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Zohreh Karimi,1 Zhila Fereidouni,2 Mohammad Behnammoghadam,3,4 Nasrollah Alimohammadi,5 Ali Mousavizadeh,6 Tahmine Salehi,7 Mohammad Saeed Mirzaee,8 Sobhan Mirzaee9 1Department of Operating Room, School of Paramedicine, Yasuj University of Medical Sciences, Yasuj, Iran; 2Department of Medical Surgical Nursing, Nursing School, Fasa University of Medical Sciences, Fasa, Fars, Iran; 3School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran; 4School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran; 5Critical Care Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran; 6Department of Biostatistics and Epidemiology, School of Health, Yasuj University of Medical Sciences, Yasuj, Iran; 7Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran; 8School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran; 9Student Research Committee, Yasuj University of Medical Sciences, Yasuj, IranCorrespondence: Mohammad Behnammoghadam School of Nursing and MidwiferyIsfahan University of Medical Sciences, Isfahan, IranEmail mbehnam1363@gmail.comMohammad Saeed Mirzaee School of Nursing and MidwiferyIran University of Medical Sciences, Tehran, IranEmail Saeedmirzaee75@gmail.comObjective: This study aimed to explore the lived experiences of nurses caring for patients with COVID-19 in Iran.Methods: This study was a descriptive phenomenology. Sampling was purposefully performed, and participants were selected in terms of the inclusion criteria. Data were collected through semi-structured interviews using the WhatsApp mobile messaging application. Colaizzi’s method was used to analyse the data. The criteria introduced by Lincoln and Guba were used for the study rigour.Results: The data were obtained from 12 nurses caring for patients with COVID-19. The mean age of the participants was 29.41 years (SD = 2.72) with a mean work experience of 6.75 years (SD = 2.52). Three main themes and six subthemes were identified: mental condition (subthemes included “anxiety and stress” and “fear”), emotional condition (subthemes included “suffering and affliction” and “waiting for death”), and care context (subthemes included “turmoil” and “lack of support and equipment”).Conclusion: The results of this study show that nurses working in the wards and care centres designated for patients with COVID-19 are experiencing mental and emotional distress and are working in inadequate professional conditions.Keywords: nurse experience, nursing care, COVID-19, phenomenology

Zeynab Kord,1 Nasrollah Alimohammadi,2 Soheila Jafari Mianaei,3 Ali Riazi,4 Behrooz Zarasvand5 1School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran; 2Critical Care Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran; 3Children Care Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran; 4Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran, Department of Pediatric Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran; 5Department of Neurosurgery, Dezful University of Medical Sciences, Dezful, IranCorrespondence: Nasrollah AlimohammadiCritical Care Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranEmail alimohammadi@nm.mui.ac.irBackground: Head trauma is a major health problem. Its primary complications happen at the time of trauma and are inevitable; thus, head trauma management is focused on the prevention and management of secondary complications. A clear clinical guideline for head trauma care can help nurses effectively prevent and manage secondary complications. This study aims to develop the clinical guideline for nursing care of children under 18 years with head trauma hospitalized in emergency departments, critical care units, and neurosurgery wards.Methods: This sequential exploratory mixed-method study will be conducted in three main phases as follows: qualitative, systematic review, and integration phases. In the qualitative phase, semi-structured interviews will be conducted to determine the care-related needs of children with head trauma. In the systematic review phase, a systematic review will be performed to find and then to review the most relevant articles, books, and the appropriate clinical guidelines. The quality of the retrieved guidelines will be assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. In the integration phase, the findings of the qualitative and systematic review phases were integrated, the draft of the guideline will be prepared, which will then be revised and validated through a nationwide Delphi survey.Discussion: The guideline for nursing care of children with head trauma can help to more effectively prevent, reduce, and manage the secondary complications of head trauma. Moreover, it reduces disability and mortality rates, improves nursing care quality, decreases healthcare costs, shortens hospital stay, and makes more rational clinical decisions.Keywords: head trauma, nursing care, children, clinical guideline

Background and Objective: Different coagulants including aluminum sulfate (Alum) and Polyaluminum Chloride (PAC) are used for water clarification process and deposition of colloidal particles. The use of coagulants causes some residual aluminum in water. The residual aluminum higher than 0.2 mg/l, has adverse effects on human health and environment. This study was conducted to determine the amount of residual aluminum by applying Polyaluminium chloride and aluminum sulfate for turbidity removal from turbid water. Methods: In this laboratory study, the experiments were run by using synthetic water having low (10-30 NTU), medium (100-130 NTU) and high (200-230 NTU) initial turbidities. Synthetic turbid water was prepared by adding stock kaolin suspension into distilled water. Samples of 1 liter of water were poured on 6 Jars. After adjusting of pH, coagulant was added into each beaker at various doses and agitated at 100 rpm for 30s. The mixing speed was then reduced to 20 rpm and kept for another 15 minutes. The suspensions were left for sedimentation and after 30 minutes of sedimentation, clarified samples were collected from the top of the beakers. Residual turbidity and residual aluminum was measured. The residual turbidity was measured using a Turbidimeter according to Nephlometric method. The residual aluminum was determined by Eriochrome cyanine R method. Results: Residual alminium in low, medium and high turbidities was 0.006 mg/l, 0.05 mg/l and 0.07 mg/l by applying Polyaluminum Chloride and 0.065 mg/l, 0.15 mg/l and 0.22 mg/l by applying alum, respectively. There was a significant correlation between dosage of Alum and Polyaluminum Chloride with residual aluminium (P

Background and Objective: Patients after lumbar disc herniation surgery experience chronic pain and disability and can impact on their quality of life. This study aimed to determine the effect of movement therapy on quality of life of patients after lumbar disc herniation surgery. Materials and Method: The current clinical trial study with before and after design in three stages was done on patients with lumbar disc herniation surgery in one of the hospitals in Isfahan in 2013. Patients were selected through convenience sampling and then were randomly allocated into two intervention and control groups (32 patients in each group). The movement program was implemented 4 weeks after surgery for 2 weeks. Data were collected through demographic questionnaire and SF-36 quality of life questionnaire. Data were analyzed by SPSS-18 using independent t-test and repeated measures ANOVA. Results: There has been a significant increase in the mean of overall quality of life score in intervention group 6 weeks (65.2 ± 7.45) and 3 months after intervention (70.9 ± 8.2), in compare with before the intervention (31.5 ± 6.05) (p < 0.001). Also the mean of overall quality of life score showed the significant difference in two groups (p < 0.001). Physical and psychological aspects increased significantly in both groups in the period of 6 weeks and 3 months after intervention, the increase was greater in intervention group than control group. (p

Background: Self-care needs are major problems among stroke patients. Nurses can support them through interventions such as education, a change in their attitude and emphasis on their remaining abilities. However, research has shown some weak points in the quality of care given to these patients. So the aim of this study was to improve the nurses’ practice in self-care education to stroke patients. Methods: This is a participatory action research, conducted in internal neurology ward of Al-Zahra hospital in Isfahan, Iran during 2013-2014 in five stages of diagnosis, planning, action, reflection and evaluation. Participants comprised 27 nursing personnel including staff nurses, matrons, educational supervisors and the staff in charge of Nurse Educators’ Al_Zahra Role Expansion Action Research (NEAREAR) project. In the evaluation stage, data were collected from five personal interviews and two focus group discussions and analyzed by qualitative content analysis. Results: The findings of evaluation phase showed that during action research, approaching the nurses’ empowerment in self-care education to stroke patients has been set in motion. The nursing practice improvement, knowledge based practice, nurses’ attitude change, ability to respond against routinization, and motivation promotion emphasize the success of change process. Facilitators and barriers of educating patients are acknowledged by the participants as a factor influencing the continuation of change. Conclusions: The lack of nurses’ educating performance skills was overcome using action research and changes were made to improve the performance of nurses.

Background & Aim: Traumatic brain injury management focuses on the prevention and treatment of secondary brain injuries. The aim of this study was to adapt a clinical guideline (CG) for nursing care of secondary brain injuries in adults. Methods & Materials: This study was carried out through a multi-stage evolutionary study at Isfahan University of Medical Sciences in 2017. Based on the opinions of experts using AGREE tool, the quality of 8 out of 13 CGs for the treatment and care of head injuries was assessed as optimal. These were used in drafting the adaptive CG. In addition, 12 CGs, 13 articles and 5 books were used to complete the recommendations of the mentioned guideline. The CG draft was evaluated using the Delphi method and the panel of experts. Finally, it was presented as an adaptive CG. Results: The adaptive CG for nursing care of secondary brain injuries was developed in 158 recommendations and five sections; nursing care to prevent and manage the increased intracranial pressure, nursing care to maintain and increase cerebral blood pressure, nursing care to prevent and control seizures, nursing care to prevent and control brain infections, and nursing care to prevent and control secondary extracranial injuries. Conclusion: The nursing staff of emergency and neurological wards and intensive care units can apply the recommendations of this clinical guideline to address some of the care needs of the injured patients and improve their health conditions.