@article{ author = {Gharacheh, M and Ranjbar, F}, title = {Editorial Letter” HIV-related Stigma: A Dilemma in the Prevention of HIV Spread}, abstract ={HIV/AIDS is a global health concern that spans three decades of its emergence(1). However, it remains a complex, unique issue among experts. While HIV/AIDS is medically recognized as a chronic, fatal disease, there is a social stigma attached to the disease, which targets the dignity of the patients. In addition to the burden of the disease, stress, and fear of death, an HIV-infected patient is faced with negative emotions, such as social rejection, prejudice, humiliation, and discrimination, so that HIV-related stigma seems to be more burdensome for the patients than the disease(2). Since HIV infection is associated with avoidable behaviors (e.g., unsafe sexual relations and substance abuse), the patients are often responsible for their own illness(3). On the same note, the failure of the media to properly inform people has led the populace to regard AIDS immoral(4). The fear of judgment or discrimination from others deeply affects the self-image of the patients with HIV infection, as well as their coping abilities. This experience may cause self-blame in the patients, who may, as a result, presume themselves to be deserving of maltreatment(5). They may even give up their rights to treat and receive other social benefits, which is associated with devastating effects on HIV prevention, care, and treatment. HIV-related stigma also interacts with cultural prejudices and gender issues. Globally, when a woman is infected with HIV, her status subjects her to more discriminatory treatment compared to a man. Therefore, many women living with HIV tend to hide their status from their spouses due to the fear of rejection, violence, and even death. This leads to the loss of the opportunity to prevent the infection of the spouse, and also deprives women of access to the necessary care and treatment(6). There is a cyclical relationship between stigma and HIV; the individuals who experience stigma and discrimination due to HIV infection are marginalized, thereby becoming more vulnerable to HIV. On the other hand, patients with HIV are more prone to discrimination and stigma than others(7). The World Health Organization has identified the fear of stigma and discrimination as the main barriers to HIV testing, HIV status disclosure, and access to HIV treatment. It is reported that in 35% of countries, more than 50% of the population have discriminatory attitudes toward HIV patients(8), and about one out of eight peopleinfected with HIV does not use health services due to the fear of discrimination and social stigma. In 2016, 60% of the countries across the world reported the discriminatory attitude of healthcare providers toward intravenous drug users, which in turn discourages them to provide adequate services for HIV prevention to these patients(9). HIV-related stigma and discrimination have been frequently observed in healthcare professionals at all levels, and the attitudes are manifested in a variety of manners. Healthcare providers may minimize their contact with HIV, neglect their proper care, delay their treatment, and isolate these individuals from other patients. However, the unwillingness of people to receive HIV testing delays the diagnosis of the disease, leading to its progression to the stage of AIDS and ineffective treatment, thereby increasing the risk of infection transmission and untimely death(7). Despite the advancement in the detection of HIV and its transmission, there have not been sufficient effort to reduce the social stigma and labeling attached to this disease(10,11). Management of HIV-related stigma and discrimination is a major impediment to the coordinated action at global, regional, national, and social levels, as well as a human rights obligation. Implementing specific programs that emphasize on the rights of HIV patients is a well-known way of eradicating HIV-related stigma(12). Stigma is a social construction(2), and it is imperative to adopt a comprehensive approach to deal with it. Therefore, tackling with stigma should be taken into consideration at the individual, social, organizational, and policy-making levels. At the individual level, raising public awareness regarding HIV transmission, care, and prevention, while ensuring access to proper services and legal rights is absolutely essential. Another influential factor in this regard is providing social support to HIV patients. In the educational programs for healthcare providers, the cultural stimuli for the establishment of HIV-related stigma and discrimination (e.g., fear of infection, prejudice toward vulnerable groups, and misconceptions/lack of knowledge regarding HIV transmission, treatment, and prevention) should be considered. Furthermore, the media should raise public awareness regarding HIV and its effects on the lives of people, thereby tackling HIV-related stigma through changing the false attitudes and emphasizing on the fact that patients with HIV have the same human rights as others. At the policy-making level, factors such as discrimination in employment, education level, health service provision, and other needs of HIV patients must be addressed. Eradicating the discrimination and stigma attached to HIV infection, which is a major obstacle to access to health and preventive services, is the key to stopping the HIV epidemic.}, Keywords = {Stigma, HIV, Aids, Nurse}, volume = {31}, Number = {114}, pages = {1-5}, publisher = {دانشگاه علوم پزشکی ایران}, doi = {10.29252/ijn.31.114.1}, url = {http://ijn.iums.ac.ir/article-1-2745-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-2745-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2018} } @article{ author = {Rajabi, M and Bastami, M and ShahvaroughiFarahani, N and Tavanaie, A H and Ghanbari, B and Alasti, H}, title = {Religious Coping as a Predictor of the Burden of Care in the Caregivers of End-stage Cancer Patients}, abstract ={Background & Aims: Advanced cancer is accompanied by physical, mental, and social complications in the patients. During the diagnosis and treatment processes, the necessary care is provided to the patient by formal caregivers for only a short period at the hospital; in other cases, the care is provided by informal caregivers. Informal caregivers are untrained individuals who are not paid for care provision, delivering care to their family members and close relatives. Under such circumstances, if the caregiver is not able to manage the caretaking time and their personal time, they will become prone to caregiver burden. Caregiver burden has a covert and personal nature, encompassing components such as time-related, evolutionary, physical, social, and emotional caregiver burden. The concept has external and internal dimensions; the external dimension of caregiver burden consists of the factors that are related to the patient, such as attention to the patients’ needs, allocating time to the patients, and the provided services for the recovery of the patients. Internal caregiver burden involves personal beliefs, angers, internal emotions, and the individual’s sense of importance toward the role of the caregiver. Meanwhile, coping strategies are the internal factors used by caregivers in the face of life tensions. In this regard, the role of religion as a strategy for coping with stress is considered as a form of defensive mechanism in a positive view (benevolent religious reappraisal, reappraisal of God's power, seeking spiritual support, collaborative religious coping, religious purification, religious redemption, religious helping, religious focus, spiritual connection, and seeking support from clergies) and a negative view (reappraisal of the punishing God, active/passive deference, self-directing religious coping, demonic reappraisal, spiritual discontent, and interpersonal religious discontent). Despite the importance of coping strategies and role of religion as an index that has been constantly emphasized in facing difficulties and adversities, it remains unclear in the literature whether religious coping could predict the caregiver burden of the caregivers of advanced cancer patients. Although extensive research has been conducted in this regard, further investigations should be focused on end-stage cancer patients and their caregivers. The present study aimed to predict the burden toleration among end-stage cancer patient caregivers based on their religious coping styles. Materials & Methods: This cross-sectional, correlational study was conducted on the caregivers of end-stage cancer patients referring to the palliative care center of Firoozgar Hospital in Tehran, Iran during April-September 2017. In total, 154 individuals were selected via convenience sampling based on Tabachnick and Fidell sample size estimation method. The inclusion criteria were the minimum caregiving period of one month, disease course and treatment (end-stage patients requiring a main caregiver for full-time care), basic literacy (ability to read and write), age of 15-75 years, Iranian nationality, and willingness to participate in the research. The exclusion criterion was the diagnosis of psychotic disorders in the patients affecting the interview process and validity of responses. Data were collected using the caregiver burden inventory by Guest and Novak and the religious coping questionnaire (RCOPE) by Pargament with 14 items. Data analysis was performed in SPSS version 16 using Pearson’s correlation-coefficient and multiple regression analysis simultaneously. Results: Out of 146 participants, 71 (48.6%) were male and 75 (51.4%) were female within the age range of 15-72 years. No significant association was observed between the positive religious coping style and caregiver burden, while the negative religious coping style was positively and significantly correlated with the caregiver burden, with the correlation level of 34%. Furthermore, the negative religious coping style (t=4.444; β=0.352) could significantly predict the caregiver burden, while the positive religious coping (t=0.438; β=0.035) could not significantly explain the caregiver burden. Conclusion: According to the results, the positive religious coping style and caregiver burden had no significant correlation, while the association between negative religious coping style and caregiver burden was positive and significant. Therefore, using the negative religious coping styles could reduce mental health and increase the caregiver burden. In fact, as a dimension of spirituality and a coping style, religion could result in the reduction of tensions, and the World Health Organization (WHO) has also acknowledged spirituality as a fundamental factor to enhance mental health. On the other hand, the positive religious coping style could not predict the caregiver burden in this study. Long-term and extensive care provided to end-stage cancer patients by the caregivers may reduce the effectiveness of coping strategies (e.g., positive coping styles) in the reduction of the caregiver burden due to the prolonged disease course and treatment process. Our findings also indicated that the negative religious coping style exerted a negative impact on the burden tolerance of the caregivers of the end-stage cancer patients, exposing these individuals to a higher sense of burden and reduced quality of life. As such, training on coping skills with a focus on improving positive religious coping strategies in the caregivers of cancer patients since the initial stages of the disease could be an effective step toward reducing the caregiver burden incurred upon these caregivers during the treatment process. In conclusion, it is recommended that the results of this study be incorporated into the psychological services provided to the caregivers of end-stage cancer patients in order to decrease their burden.}, Keywords = {Burden of Care, Religious Coping, Caregivers, Cancer}, volume = {31}, Number = {114}, pages = {6-16}, publisher = {دانشگاه علوم پزشکی ایران}, doi = {10.29252/ijn.31.114.6}, url = {http://ijn.iums.ac.ir/article-1-2751-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-2751-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2018} } @article{ author = {GholamiBaroughi, S and Ravanipour, M and Jahanpour, F and Bayandari, F}, title = {Nursing Students and Conveying Bad News to Patients}, abstract ={Background & Aims: Communication skills are the foundation of clinical capabilities in healthcare providers. The process of delivering bad news is one of the most challenging aspects of clinical communication in health care, which has subtle psychological details. The present study aimed to assess the knowledge of nursing students regarding the conveying of bad news to patients and their companions in the hospitals affiliated to Bushehr University of Medical Sciences, Iran. Materials & Methods: This cross-sectional, descriptive-analytical study was conducted in 2017 in order to assess the knowledge of nursing students at Bushehr University of Medical Sciences regarding the delivery of bad news to patients and their companions. Data were collected using a valid and reliable researcher-made questionnaire. Data analysis was performed in SPSS version 18 using descriptive and analytical statistics. Results: The nursing students had moderate to high knowledge of delivering bad news to patients. In addition, significant associations were observed between the knowledge level, passing the courses of nursing ethics and professional communication (P=0.011), and academic year of education (P=0.037), so that the students who had passed the courses and were in inferior academic years had higher knowledge levels in this regard. However, no significant correlation was observed between the knowledge level, gender (P=0.550), and interest in the academic discipline (P=0.546). Conclusion: Adequate knowledge of professional ethics and effective communication is an advantage for healthcare providers. Based on the obtained results, presenting additional courses on professional ethics and communication skills in nursing education, as well as related training programs, by medical education authorities could lead to better outcomes in this regard.}, Keywords = {Bad News, Health Communication, Professional Ethics, Nursing Knowledge, Patient}, volume = {31}, Number = {114}, pages = {17-27}, publisher = {دانشگاه علوم پزشکی ایران}, doi = {10.29252/ijn.31.114.17}, url = {http://ijn.iums.ac.ir/article-1-2752-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-2752-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2018} } @article{ author = {Rafiei, F and Ameri, F and Haghani, H and Ghobadi, A}, title = {Effect of Aromatherapy Massage with Lavender and Chamomile Oil on the Intensity of Background Pain in Burn Patients}, abstract ={Background & Aims: Given the importance of pain management in burn patients, the present study aimed to assess the effect of aromatherapy massage with aromatic oils of lavender and chamomile on the intensity of the background pain in burn patients. Materials & Methods: This quasi-experimental study was conducted on 105 patients with burn injuries admitted to Shaheed Motahari Hospital in Tehran, Iran during January-May 2018. The patients were selected via convenience sampling and allocated to three groups of control, placebo massage, and combined aromatic oil massage by drawing lots and blocks of four with cards. The interventions were performed 20 minutes before bedtime in three sessions for one week. The control group only received routine care. Data were collected using the visual analogue scale (VAS). Data analysis was performed in SPSS version 20 using descriptive statistics (frequency, frequency percentage, mean, and standard deviation), and inferential statistics (Chi-square, Fisher’s exact test, analysis of variance, and paired t-test) were applied to determine the significance. Results: Before the interventions, the three groups had no significant difference in terms of the pain score (P=0.746), while after the intervention, the results indicated a significant difference between the three groups in terms of the pain score, (P<0.001), so that the mean pain intensity was lower in the combination oil massage group compared to the other groups, as well as the placebo group compared to the control group. Conclusion: Considering that aromatherapy massage could effectively improve the background pain in burn patients as a non-pharmacological, simple method, it is recommended that nurses and burn injuries medical teams apply this technique in the routine care program of these patients.}, Keywords = {Aromatherapy Massage, Chamomile, Lavender, Pain, Burn}, volume = {31}, Number = {114}, pages = {28-37}, publisher = {دانشگاه علوم پزشکی ایران}, doi = {10.29252/ijn.31.114.28}, url = {http://ijn.iums.ac.ir/article-1-2758-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-2758-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2018} } @article{ author = {Joolaee, S and Shali, M and HaratiKhalilabad, T and Haghani, H and Vaezi, A and Sepehrinia, M}, title = {Association of the Incidence of Patient Falls and Work Environment of Nurses}, abstract ={Background & Aims: Patient falls are among the most significant threats to patient safety. Nurses play a pivotal role in maintaining and improving the standards of patient safety. The work environment of nurses is among the major influential factors in this regard. The present study aimed to investigate the association between the incidence of patient falls and work environment of nurses. Materials & Methods: This correlational study was conducted on 300 nurses employed in the hospitals affiliated to Tehran University of Medical Sciences, Iran, who were selected via proportionate stratification sampling. Data were collected using a questionnaire with three sections of demographic data, work environment of nurses, and patient falls. Data analysis was performed in SPSS version 16 using Pearson’s correlation-coefficient, Kruskal-Wallis test, t-test, and frequency tables. Results: Mean age of the participants was 32±6.17 years, and the majority were female (86.7%) and married (64%). Mean incidence of patient falls was 6±1.61 within the past three months, and the mean score of the work environment of nurses was estimated at 67.34 (favorable). A significant, weak correlation was observed between the work environment of nurses and incidence of patient falls (P<0.034; r=-0.15). Conclusion: Given the significant association between the incidence of patient falls and work environment of nurses, it seems essential that nursing managers adopt effective strategies to improve the working conditions of nurses through the participation of nurses in decision-making, support, and adequate staff and resources, thereby facilitating safe patient care.}, Keywords = {Patient Safety, Patient Falls, Work Environment, Nurse}, volume = {31}, Number = {114}, pages = {38-48}, publisher = {دانشگاه علوم پزشکی ایران}, doi = {10.29252/ijn.31.114.38}, url = {http://ijn.iums.ac.ir/article-1-2762-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-2762-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2018} } @article{ author = {Gholizadeh, A and JafarJalal, E and Haghani, H}, title = {Attitude of Nurses toward the Care of Elderly Patients with Delirium and the Infleuntial Factors in the Teaching Hospitals Affiliated to Iran University of Medical Sciences (2017)}, abstract ={Background & Aims: Nurses are one of the most important members of healthcare teams, who are directly responsible for the care of the elderly. Positive attitude toward the recipients of care plays a fundamental role in the provision of care. The quality of care provision to the elderly, especially those with delirium, is influenced by several factors, including the attitude of nurses toward this patient group. The present study aimed to assess the attitude of nurses toward the care of elderly patients with delirium in the dimensions of knowledge, ability and self-confidence, ability to identify and understand the consequences, willingness to enhance knowledge, and burden of care. Materials & Methods: This cross-sectional, descriptive-analytical study was conducted on 200 nurses employed in three teaching hospitals affiliated to Iran University of Medical Sciences, Iran, who were selected via convenience, proportionate stratification sampling in case they met the inclusion criteria. Data were collected using questionnaires of demographic data and attitude of nurses toward delirium consisting of 38 items. Data analysis was performed in SPSS version 16 at the significance level of P≤0.05. Results: The attitude of head nurses toward the elderly patients with delirium was significantly better compared to nurses (P=0.005). The results of the analysis of variance indicated a significant difference with the variable of work experience with the elderly (P=0.003). In addition, occupational position (head nurse) was the only significant variable in the linear regression model. Conclusion: According to the results, occupational position and work experience with the elderly had the most significant associations with the attitude of the nurses toward the elderly patients with delirium. It is suggested that continuous training, evidence-based, and performance-based education be implemented to improve the attitude and practice of nurses. Furthermore, the care of elderly patients must be assigned to trained, experienced, enthusiastic, and interested personnel.}, Keywords = {Delirium, Attitude, Elderly Care}, volume = {31}, Number = {114}, pages = {49-64}, publisher = {دانشگاه علوم پزشکی ایران}, doi = {10.29252/ijn.31.114.49}, url = {http://ijn.iums.ac.ir/article-1-2766-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-2766-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2018} } @article{ author = {Ghaljeh, M and Rezaee, N}, title = {Experiences of Nurses about End-of-life Care for Cancer Patients in Iran: A Qualitative Study}, abstract ={Background & Aims: Cancer is an important cause of mortality worldwide. Many cancer patients are hospitalized at the end of their life, requiring end-of-life care. The perception of nurses toward end-of-life care could correct inappropriate care behaviors and enhance the quality of care. The present study aimed to assess the understanding of nurses regarding the end-of-life care of cancer patients. Materials & Methods: This qualitative study was conducted using the conventional content analysis method in 2017. Sample size included 16 nurses employed in oncology wards, who were selected via purposive sampling. Data were collected via semi-structured interviews. All the interviews were transcribed and reviewed, and data analysis was performed using content analysis.  Results: The nurses perceived end-of-life care as the main category of ‘comprehensive care’ and three subcategories of ‘value-based care’, ‘support-based care’, and factors in care’. Conclusion: According to the results, the comprehensive perception of the nurses toward end-of-life care, which arises from their perception toward the care of these patients, could help them provide high-quality care that is value-based, nursing-based, and support-based. Such care services seem to bring about a sense of proper care provision for the nurses, as well as peaceful death for the patients.}, Keywords = {End-of-life care, Cancer, Nurse}, volume = {31}, Number = {114}, pages = {65-75}, publisher = {دانشگاه علوم پزشکی ایران}, doi = {10.29252/ijn.31.114.65}, url = {http://ijn.iums.ac.ir/article-1-2771-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-2771-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2018} } @article{ author = {Darvishpour, A and JavadiPashaki, N}, title = {Associations of Hospital Stress Dimensions and Ward of Employment in the Nurses of the Medical Centers Affiliated to Guilan University of Medical Sciences, Iran}, abstract ={Background & Aims: Nurses are faced with numerous physical and psychological stressors in their workplace. Identification of stressors and their control in nurses could improve the quality of patient care. The present study aimed to identify the dimensions of occupational stress in the nurses employed in various wards of the hospitals affiliated to Guilan University of Medical Sciences, Iran. Materials & Methods: This analytical, cross-sectional study was conducted on 324 nurses, who were selected via multistage cluster sampling. Initially, 12 healthcare centers were selected from three clusters of the center, west, and east of Guilan province, Iran. Based on the share of each healthcare center in the required sample size, the samples were randomly selected from various wards, including the emergency, internal medicine, surgery, pediatrics, nursing office, critical care unit (CCU), intensive care unit (ICU), hemodialysis ward, and operating room. Data were collected using the hospital stress scale (HSS-35) consisting of 35 items and 11 subscales. Data analysis was performed in SPSS version 19 using descriptive statistics and analysis of variance (ANOVA). Results: The majority of the subjects (39.8%) were aged 31-40 years, female (96%), and married (77.2%) and had a BSc degree (93.2%). Regarding the mean score of general stress, the personnel of the emergency ward had the highest stress level (120.17 ± 16.13), while the ICU personnel had the lowest stress level (114.14 ± 19.01). However, the difference was not statistically significant (P>0.05). In terms of the severity of stress, the dimensions of ‘role ambiguity’ (3.58 ± 0.63) and ‘chemical stress’ (3.12 ± 1.26) represented the most and least significant stressors, respectively. Conclusion: According to the results, the highest hospital stress levels were observed in the staff of the emergency and pediatrics wards. Therefore, it is recommended that hospital managers pay special attention to the personnel of these wards through planning for the reduction of hospital stress and training the staff on the most effective coping strategies.}, Keywords = {Occupational Stress, Nurse, Hospital}, volume = {31}, Number = {114}, pages = {76-85}, publisher = {دانشگاه علوم پزشکی ایران}, doi = {10.29252/ijn.31.114.76}, url = {http://ijn.iums.ac.ir/article-1-2777-en.html}, eprint = {http://ijn.iums.ac.ir/article-1-2777-en.pdf}, journal = {Iran Journal of Nursing}, issn = {2008-5931}, eissn = {2008-5931}, year = {2018} }