Characteristics of Iranian Nursing Students in Their Relationship with Clinical Nurses

Introduction: The purpose of this study was to explore the characteristics of undergraduate nursing students, which may determine the nature of their relationship with clinical nurses. Relationships between nursing students and clinical nurses are critical to maximize student learning outcomes and produce skilled graduates for the future health workforce. Methods: This qualitative content analysis study was conducted from January to August 2016. Twenty nine semi-structured in-depth interviews were conducted with 20 undergraduate nursing students in Tabriz nursing and midwifery faculty. Interviews were recorded and transcribed verbatim (in Persian), and analyzed using conventional content analysis to identify themes. Results: Four key themes emerged: educational factors (cognitive knowledge and practical skills, and learning motivation); communication skills; perceived support (perceived support from nurses and educators); and psychological state (fear of the relationship and self-confidence). Self-confidence is an emphasized concept in nursing students' willingness and ability to relate with clinical nurses. Conclusion: The results of the study showed that educational, communicative and psychological factors are important determinants of student communication with nurses. However, self-confidence is the most important factor in establishing such relationship. Self-confidence could be further assessed to identify nursing students who need greater support or would benefit from greater educational interventions to achieve relational skills.

Iranian pre-hospital emergency care nurses' strategies to manage workplace violence: A descriptive qualitative study

AIM

To explore the experiences of Iranian nurses working in pre-hospital emergency care services and the strategies used to manage of workplace violence.

BACKGROUND

Pre-hospital emergency nurses are subject to workplace violence; however, little research addresses their experiences, particularly related to their strategies in dealing with workplace violence.

METHODS

A descriptive qualitative study that involved nineteen male nurses who were working in pre-hospital services collected data using semi-structured interviews and analysed it using qualitative content analysis.

RESULTS

Data analysis yielded four descriptive categories including no reaction to violence (tolerance and acceptance as common workplace conflicts), situational management (patient and scene management), confrontation (direct and indirect) and escaping the scene. Patient management was the dominant strategy used and had the best outcomes related to both patient and personnel safety.

CONCLUSION

This study showed that pre-hospital nurses use different strategies to manage violence and patient management was a common and useful strategy for managing workplace violence. However, the pre-hospital nurses have little training, insufficient support and are poorly prepared to manage workplace violence.

IMPLICATIONS FOR NURSING MANAGEMENT

The development of context-based guidelines, continuing education, better-equipped ambulances that include medical and defence equipment, as well as better coordination of the police force in ambulance operations, can help to reduce workplace violence.

Compassion Satisfaction, Burnout, and Secondary Traumatic Stress Among Critical Care Nurses in Iran

Introduction: This study investigated the relationship between compassion fatigue and compassion satisfaction among Iranian nurses working in critical care units. Method: A cross-sectional, descriptive survey using the Professional Quality of Life instrument was administered to 400 nurses working in the intensive care units of Iranian hospitals. Results: High risk levels of burnout and secondary traumatic stress existed among 42% and 96% of participants, respectively. Significant positive relationships were detected between burnout and secondary traumatic stress. An inverse relationship was detected between measures of compassion fatigue and compassion satisfaction. Discussion: To ensure culturally congruent care, it is important to evaluate professional quality of life within the context of specific cultures and societies. Iranian critical care nurses are at risk for burnout and secondary traumatic stress. Personal self-care and organizational wellness approaches that consider cultural norms should be designed to boost compassion satisfaction and reduce negative effects of stressful work environments.

The Correlation between Respecting the Dignity of Cancer Patients and the Quality of Nurse-Patient Communication

Context:

Nurse–patient communication is one of the important factors affects the promotion and maintenance of the dignity of cancer patients in the hospital settings.

Aims:

This study aimed to determine the perceptions of cancer patients regarding respecting their dignity and its correlation with nurse–patient communication in the hospital settings.

Subjects and Methods:

This correlational study was conducted on 250 cancer patients admitted to the Oncology Departments of Tabriz Shahid Ghazi University Hospital, Iran. These patients were selected using a convenience sampling method. The Patient Dignity Inventory and Nurse Quality of Communication with Patient Questionnaire were used for collecting the data.

Statistical Analysis Used:

Descriptive and inferential statistics were applied to the data.

Results:

The score of nurse–patient relationship is significantly correlated with patient's dignity score (R = −0.21, P = 0.001).

Conclusions:

Due to the importance of nurse–patient communication on maintenance of the dignity of cancer patients, it is a necessary requirement to take proper actions in this area, particularly by promoting “nurse's communication skills.”

Experiences of Iranian Nursing Students Regarding Their Clinical Learning Environment

PURPOSE

The aim of this study was to explain the experiences of Iranian nursing students regarding their clinical learning environment (CLE).

METHODS

Twenty-one nursing students participated in this qualitative study. Data were collected using semistructured interviews and analyzed using conventional content analysis.

RESULTS

Analysis of interviews identified six categories: educational confusion, absence of evaluation procedures, limited educational opportunities, inappropriate interactions with nursing staff, bullying culture, and discrimination. Systematic and consistent methods were not used in clinical education and evaluation of nursing students. In addition, there were inadequate interactions between nursing students and health-care staff, and most students experienced discrimination and bullying in clinical settings.

CONCLUSION

Findings showed that the CLE of Iranian nursing students may be inadequate for high-level learning and safe and effective teaching. Addressing these challenges will require academic and practice partnerships to examine the systems affecting the CLE, and areas to be addressed are described in the six themes identified.