bluuebunny/crossref_metadata_2025 huggingface dataset:
The Status of Geriatric In-Hospital Nursing Care from the Perspective of Nurses Working in the Emergency Department of Hospitals in the Northwest of Iran in 2020
Authors: Sadraei Indira Modarres , Dadkhah Behrouz , Mozaffari Naser , Ali Mohammadi Mohammad
Published: May 2024

Background:

The evaluation of geriatric care in the emergency departments is necessary to improve the quality of care. This study aimed to determine the status of geriatric nursing care from the perspective of nurses working in the emergency department of hospitals.

Materials and Methods:

This study was a cross-sectional research study. Through census sampling, 252 nurses working in the emergency departments of hospitals of Ardabil Province were selected. The status of elderly care was assessed using the Geriatric In-Hospital Nursing Care Questionnaire. Data were analyzed using independent and one-sample t-tests and analysis of variance.

Results:

The mean (GerINCQ) score of the participants [mean (SD): 237.30 (75.30)] was significantly higher than the criterion score (201) (p = 0.001). The scores of the sub-scales of perception of elderly care [mean (SD): 45.42 (7.53)], aging-sensitive care delivery [mean (SD): 41.55 (10.25)], professional responsibility [mean (SD): 39.62 (9.86)], and attitude toward caring for elderly [mean (SD): 56.14 (12.53)] were significantly higher than the standard score (p = 0.001). However, the score of performed intervention [mean (SD): 38.36 (8.42)] was significantly (p = 0.02) lower than the criterion score (39). The score of professional responsibility and attitude toward elderly care was higher in women than men, and this difference was statistically significant (p < 0.05).

Conclusions:

The results showed that aging-coordinated care delivery, professional responsibility, and attitudes and perceptions of nurses toward elderly care were satisfactory, but performed intervention was unfavorable. According to the results of this study, nursing service managers can improve the quality of elderly nursing care through appropriate policies, fixing the workforce shortage, and closely monitoring elderly care in the emergency departments.
The Effect of Body Relaxation Techniques on Pre-Eclampsia Syndrome
Authors: Valiani Mahboubeh , Bahadoran Parvin , Azizi Mohammadreza , Naseh Zahra
Published: May 2024

Background:

Hypertension in the second trimester of pregnancy is accompanied by proteinuria that is called Preeclampsia Syndrome (PES). Body relaxation is a technique which makes harmony between mind and body. The aim of this study was to investigate the effect of Body Relaxation Technique (BRT) on some symptoms of Preeclampsia Syndrome (PES).

Materials and Methods:

This clinical trial was conducted on 96 high-risk pregnant women who were selected by random sampling method from among women referring to community health centers of Isfahan city. The samples were divided into intervention and control groups by even and odd numbers. The intervention group members received BRT during 16 sessions. Blood pressure and proteinuria were measured and recorded before and after the intervention in both groups at the beginning and in the 36th week of pregnancy. The collected data were analyzed.

Result:

According to the Chi-square test, the frequency of PES was 11.10% and 23.50% in the intervention and control groups, respectively (χ2 = 3.95, df = 1, p = 0.046). After the intervention, there was no significant difference between the two groups in terms of the diastolic blood pressure and proteinuria. Systolic blood pressure and stress were also significantly reduced in the intervention group. However, proteinuria was not significantly different between the two groups.

Conclusions:

Based on the results, the relaxation technique, as an easy technique, is recommended for pregnant women who are susceptible to pregnancy hypertension and preeclampsia. Moreover, as a clinical complementary method, it can be recommended for preventing the symptoms of PES.
Missed Nursing Care, the Related Organizational Factors, and Strategies for Decreasing it from the Viewpoints of Nurses in University-Affiliated Hospitals of Birjand in 2019-2020
Authors: Ghorbani Seyed Hasan , Ahmadi Chenari Hadi , Yazdanparast Elnaz , Javanmard Zohreh , Davoudi Malihe
Published: May 2024

Background:

For many reasons, some care services may be missed. This study was conducted to investigate missed care, the related factors, and solution for decreasing them.

Materials and Methods:

A descriptive, cross-sectional study was performed on 122 nurses. A multi-part tool was used to gather information, which included demographic information, the Missing Nursing Care and Related Organizational Factors, and Missed Nursing Care Reduction Strategies Questionnaire. Descriptive and inferential statistical tests including ANOVA, independent t-test, and the Pearson correlation were used.

Results:

The mean score (SD) of the Missing Nursing Care Questionnaire was 82.04 (8.50); thus, the amount of missed nursing care is very high. Additionally, the mean score (SD) of the Organizational Factors Questionnaire related to it was 30.98 (9.35). Considering the maximum score of the questionnaire (80), the role of organizational factors in the incidence of missing nursing care is relatively moderate. There was also a weak and inverse correlation between organizational factors and missed nursing care (r = −0.30, p < 0.01, df = 120). Based on the results, increasing the number of nurses and their level of knowledge has the greatest 67.21 (%) and least 34.42 (%) impact on reducing the incidence of missed nursing care.

Conclusions:

According to the results, the prevalence of missed nursing care was high. However, the contribution of organizational factors to it is relatively little. This suggests that from the perspective of nurses, factors other than organizational factors related to the workplace can lead to missing care.
A Critical Ethnographic Study of Families of Brain-Dead Patients: Their Experiences and Attitudes to Organ Donation
Authors: Lalegani Hedayat Allah , Babaei Sima , Alimohammadi Nasrollah , Yazdannik Ahmadreza , Sanei Behnam , Ramezannezhad Pantea
Published: May 2024

Background:

Despite the difficulty of making decisions providing facilitating mediators and removing barriers to making decisions about choosing the right path to donate the organs of brain-dead patients by families can assist in improving the services and help the lives of fellow human beings. This study aimed to explain the decision-making mediator for organ donation in families with brain-dead patients in a cultural context.

Materials and Methods:

This qualitative study with a critical ethnographic approach was conducted based on Carspecken’s stages from August 2021 to March 2022. In this regard, 22 participants were selected through the purposive sampling method and considering the inclusion and exclusion criteria. Sampling was continued until data saturation. After obtaining the required ethical approval, data collection was performed through observation, semi-structured interviews, and document review. All data were recorded and managed using MAXQDA 18 software.

Results:

Based on the results, the main themes and subthemes of this study included “inefficient decision-making mediator” (the shadow of the socioeconomic situation on the medical status of organ recipients, as well as pessimistic influential individuals, social accountability, dialect difference, and ethnic beliefs) and “efficient decision-making mediator” (social learning, material, and spiritual motivation, mother role, and divine reward).

Conclusions:

The results of this study, derived from a cultural context, can be applied to carrying out future applied and empirical research. Moreover, they can be used in the field of various nursing roles, especially management, care, and education.
Theory-Practice Gap
Authors: Abdullahi Kabir Ozigi , Ghiyasvandian Shahrzad , Hasanpour Marzieh
Published: May 2024

Background:

The theory-practice gap can be described as a lack of ability to relate the knowledge acquired in academics and research work with practice. This study aims to assess the knowledge and the perception of Nigerian nurses on the theory-practice gap in Nursing.

Materials and Methods:

This cross-sectional correlational study was carried out with a sample of 196 nurses who were working in the Federal Medical Centre Keffi and Aminu Kano Teaching hospital in Kano, all from the northern part of Nigeria, from April to June 2019. The participants were selected using a convenient sampling technique, where a self-administered questionnaire was utilized to collect the data and analysis was undertaken using SPSS.

Results:

The results of this study showed that 83.80% of respondents had good knowledge and 89.10% of the respondents had good perceptions. The levels of knowledge were significantly different in correlation with the educational level of respondents (χ2 = 13.88, df = 6, p = 0.022), which was determined using a Fischer exact test. Also, the level of perception was significantly different when considering the nature of work participants undertook (X2 = 7.65, df = 2, p = 0.022).

Conclusions:

Given the participants' awareness and perceptions in this study, it is clear that they are well informed of the theory-practice gap. This is a call for all professionals at an individual and organizational level to work, as it will translate into gap minimization, thereby increasing the quality of health care delivery as nurses constitute the largest part of the health care team in Nigeria.
Adherence Barriers to Treatment of Patients with Cardiovascular Diseases
Authors: Kalantarzadeh Mozhgan , Yousefi Hojatollah , Alavi Mousa , Maghsoudi Jahangir
Published: May 2024

Background:

Adherence to treatment is highly important in the management of Cardiovascular Diseases (CVD). Barriers to effective and long-term adherence to treatment by the patient make achieving care and treatment goals challenging. The aim of this study was to identify the adherence barriers to the treatment plan in patients with CVD.

Materials and Methods:

A qualitative content analysis study was conducted to explore the experience of patients, family caregivers, and healthcare professionals (n = 35) using qualitative content analysis. The study was carried out between 2019 and 2020 in Isfahan, Iran. Purposive sampling was performed. Data collection was conducted through in-depth interviews and semi-structured until data saturation. Graneheim and Landman content analysis was performed simultaneously with data collection.

Results:

After data analysis, 3 themes and 6 categories were identified and named. Themes (and categories) include “Patients unreadiness to change” (misunderstanding of conditions and consequences and deterrence cultural practices and beliefs); “gap in healthcare services” (lack of adequate support for patients and discordance between healthcare professionals); and “limited access to healthcare services” (limited physical access and financial burden).

Conclusions:

The findings of the present study can provide a framework for healthcare professionals to employ preventive strategies, reduce disease complications, decrease unhealthy behaviours, and increase prolonged adherence to treatment recommendations in patients with CVD.
Lived Experiences of Nurses in the Care of Patients with COVID-19
Authors: Moghaddam-Tabrizi Fatemah , Sodeify Roghieh
Published: May 2024

Background:

Nurses are at the forefront of caring for patients with COVID-19 and face a life-threatening risk to perform their duties. The complexity of disease conditions such as emerging disease may interfere with good nursing care and holistic care. The aim of this study is to reveal the lived experiences of nurses in the care of patients with COVID-19.

Materials and Methods:

This qualitative study was conducted in Khoy, Iran from March 2020 to May 2020. Fourteen nurses underwent in-depth semi-structured interviews at COVID-19 Central Hospital. All interviews were recorded, transcribed, and analyzed. Diekelmann's hermeneutic phenomenological approach was used to analyze and interpret the data. MAXQDA software version 2007 was used to manage and organize the data.

Results:

After extensive analysis and reflection, four main themes emerged, including staying in an ethical dilemma, emotional turmoil, response to professional commitments, and seeking help.

Conclusions:

The results of this study provided basic information about the lived experiences of nurses in different dimensions. Nursing managers need to be aware of these needs and expectations and provide a variety of programs and strategies not only to support nurses but also to ensure the quality of patient care.
We have Neglected “Ourselves”; A Qualitative Study on Iranian Parents of Children with Aphakia
Authors: Alipour Fatemeh , Kooshki Abdolreza Mohammadi , Norouzi Elahe , Madani Hila , Shahvari Zahra
Published: May 2024

Background:

Contact lenses play a substantial role in the management of childhood aphakia. However, the use and care of the lenses can be challenging. Despite its prevalence, the phenomenon of living with children with aphakia is not explained in Iran yet. The aim of this study was to illuminate the lived experience of the parents of children with aphakia.

Materials and Methods:

This hermeneutic phenomenological study was conducted on the parents who have been referred to Farabi Eye Hospital of Tehran, Iran in 2019, whose children were diagnosed with aphakia, and the condition was corrected with contact lenses. Qualitative semi-structured interviews were conducted with 20 parents of children with congenital cataract. Analysis was based on the framework of Diekelmann enabled data interpretation and elaboration of shared themes.

Results:

The 20 parents involved in the study consisted of 12 women and 8 men. The participant’s experiences were classified in 4 categories: Self-Ignorance, Troubled mind, Self-Regulation, and Coping with the problem while hoping for the future.

Conclusions:

“Self-Ignorance” and “Troubled Mind” indicates that because of the risk of burnout in the long-term process of treatment, the psychological support of parents is necessary. Psychological support will continue until the parents acquire the ability of self-regulation. Giving a realistic hope to families is a core element in psychological support.
Explaining the Psychological Distress of Women with High-Risk Pregnancies in Iran
Authors: Mohammadi Solmaz , Shojaei Kobra , Maraghi Elham , Motaghi Zahra
Published: May 2024

Background:

Psychological Distress (PD) is one of the most common mental disorders during pregnancy and involves stress, anxiety, and depression. According to the literature, High-Risk Pregnancy' (HRP) is a major physiological risk factor associated with PD during pregnancy. The main purpose of this study was to explore the perception and experience of women with HRP who, based on standard questionnaires, had moderate-to-severe stress and anxiety scores.

Materials and Methods:

This qualitative study was conducted using conventional content analysis from December 2020 to June 2021. To this aim, 16 women with HRP were purposefully selected from Imam Khomeini Hospital in Ahvaz, Iran, with maximum diversity. In-depth, semi-structured, individual interviews were conducted to collect the data. The MAXQDA software was used for data analysis.

Results:

Data analysis led to the extraction of two main categories and nine subcategories. “Disrupted peace” and “inefficient adaptation to the situation” were the two extracted categories. The former included the five subcategories of concerns about pregnancy complications, concerns about the parenting process, concerns about the couple's relationship, fear of Covid-19, and occupation-related stress. The latter included the three subcategories of unpleasant feelings, current pregnancy experiences, and previous pregnancy experiences.

Conclusions:

This study highlighted a wide range of psychosocial factors involved in the PD of women with HRP. These findings can be used to design appropriate prevention strategies to manage the mental health problems of these women in order to turn their pregnancy into a pleasurable experience.
The Effect of the Family-Centered Self-Care Program on the Health Literacy Level and Self-Efficacy of Patients with Acute Coronary Syndrome During Discharge from Hospital
Authors: Ghaemmaghami Anis , Moeini Mahin , Keshvari Mahrokh
Published: May 2024

Background:

One of the factors effective in controlling acute coronary syndrome (ACS) symptoms, such as heart failure, is sufficient knowledge of the disease, factors effective on its occurrence, and its prevention. Moreover, the improvement of self-efficacy, which is a predictor of important life factors in these patients, such as treatment process and quality of life (QOL), must be considered as one of the main goals of nursing care for these patients. The aim of this study was to determine the effect of the family-centered self-care program on the health literacy level and self-efficacy of patients with ACS during hospital discharge.

Materials and Methods:

The present study was a quasi-experimental study performed with a pretest-posttest design. The statistical population of the study consisted of all patients with ACS hospitalized at Shahid Chamran Hospital in Isfahan in 2020. Through the convenience sampling method, 50 patients were selected and randomly divided into intervention and control groups. For the intervention group, 6 sessions of 45–60 minutes of family-centered self-care intervention were held. The subjects completed the Health Literacy for Iranian Adults (HELIA) questionnaire before and after the intervention. Data were analyzed using Chi-square test, independent t-test, and paired t-test in the SPSS statistical software.

Results:

The mean score of health literacy did not significantly differ between the intervention and control groups before the intervention (p > 0.050). However, after the intervention, this rate was equal to 82.16 (7.94) and 60.85 (15.71) in the intervention and control groups, respectively, which was significantly higher in the intervention group compared to the control group (p < 0.001). Furthermore, there was no significant difference between the two groups in terms of the mean self-efficacy score before the intervention (p > 0.05). However, after the intervention, this score was significantly higher in the intervention group 34.71 (10.11) compared to the control group 35.22 (13.30).

Conclusions:

Family-centered self-care program after discharge, as a simple, applicable, and efficient method can improve the health literacy level and self-efficacy of patients with ACS.
The Neonatal Mortality and Hospitalization Rate among High-Risk Neonates who Underwent Home Care Services
Authors: Khadivi Reza , Mirzaeian Shadi , Toghyani Raheleh
Published: May 2024

Background:

Low birth weight neonates often require intensive care. However, in the absence of resources, Home Care (HC) could replace theoretically the essential health care. HC was presented for high-risk neonates who were born in 2016 in Isfahan city as a national pilot study. The aims of this study were to evaluate the Neonatal Mortality Rate (NMR) and hospitalization rates in the HRNs who received HC during the neonatal period.

Materials and Methods:

In a cohort study without a control group that was performed during 2016–2017, 130 HRNs who received HC in the neonatal period in Isfahan city were evaluated during 1 year. Data about the neonates' gender, age, birth weight, gestational age, congenital anomalies, cause of death (in terms of prematurity and related problems), and age at death were gathered and analyzed using the Chi-square test, independent t-test, Mann–Whitney U test, and multiple linear regression tests.

Results:

Out of the 129 HRNs who had received HC and completed a 1-year follow-up period, one neonatal death occurred due to multiple anomalies. In this way, the NMR was estimated as 7.75 per 1000 live neonates. In addition, 86 cases (66.66%) were hospitalized for one time in the neonatal period, 10 (6.14%) cases for the second time, and one HRN for the third time for 10 days.

Conclusion:

About one-third of the HRNs who had previously received HC in the neonatal period did not require inpatient care. In addition, the neonatal and infant mortality rates were low.
The Impact of an Educational Programme on Jordanian Intensive Care Nurses’ Knowledge, Attitudes, and Practice Regarding Delirium and their Levels of Self-Efficacy: A Quasi-Experimental Design
Authors: Alhalaiqa Fadwa , Masa’Deh Rami , Al Omari Omar , Shawashreh Atef , Khalifeh Anas H. , Gray Richard
Published: May 2024

Background:

Delirium is a common problem among patients in Intensive Care Units (ICUs); however, it remains underdiagnosed. We aimed to determine the impact of a nursing education program on Jordanian nurses’ knowledge, practice, attitudes, self-efficacy, and ability to detect delirium among ICU patients.

Materials and Methods:

We conducted a nonequivalent, quasi-experimental design from January 2019 to January 2020. A total of 175 nurses who work in an ICU were included at the baseline and divided into two groups: (1) intervention (86 nurses), who received education for 6 hours each day across two different days and (2) a control group (89 nurses), who maintained their usual routine of care. Data were collected by means of a booklet of questionnaires about the nurses’ knowledge and practice, attitudes, and self-efficacy.

Results:

Data from 160 nurses were included in the analysis. The education program intervention (n = 81) significantly increased nurses’ knowledge and practice, positive attitudes, and self-efficacy compared with the control group (n = 79, p < 0.001). In addition, nurses who received the educational intervention were able to detect more cases of delirium (28%, from a total of 51 patients) than the controls, who detected three (6.50%) out of a total of 31 patients (p = 0.003).

Conclusions:

The ICU nurses who received the delirium-focused educational program increased their knowledge and practice, positive attitudes, and their self-efficacy; in addition, their ability to detect delirium was increased. The implementation of such a program is recommended for the health policymakers and stakeholders.
The Effect of Education Based on Human Care Theory on Caring Behaviors and Job Involvement of Nurses in Intensive Care Units
Authors: Elahi Maasumeh , Mansouri Parisa , Khademian Zahra
Published: May 2024

Background:

Caring is the essence of nursing, and nurses who are dissatisfied with their job are not able to perform optimal patient care. This study was conducted with the aim to determine the effect of education based on human care theory on nurses' caring behaviors and job involvement.

Materials and Methods:

In this clinical trial, a total of 110 intensive care unit nurses from Nemazee Hospital, Shiraz, Iran, were randomly allocated to control and intervention groups. The intervention group received a 6-h workshop based on Watson's human care theory using a collaborative and role-playing approach and 1-month follow-up period through presenting weekly preplanned care and caregiving scenarios. The control group received routine hospital trainings. The data collection tools used were included in a demographic information form, and the Larson Caring Assessment Questionnaire, and Kanungo Job Involvement Questionnaire. Data were analyzed using Chi-square test, and independent and paired t-test in SPSS software.

Results:

Majority of the participants were married women and had Bachelor of Science degree in Nursing. The participants' age ranged from 21 to 52 years. After the education, caring behaviors and job involvement scores significantly increased in the intervention group compared to the control group (p < 0.001).

Conclusions:

The findings suggest that a care workshop can be effective in improving care behaviors and job involvement. Therefore, we recommend more extensive research to determine the effectiveness of long-term intervention on nursing care behaviors.
The Effect of Continuous Care Program on the Self-Efficacy of Patients with Implantable Cardioverter Defibrillator: A Randomized Control Trial
Authors: Khani Shirin Afshar Ghahreman , Matourypour Pegah , Haghjoo Majid , Zakerimoghadam Masoumeh
Published: May 2024

Background:

The majority of cardiac disorders resulting from ventricular dysrhythmias are fatal. The Implantable Cardioverter Defibrillator (ICD) is one of the most common treatments of ventricular dysrhythmias. Despite the benefits of ICD in preserving life, patients with ICD experience adverse physical, psychological, and social consequences. This study investigated the effects of the continuous care program on self-efficacy in patients with ICD.

Materials and Methods:

The present study was a randomized clinical trial. Based on the inclusion criteria, 80 patients attending an educational cardiovascular center in Tehran during 2017–2018, were randomly assigned to two intervention and control groups (40 in each). The intervention included the continuous care program, an educational session, and a follow-up program undertaken for the patients receiving the ICD. The control group received routine care. Self-efficacy was then measured by ICD (SE-ICD and OE-ICD) questionnaires and compared between the two groups.

Results:

The results showed no difference between the two groups before the intervention (p > 0.05). However, there was a significant difference in the mean self-efficacy score between the two groups after the intervention, being significantly higher in the intervention group (t77 = 4.9, p < 0.001).

Conclusions:

The results of the present study indicated that providing a continuous care program can increase self-efficacy in patients with ICD and can be used as an effective model in the nursing care of patients with ICD.
Effect of Spiritual Care Program on Resilience in Patients with Heart Failure
Authors: Movahedimoghadam Farideh , Naderi Nasim , Shabani Fidan , Fathollahi Mahmood Sheikh
Published: May 2024

Background:

Heart Failure (HF) is a chronic disease that appears to affect resilience. One of the important programs that may affect resilience is a spiritual care program. As a result, the present study was conducted to determine the effect of a spiritual care program on the resilience of patients with HF.

Materials and Methods:

This randomized clinical trial study was performed at Rajaie Cardiovascular Medical and Research Center in Tehran, Iran in 2020. Eighty-four patients were selected by convenience sampling method and randomly divided into two groups using a block size of 6. Connor-Davidson Scale and Parsian and Dunning Spirituality Questionnaire were completed by both groups before and after the intervention. For the experimental group, two educational sessions were carried out in one hour and thirty minutes and then continued three times a week for 1 month in order to practice spiritual care via WhatsApp. The control group did not receive the intervention that is done for the experimental group during performing intervention. In the end, the data related to 74 patients in each group (n = 37) were analyzed using Multivariate Analysis of Covariance (MANCOVA).

Results:

Dimensions of individual competence (F = 12.85, p = 0.001) and negative emotion tolerance of resilience (F = 8.71, p = 0.005) increased significantly in the experimental group compared to the control group and caused a significant increase in the total resilience score of the patients (F = 7.78, p = 0.007).

Conclusions:

Results of the study showed that a spiritual care program has a great role in improving the total resilience score and can be considered as a part of the holistic treatment program.
The omission of some patterns of knowing in clinical care
Authors: Rafii Forough , Nasrabadi Alireza Nasrabadi , Tehrani Fereshteh Javaheri
Published: May 2024

Background:

Providing holistic and humanistic care to patients requires a variety of factors. A care solely based on objective knowledge might be unsafe and of low quality. Using the patterns of knowing in an integrated manner and relative to the context of caring is one of the necessities for proving a holistic and efficient nursing care. This study aimed to explore the role of patterns of knowing in the formation of uncaring behaviors.

Materials and Methods:

The researchers used a qualitative research design for this study. Participants included 19 clinical nurses who attended semi-structured and in-depth interviews. In addition, theoretical and purposeful sampling methods were used in this research. Observation of caring processes in different hospital wards was another method used for collecting data. The data analysis was carried out according to conventional content analysis technique.

Results:

The study findings revealed five categories for the theme of “omission of some patterns of knowing” including omission of scientific principles, omission of therapeutic relationship, omission of ethics, omission of social justice, and omission of flexibility.

Conclusions:

The omission of some patterns of knowing creates an ugly image of nursing and a negative outcome of caring as well.
Comparison of the Effects of Nika Vaginal Cream with Clotrimazole Cream on Vaginal Candidiasis Symptoms
Authors: Parsapour Hamideh , Masoumi Seyedeh Zahra , Shayan Arezoo , Moradkhani Shirin , Ghiasian Seyed Amir , Rashidi Mohammad Kazem
Published: May 2024

Background:

The prevalence of vaginal candidiasis is high in women and proper treatment is essential in this regard.

Materials and Methods:

This single-blind randomized controlled clinical trial was conducted on 120 women who were referred to Hamadan health centers in 2019. The patients were randomly divided into Clotrimazole cream and Nika vaginal cream groups each including 60 cases. The intervention group received Nika vaginal cream once a day for a week and those in the control group were given Clotrimazole vaginal cream in the same way. The clinical symptoms were studied by clinical examinations and the culture of vaginal discharge before and 7 days after the treatment to confirm the diagnosis of Candida albicans. The results were analyzed by SPSS 21.0 using an independent t test, Mann–Whitney U test, and Chi-square, Fisher's exact, and McNemar's tests, the significance level was set at 0.05.

Results:

Most patients in both groups reported no clinical symptoms after the intervention, and no significant difference was observed between the two groups in this regard (χ2 = 2.23, p = 0.566). Conversely, a significant difference was found in Nika and Clotrimazole groups before and after the intervention regarding improving Vulvovaginal Candidiasis (VVC) symptoms χ2 = 86.01, χ2 = 99.41, respectively (p < 0.001). Finally, 84.48% and 75.86% of women in the Nika χ2 = 45.02 (p < 0.001) and Clotrimazole cream χ2 = 40.02 (p < 0.001) groups had negative culture results after the intervention.

Conclusions:

In general, the Nika and Clotrimazole vaginal creams have the same effects concerning improving the symptoms of vaginal candidiasis and thus can be used to treat VVC.
Patients' Satisfaction with Humane Care in Critical Care Units
Authors: Goudarzi Fateme , Pour Fatemeh Jafari , Hasanvand Shirin , Ebrahimzadeh Farzad , Kvist Tarja
Published: May 2024

Background:

It is important to assess the provision of care in a humane framework to achieve patients' holistic needs in Critical Care Units (CCUs) and to promote health outcomes. The aim of the current study was to determine patients' satisfaction with humane care in CCUs.

Materials and Methods:

In the current descriptive–analytical study, data were collected from 225 patients admitted to the CCUs of seven teaching hospitals in Lorestan Province, Iran, in 2017. The Persian version of the Revised Humane Caring Scale (P-RHCS) was used in this study. Data were analyzed using descriptive statistics and inferential statistics (independent t-test and one-way ANOVA).

Results:

The mean (SD) overall score of the P-RHCS was 4.61 (0.53), which indicated that patients were highly satisfied with humane care. The patients were most satisfied with “professional performance” [mean (SD) 4.72 (0.60)] and “interdisciplinary collaboration” [mean (SD) 4.72 (0.65)], and the least satisfied with “awareness of and contribution to self-care” [mean (SD) 4.23 (0.78)]. The findings revealed that patients' satisfaction with humane care depends on their demographic and clinical characteristics.

Conclusions:

Generally, patients were satisfied with humane care provided in CCUs; however, it is recommended that nurses' skills be reinforced, especially regarding information provision and effective communication with patients to improve health outcomes.
Prioritizing the Psychosocial Support Needs of Mothers with Gestational Diabetes: A Delphi Study
Authors: Javadifar Nahid , Siahkal Shahla Faal , Najafian Mahin , Iravani Mina , Zakerkish Mehrnoosh , Heshmati Rasoul
Published: May 2024

Background:

Gestational diabetes is the most common medical complication in pregnancy, and the psychosocial health of women suffering from this condition affects their adherence to treatment and self-efficacy. However, since it is not possible to design interventions dealing with all of these needs, the aim of this study was to prioritize the psychosocial supportive needs of women with gestational diabetes.

Materials and Methods:

This was a modified Delphi design study involving 22 experts who were selected using purposive and snowball sampling methods. The study was conducted between April 2021 and June 2021. First, the psychosocial needs of diabetic pregnant women were extracted through a qualitative study involving interviews with multidisciplinary specialists and diabetic pregnant mothers (22 participants) and a systematic review of reputable scientific databases. Throughout the two Delphi stages, the questionnaire was classified, quantified, and analyzed.

Results:

Based on the results of this study, the following are the top priorities when addressing the psychosocial needs of mothers with gestational diabetes: paying attention to and identifying the mother’s worries and anxiety, husband and family support for diabetic pregnant women, the inclusion of specialized nutrition counseling services in mothers’ treatment plan, timely education of mothers about diabetes and its complications, and proper nutrition for diabetic mothers.

Conclusions:

The priorities of the supportive needs obtained in this study can be used to design interventions aimed at promoting psychosocial health, reducing stress and anxiety, and improving medication adherence in women with gestational diabetes.
Evaluation of retinal and choroidal vascular structures in obsessive-compulsive disorder
Authors: Mesen Ali , Turgut Celaleddin , Mesen Selma , Beyoğlu Abdullah
Published: May 2024

Purpose:

To evaluate the optical coherence tomography-angiography (OCT-A) findings and choroidal vascularity index (CVI) of patients followed with a diagnosis of obsessive-compulsive disorder (OCD) by comparing them with the healthy control group (HCG).

Methods:

This prospective study included 33 patients diagnosed with OCD and 32 HCG patients who followed up for at least 3 months. OCT-A images were obtained to evaluate the microvascular circulation, and enhanced HD line images were obtained for the CVI calculation of all patients.

Results:

Statistical analysis results revealed that the rates of superficial vascular density in the fovea region and deep vascular density in the parafovea region decreased in the OCD group compared to the HCG group (P = 0.003 and P = 0.010, respectively). Subfoveal choroidal thickness values of the OCD group were lower than those of the HCG group (P = 0.008). While total choroidal area and lumen area values were lower in the OCD group than in the HCG group (P < 0.001 and P < 0.001, respectively); CVI values were similar in both groups (P = 0.436).

Conclusion:

The use of the OCT-A device, which is a non-invasive method for detecting retinal and choroidal changes in OCD cases, may provide insight into the pathogenesis of the disease.
Do well-orchestrated pharmacokinetic properties of curcumin downregulate PYGB expression for glycogen phosphorylase in cancer cells?
Authors: Singh Divya , Srivastava Akhileshwar Kumar
Published: May 2024

BACKGROUND:

Metabolic reprogramming contributes energy and multiple factors in the adaption of cancer cells in nutrient-deficient conditions. In such conditions, glycogen metabolism is upregulated by the activity of glycogen phosphorylase (PYGB) to produce glucose for promoting cell proliferation as well as resistance to anticancer therapies. Hence, the present study emphasized the assessment of the pharmacokinetic properties of a natural product, curcumin, to downregulate the PYGB expression.

METHODS:

The pharmacokinetic properties of curcumin were performed by the admetSAR database and SwissADME web tool. Next, molecular docking of curcumin with PYGB was done by PatchDock and FireDock Server. The CABS-flex2.0 server was used for the calculation of the RMFS (root mean square fluctuation) value of PYGB. The STRING database was used for PYGB protein-interaction network (PIN) analysis.

RESULTS:

Curcumin followed all parameters of pharmacokinetic properties. Further, molecular docking revealed that curcumin has the potential to disrupt structural PYGB protein with binding energy (-24.62 kcal/mol). The CABS-flex2.0 server calculated the RMFS value of active sites of the docked PYGB to understand the flexibility of the interacted residues (GLU124, SER651, GLN96, LYS655, GLU121, and LYS551). The STRING database for PYGB PIN analysis suggested that other proteins like PYGL, PYGM, nuclear speckle splicing regulatory protein 1, C6orf221, and APOA1BP could also be altered by employing of curcumin.

CONCLUSION:

This study suggested that curcumin can alter the activity of metabolic reprogramming by targeting several factors associated with carcinogenesis in stress conditions.
Pharmaco-therapeutic potentials of Mucuna pruriens (L.) in male infertility and associated sexual dysfunctions
Authors: Parveen Rehana , Baruah Himangshu , Bramhankar Rakesh , Munishwar Nisha
Published: May 2024

Mucuna pruriens (L.) (MP), also known as Kapikacchu in Sanskrit, is a well-known medicinal plant, the seed of which is commonly used in traditional systems of medicine worldwide, mainly for treating male infertility and associated conditions. Infertility is a multifactorial disease process with several potential contributing causes, among which male factors contribute to almost 50% of cases of infertility, the causative factors of which can be counted from faulty lifestyle to stress factors. In Ayurvedic system of medicine, various formulations of MP are explained in Vajikarana (Aphrodisiac) context. In this review, Pubmed, Google Scholar, Scopemed, and other online databases, including fields of pharmacology, pharmacognosy, and health, and published chapters of both classical and contemporary books, were rationally scrutinized to find out the scope, research possibilities, and potential role in improving male infertility and associated sexual dysfunctions. After thorough scrutiny, it has been observed that MP has an action on multiple aspects of infertility like aging, depression, cardiovascular diseases, diabetes mellitus, and Parkinson’s disease due to the presence of a complex mixture of alkaloids (like L-DOPA and its metabolites) and its nutritional component, along with its antioxidant and adaptogenic properties, which raises hope for the researchers to explore the effect of the drug in more accurate and aggressive way to fulfill the demand of the global issue.
Use of ROC curve analysis for prediction gives fallacious results: Use predictivity-based indices
Authors: Indrayan A , Malhotra RK , Pawar M
Published: May 2024

The area under the ROC curve is frequently used for assessing the predictive efficacy of a model, and the Youden index is commonly used to provide the optimal cut-off. Both are misleading tools for predictions. A ROC curve is drawn for the sensitivity of a quantitative test against its (1 – specificity) at different values of the test. Both sensitivity and specificity are retrospective in nature as these are indicators of correct classification of already known conditions. They are not indicators of future events and are not valid for predictions. Predictivity intimately depends on the prevalence which may be ignored by sensitivity and specificity. We explain this fallacy in detail and illustrate with several examples that the actual predictivity could differ greatly from the ROC curve-based predictivity reported by many authors. The predictive efficacy of a test or a model is best assessed by the percentage correctly predicted in a prospective framework. We propose predictivity-based ROC curves as tools for providing predictivities at varying prevalence in different populations. For optimal cut-off for prediction, in place of the Youden index, we propose a P-index where the sum of positive and negative predictivities is maximum after subtracting 1. To conclude, for correctly assessing adequacy of a prediction models, predictivity-based ROC curves should be used instead of the usual sensitivity-specificity-based ROC curves and the P-index should replace the Youden index.
Clinical value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography combined with computed tomography angiography in large-vessel vasculitis
Authors: Wang Rui , Zhang Jifeng , Wang Dongxue , Yang Funing , Li Ping
Published: May 2024

OBJECTIVES:

The objectives of this study were to investigate the clinical application of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) combined with CT angiography (CTA) fusion images at diagnosis and assessment in large-vessel vasculitis (LVV).

MATERIALS AND METHODS:

Forty-six patients with LVV who underwent both 18F-FDG-PET/CT and CTA procedures were studied in the Second Hospital of Harbin Medical University from September 2019 to June 2022, and the clinical disease activity of patients was judged by the Physician Global Assessment. Clinical data, acute-phase reactants (APRs), and imaging data were collected. Meanwhile, the APRS must be obtained within 1 week of 18F-FDG-PET/CT. 18F-FDG-PET/CT was primarily used to evaluate LVV activity, while CTA was primarily used to observe morphological changes in arteries, including arterial wall thickening, narrowing, and corresponding complications. PET/CT images were evaluated by two nuclear medicine physicians, both of them unaware of the patients’ laboratory tests and clinical signs. Two nuclear medicine specialists evaluated the PET/CT images and PET/CTA images, who were blinded to the patients’ information. The concordance of two physicians in the LVV visual grading scale was studied by calculating the Cohen’s kappa index (k) which evaluates the power of concordance. The paired t-test was used to analyze the differences between PET/CTA images and PET/CT images.

RESULTS:

The sensitivity and specificity of the semi-quantitative analysis to assess LVV activity was 94.1% and 93.1%, respectively, when a cutoff of the mean SUVmax/SUVmeanliver of 1.15. It was found that the images obtained after delayed phase were clearer and the contrast between the arterial wall and the lumen was higher in 19 patients. We also concluded that PET/CTA examinations were able to detect more lesion sites compared to PET/CT examinations in 28 patients (P < 0.001), especially for patients with long-term treatment, and the interpretation of PET/CTA images took less time than PET/CT images(P < 0.001), ultimately achieving a shorter time, more comprehensive and accurate interpretation.

CONCLUSION:

Although 18F-FDG-PET/CT can assess the activity of LVV, it is poor at observing morphological changes in arteries. The use of 18F-FDG-PET/CTA imaging scans in LVV can accurately assess disease activity while at the same time providing a comprehensive, accurate, and efficient determination of disease severity, allowing patients to receive comprehensive diagnostic information from PET/CTA examination.
Case series: Clinical response of ketamine infusion in patients with treatment-resistant depression
Authors: Preetinanda Pallavi , Nukala Srikrishna , Garapati Abhilash , Singisetti Srinivas , Vasireddy Niveditha , Sanapala Vidya , Tata Ramya Spandana
Published: May 2024

Treatment-resistant depression (TRD) is one of the most debilitating conditions that does not respond to conventional pharmacotherapy. Ketamine is a recently used effective treatment option in depressive disorders with a novel mechanism of action. Still, studies estimating the improvement of depressive symptoms in TRD with multiple doses of ketamine are limited. Hence, we report 5 TRD cases that received six open-label intravenous (IV) infusions of ketamine. Five cases of TRD, diagnosed by a clinician defined as the persistence of significant depressive symptoms despite being treated with two different antidepressant regimens, each used for more than 6 weeks were evaluated to identify the need for ketamine infusion and were administered six open-label IV infusions of ketamine which were done at the rate of 0.5 mg/kg body weight, thrice weekly, on alternative days for 2 weeks, following standard protocol. The Montgomery–Åsberg Depression Rating Scale (MADRS) scores were administered by the clinician before the infusion and were repeated after 2 weeks post-infusion. The response was recorded and was seen as a more than 50% decrease in MADRS scores and our cases showed significant improvement clinically. Our low infusion rate and serial dosing trial with ketamine support the efficacy of this drug in TRD. Approximately 30% of patients with major depressive disorder are treatment-resistant. New treatment strategies are needed to address that portion of cases. Subanesthetic doses of IV ketamine have a rapid antidepressant effect in TRD, this signifies the potential of ketamine to be used in this regard.
A study to assess the help-seeking behavior of patients and their caregivers with mental health problems visiting a tertiary care center in Hyderabad
Authors: Archana R. , Kondaparthi Phanikanth , Boorla Vivaswan , Akula Vishal , George Reddy V.
Published: May 2024

Background:

Various sources of help are available for mental health issues among the common public, such as faith healers, family physicians, religious heads, registered medical practitioners, private medical practitioners, or alternative medicine practitioners. Psychiatrists are usually the last resort and are least preferred due to stigma. This study was carried out to know the various help-seeking behaviors used by mentally ill subjects before visiting a mental hospital.

Aim:

The aim of this study was to assess the help-seeking behavior among psychiatric subjects visiting a mental hospital.

Study Setting and Design:

This was a cross-sectional study. 100 new subjects visiting the psychiatric out patient service at a tertiary care hospital in Hyderabad were interviewed on a semi-structured questionnaire for the various services utilized by them for their mental health problems.

Materials and Methods:

Institutional Ethics Committee approval was obtained for conducting this study. Participants who fulfilled the assessment criteria were taken up for the study and explained about the procedure and written informed consent was obtained. Intake pro forma was administered to record the sociodemographic details. Socioeconomic status was recorded using the modified Kuppuswamy scale.

Results:

Psychiatrists were the first choice in 47% of the cases, followed by nonpsychiatric physicians and religious faith healers. Important reasons to seek help from different sources included easy accessibility, belief in the system or particular healer, and good reputation. The mean expenditure per visit to service was the highest for the nonpsychiatric physician and the lowest for alternative system practitioners.

Conclusions:

In the present study, it was found that subjects sought help from a psychiatrist initially. Through this study, it was found that the maximum expenditure was incurred when initial contact was with a nonpsychiatric physician, and the least when initial contact was with a psychiatrist. The level of education among caregivers has a direct impact on choosing a psychiatrist for professional help above others as a first resort.