Stigma is one of the main problems of patients suffering from cirrhosis, and it causes many challenges for the patients and their treatment. The present study aimed to discover and define the perceived stigma by cirrhotic patients. This qualitative study was conducted through a content analysis approach. The participants were 15 patients suffering from cirrhosis. Data were collected via semistructured, in-depth interviews and analyzed on the basis of methods described by Granheme and Landman. During data analysis, stigma was categorized into four categories and 13 subcategories: external representation of social stigma (others' avoidance behaviors, inadmissible tag, discriminative behaviors of treatment personnel, blaming behaviors), internal representation of social stigma (social ostracism, social isolation, curiosity to perceive people's perceptions), external representation of self-stigma (fear of disclosure of illness, threatening situation, difficult emotional relationships), and internal representation of self-stigma (condemned to suffer, self-punishment, self-alienation). Experiencing stigma is common among cirrhotic patients and may affect patients' coping with the illness and treatment. Thus, it is specifically important that treatment personnel know patients' perception, provide comprehensive support for these patients, and plan to enhance public awareness about the disease recommended.
Objective: Although several factors have been shown to have etiological roles in colorectal cancer, few investigations have addressed how and to what extent these factors affect the genetics and pathology of the disease. Precise relationships with specific genetic mutations that could alter signaling pathways involved in colorectal cancer remain unknown. We therefore aimed to investigate possible links between lifestyle, dietary habits, and socioeconomic factors and specific mutations that are common in colorectal cancers. Methods: Data were retrieved from a baseline survey of lifestyle factors, dietary behavior, and SES, as well as anthropometric evaluations during a physical examination, for 100 confirmed primary sporadic colorectal cancer patients from Northwest Iran. Results: High socioeconomic status was significantly associated with higher likelihood of a KRAS gene mutation (P < 0.05) (odds ratio: 3.01; 95% CI: 0.69–13.02). Consuming carbohydrates and alcohol, working less, and having a sedentary lifestyle also increased the odds of having a KRAS mutation. Conclusion: Although research has not yet described the exact relationships among genetic mutations with different known risk factors in colorectal cancer, examples of the latter may have an impact on KRAS gene mutations.
Background: Among respiratory support techniques, nasal continuous positive airway pressure (NCPAP) and mechanical ventilation (MV) are more known for their effectivity in reducing complications associated with respiratory distress syndrome (RDS). Moreover, early application of NCPAP and administration of surfactant are effective in decreasing the need for MV and its adverse effects. This study was designed to compare NCPAP and MV after administration of surfactant in preterm neonates with RDS. Materials and Methods: In this clinical trial, 60 preterm neonates (<32 weeks) were evaluated. After receiving one dose of surfactant (4 cc/kg), the subjects were randomly divided into treatment and control groups, and respiratory support was established via positive airway pressure or MV. Results: There were no significant differences between the neonates in the two groups in terms of gestational age and birth weight. The mean duration of MV was significantly lower in the treatment group (p=0.001). On day 3, the number of ventilator-dependent neonates in the control group was more (26.7% versus 83.3%). There were no significant differences between the two groups in the number of second surfactant doses, mortality rate, and the number of patients who had developed short-term complications during hospital stay. Conclusion: In a significant number of preterm babies with RDS, NCPAP can be extubated after receiving one dose of surfactant. This is a potentially useful modality for respiratory support with a low mortality and morbidity rate and limited complications in very premature infants.
Inherited bleeding diseases greatly affect education, working, job, social activities and quality of life. We aimed to discover the sources of identity challenges among patients with Haemophilia.The present study has been designed and performed as a qualitative content analysis research.Participants were purposively selected from haemophilia patients referred to our clinic during one year, from March 2018 to April 2019. Data collection was done through semi-structured, in-depth interviews using purposeful sampling. Data were analysed based on Granheme and Landman method. The main categories were fear of rejection, losing social roles, discrimination and stigma and marriage breakdown.Patients with haemophilia encounter several challenges due to physical and social constraints caused by the disease. Such challenges result in disturbances in the self-identity of the patients.According to the results of this study, the nurses should plan to have attention to the patients with haemophilia, based on more protection and better supports.
Standard precautions (SPs) including hand hygiene are considered fundamental protective measures to manage health care-associated infections (HCAIs) and to reduce occupational health hazards. The purpose of this research was to examine the effectiveness of an infection control link nurse (ICLN) program on compliance with SPs and hand hygiene among nurses.A quasi-experimental study with a pretest-post-test design was conducted with participating of 154 clinical nurses who worked in different wards of a tertiary referral teaching hospital in Iran. The intervention group (n = 77) had 16 infection control link nurses nominated. The control group (n = 77) received only the standard multimodal approach used in the hospital. Pre- and post-test assessment of compliance with standard precautions and hand hygiene compliance was performed via the Compliance with Standard Precautions Scale (CSPS) and the World Health Organization observational hand hygiene form. Two independent sample t-tests were used to examine differences between Compliance with Standard Precautions and hand hygiene Compliance among nurses in intervention and control group. Multiple linear regression analysis was used to assess the effect size.After developing and implementing the infection control link nurse program, no statistically significant improvement was found in the Compliance with Standard Precautions (β = 5.18; 95% CI= -0.3-10.65, p = 0.064). An improvement in hand hygiene compliance was observed among nurses in the intervention group that improved statistically significant from 18.80% before the program to 37.32% 6 months after the program (β = 20.82; 95% CI 16.40-25.25, p < 0.001).Given the continuing level of interest that exists in improving health care workers' hand hygiene practices, the findings of this study provide significant practical implications for hospitals seeking to improve compliance with hand hygiene among nurses, showing the effectiveness of using infection control link nurse program. Further research is needed to assess effectiveness of using infection control link nurse program to improve compliance with standard precautions.
Illness perception and self-efficacy in patients with coronary artery disease (CAD) may affect medication adherence, which is one of the most important challenges in disease management in this group of patients.
Background & Aim: The knowledge and attitude of nurses are among the main factors in the application of the nursing process and its implementation in the patient care.Thus, this study was conducted to investigate the knowledge and attitude of nurses regarding the nursing process in the emergency departments (8 centers) of Tabriz University of Medical Sciences.Materials & Methods: This descriptive research was conducted in the Emergency Departments of Medical and Educational centers of Tabriz University of Medical Sciences.Two hundred and sixtythree emergency nurses were included in the study.Sampling was done by census method and nurses completed the electronic questionnaire of knowledge and attitude toward the nursing process.Finally, the data was analyzed using SPSS v22. Results:The results show that the overall mean score of attitude toward the nursing process is 50.33, and the overall mean score of awareness towards the nursing process is 24.19; both of them are at the average range.Also, the results show a statistically significant relationship between the nurses' age and the nurses' experience with their knowledge (p=0.016). Conclusion:According to the results of the study, it can be concluded that although the nurses' level of knowledge and attitude about the nursing process was average, they accepted the nursing process as a care framework.Investigating the items of the questionnaire showed that the nursing process implementation is time-consuming and also is mainly written.Therefore, it is possible to empower and encourage nurses to use the nursing process quickly by using the necessary training and eliminating unnecessary tasks.
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