Search

Aim The aim of this study was to explore the barriers to effective pain management in Iranian people with cancer. Design A qualitative descriptive design was used. Methods This qualitative descriptive study was performed on 14 people with cancer. Data were collected using semi‐structured interviews and analysed by Graneheim and Lundman's content analysis method. Results Four main categories emerged in relation to barriers to pain management from the perspective of people with cancer. Categories included 1) accepting and enduring divine pain, 2) negative attitudes towards the effectiveness of analgesics, 3) patients’ low knowledge of pain self‐management methods and 4) neglected pain management. Barriers to pain management are multidimensional in nature consisting of patients, healthcare providers and system components. Therefore, attempts should be focused on the education of patients and healthcare providers about pain management and eliminating the shortcomings of the healthcare system.

Aim To investigate the barriers to home‐based palliative care for cancer patients from professional caregivers' experiences. Design A qualitative study. Method This is a descriptive‐qualitative study carried out in the community‐based care. Twenty‐three participants took part in this study. Data were collected through semi‐structured interviews. Results Data analysis led to the identification of three category of barriers including the lack of instructions (the lack of clinical practice guidelines, the ambiguity of tariffs and the lack of insurance coverage), family desperation (family views of prognosis, distrust and poverty) and lack of professionalism (limited knowledge, the use of amateur nurses and siloed care). Developing a care protocol and providing resources support contribute to the development of home‐based palliative care. Moreover, the education of families and training courses for nurses must be fostered.

The relationship between healthcare providers and parents of infants in neonatal intensive care unit is based on trust and constitutes a core measure of family-centred care and health. The aim of the present qualitative study was to explore mothers and nurses experiences of trust in one another around the caregiving of the hospitalised infant in intensive neonatal care unit. Focused ethnographic research study conducted through observations and in-depth interviews with 20 mothers and 16 nurses in NICU of Tabriz (Iran) in 2017. Two main themes of 'gradual and fragile trust of mother-to-nurse' (subthemes: Primary trust-mistrust, mother's trust to responsible nurse, mother trust Increase with skilful nurse performance, and vulnerability to trust) and 'gradual and fragile trust of nurse-to-mother' (subthemes: Nurse's initial assessment of trust to mother's readiness to participate, Development of trust to mother, and vulnerability of nurse's trust to mother) were obtained. The present study revealed that mutual trust between the nurse and the mother in the care of the infant was a gradual and progressive process that was achieved over time. Complexities around the care of a hospitalised infant influenced how fragile or vulnerable the trust became between nurse and mother. Findings from this research can be used in supporting increased maternal participation in infant care and improvement of family-centred care in the neonatal intensive care unit.

The nursing profession is focused on serving others and has high expectations that each member behaves professionally and ethically, as articulated in nursing codes of practice and conduct. Where these are not upheld, inappropriate and unprofessional workplace behaviors follow. Regrettably, unprofessional behavior is neither new nor constrained to the nursing profession, but is known to negatively impact staff and workplace relationships, and importantly, patient safety and care. The aim of this qualitative study was to explore Iranian nurses' experiences of professional communication between colleagues in the emergency department. Fifteen individual interviews were conducted. The overarching theme to emerge from the data was workplace communication, supported by two subthemes: unprofessional behavior and stressors in the workplace. Individually and collectively, these subthemes demonstrated staff attitudes and behaviors that are inconsistent with expectations of professional behavior and practice. Management proactively addressing unprofessional workplace behaviors is fundamental to establishing and maintaining positive workplace environments and supporting safe, quality patient care.

Purpose To illuminate the meaning of the lived experiences of resuscitation team members with the presence of the patient's family during resuscitation in the cultural context of Iran. Design An interpretative phenomenology was used to discover the lived experiences of the nurses and physicians of Tabriz hospitals, Iran, with family presence during resuscitation (FPDR). A total of 12 nurses and 9 physicians were interviewed over a 6-month period. Methods The interviews were audio recorded and semistructured, and were transcribed verbatim. Van Manen's technique was used for data analysis. Findings Two major themes and 10 subthemes emerged, including destructive presence (cessation of resuscitation, interference in resuscitation, disruption to the resuscitation team's focus, argument with the resuscitation team, and adverse mental image in the family) and supportive presence (trust in the resuscitation team, collaboration with the resuscitation team, alleviating the family's concern and settling their nerves, increasing the family's satisfaction, and reducing conflict with resuscitation team members). Conclusions Participants stated that FPDR may work as a double-edged sword for the family and resuscitation team, hurting or preserving quality. It is thus recommended that guidelines be created to protect patients’ and families’ rights, while considering the positive aspects of the phenomenon for hospitals. Clinical Relevance A liaison support person would act to decrease family anxiety levels and would be able to de-escalate any potentially aggressive or confrontational events during resuscitation. Well-trained and expert cardiopulmonary resuscitation team members do not have any stress in the presence of family during resuscitation. Resuscitation events tend to be prolonged when family members are allowed to be present.

A novel three-component reaction involving 2-methylbenzothiazole or 2,5-dimethylbenzothiazole, acetylenic esters and 1,3-dicarbonyl compounds such as (1,3-dimethylbarbituric acid or 1,3-indanedione) leading to the synthesis of spiro pyrrolobenzothiazole derivatives. The reactions proceeded smoothly at room temperature without using any catalyst. This method is very useful to functionalize benzothiazole derivatives in a one-pot operation. The structures of the synthesized compounds have been characterized by spectral studies.

Objective: The objective of this study is to describe the experiences of cancer disclosure by Iranian cancer patients, their family members and physicians. Methods: Twenty cancer patients, ten family members and eight physicians participated in this study. Data were collected via semi-structured, in-depth interviews and analyzed using qualitative content analysis. Results: Three categories were identified: cancer avoidance, a climate of non-disclosure and mutual concern. The findings demonstrated that cancer is a taboo subject and the word cancer, as well as other indicative terms, was rarely used in daily communication. A climate of non-disclosure predominated because patients were the last to know their diagnosis, they were unaware of their prognosis, and family members and physicians employed strategies to conceal this information. The mutual concern of patients, family members and physicians was the main reason that cancer was not discussed. Conclusion: Cancer is a taboo subject in Iran that is maintained and reinforced primarily because of the mutual concern of patients, family members and physicians. The first step to address this taboo and inform cancer patients of their diagnosis would be to understand and help mitigate the individual, family and social consequences of disclosure. Copyright © 2011 John Wiley & Sons, Ltd.

Objectives: Emergency medical technicians (EMTs) in Iran experience concerning levels of workplace violence, although until now there has been no investigation of this phenomenon. The objectives of the present study were to describe the exposure of Iranian EMTs to workplace violence and to identify the importance of related factors from their viewpoint. Methods: In this descriptive, exploratory study, 160 EMTs agreed to participate in a survey that collected data regarding their exposure to the following forms of workplace violence: verbal abuse, physical assault, cultural harassment, sexual harassment and sexual assault. Results: A total of 138 questionnaires were returned, representing a response rate of 86%. The majority of participants 75% (n= 103) experienced at least one form of workplace violence in the 12 months before completing the questionnaire. The most frequently reported form of workplace violence was verbal abuse (71%), followed by physical assault (38%) and cultural harassment (9%). Violence resulting in serious injuries was reported by only 4% of participants, with no more than 8% of participants experiencing workplace violence that included the use of weapons. The most reported response to workplace violence was to 'invite the offender to calm down'. Participants took this approach because they believed that 'follow up of workplace violence is ineffectual' (34%), considered the workplace violence as a common in their job (30%), and did not know whom to report workplace violence to (13%). Conclusion: Iranian EMTs experience a considerable amount of workplace violence. The present study highlights the recommendation for formal training programmes and clearer protocols about how to manage workplace violence, especially verbal abuse in the Iranian prehospital setting.

Patients living with end-stage renal disease experience different levels of physical and psychological disability that can impact on the type and level of social interaction in which they engage with others. The researchers concurrently collected and thematically analyzed the interview data that were generated from 21 participants who were undergoing hemodialysis in Iran. Four major themes were constructed from the analysis of the transcripts: living with fatigue; changes in self-image; patients' dependency on the device, place, and time of hemodialysis; and hiding the disease. The results from this study showed that the patients who were living with hemodialysis in Iran experienced altered social interactions with others. The culture of Iran resulted in the participants trying to hide their disease from others, which led to social avoidance, thus reducing the participants' social interactions with others. It is recommended that nurses include a comprehensive assessment of the social interactions of persons who are receiving hemodialysis in their overall nursing assessment and that this is reviewed on a regular basis.

This exploratory, descriptive study investigates the experiences of Iranian war veterans living with chronic disease acquired as a result of chemical warfare. Sulphur mustard (SM) is considered one of the most important agents of chemical warfare and was widely used during the Iran-Iraq conflict in 1980-1988. There are approximately 100 000 Iranian SM casualties who suffer from serious long-term progressive health problems involving their respiratory organs, eyes and skin. Seventeen male Iranian war veterans aged between 30 and 59 years and four victims' family members participated in the study. Data was generated during individual in-depth interviews that used open-ended questions. Grounded theory techniques, including the constant comparative method of concurrent data generation and analysis, were employed in the analysis of data. Preliminary results indicate two main thematic categories: social isolation and physical disability. It is argued that a lack of knowledge about the outcomes of SM poisoning, physical restrictions and difficulty in adjusting socially decreases war veterans' functional capacity and levels of independence. Language: en

A novel three-component reaction involving 2-methylbenzothiazole or 2,5-dimethylbenzothiazole, acetylenic esters and 1,3-dicarbonyl compounds such as (1,3-dimethylbarbituric acid or 1,3-indanedione) leading to the synthesis of spiro pyrrolobenzothiazole derivatives. The reactions proceeded smoothly at room temperature without using any catalyst. This method is very useful to functionalize benzothiazole derivatives in a one-pot operation. The structures of the synthesized compounds have been characterized by spectral studies.

Amine-functionalized ordered mesoporous organic–inorganic hybrid materials are designed as solid supports to covalently immobilize the SO3H group to achieve sulfamic acid (SBA-15/ NHSO3H) as a novel catalyst. SBA-15/NHSO3H as ionic liquid-type heterogeneous catalyst could be separated easily from reaction products and recycled, showing superiority over homogeneous catalysts.

Introduction: Separating nonisthmus-dependent atrial flutter (AFL) from “organized” atrial fibrillation (AF), or isthmus-dependent AFL, may be difficult using ECG characteristics alone. We hypothesized that temporal and spatial phase analysis of ECG atrial waveforms could effectively separate these rhythms by quantifying subtle variations in ECG atrial activation during supraventricular tachycardias (SVT). Methods and Results: We studied 52 patients at electrophysiologic study (EPS) who demonstrated isthmus-dependent (n = 15) and nonisthmus-dependent (n = 9) AFL, atrial tachycardia (n = 6), AV nodal reentry (n = 9), orthodromic reciprocating tachycardia (n = 6), and AF (n = 7). Atrial activity was represented as a series of correlations of an atrial template to successive time samples of the arrhythmia ECG. Spatial phase was analyzed as a reproducible relationship of this atrial activity between leads over time; temporal regularity was measured from power spectra. Spatial phase was maintained (coherent) in lead planes V5/aVF (XY), V5/V1 (XZ), and aVF/V1 (YZ) in 15 of 15 cases of isthmus-dependent AFL, but in only 1 of 9 cases of nonisthmus-dependent AFL (P 6 dB), suggesting one activation wavefront, although this was smeared in nonisthmus-dependent cases. In contrast, AF showed inconsistent spatial phase in all planes and broad band spectra, consistent with multiple and/or variable activation paths. All other SVTs showed spatial coherence and one dominant spectral peak. Conclusion: Coherence of temporal and spatial phase is a powerful approach to measure the spatial organization of intracardiac activation from the ECG that reveals a spectrum from SVT to isthmus-dependent and nonisthmus-dependent AFL, to AF. (J Cardiovasc Electrophysiol, Vol. 14, pp. 971-981, September 2003)

Aortic stenosis is the most common valvular lesion in patients above the age of 65. The etiology, presentation, and management of aortic stenosis differs in the elderly compared to younger patients in many ways. Many of the classic physical findings are absent in the elderly, making the diagnosis of critical aortic stenosis more difficult. Due to coexisting morbidity in many elderly patients, there is often a reluctance to recommend aortic valve replacement despite the dismal prognosis of medical therapy. In the following review, the authors discuss the pathophysiology, presentation, and management of aortic stenosis in the elderly.

The reaction is conducted in the absence of a catalyst without any prior activation of the reactants.

The title reaction provides an efficient synthesis of products of type (IV) using cerium sulfate under solvent-free thermal conditions.

A facile and efficient method for the preparation of amides from ketones by the Schmidt reaction is described for the first time using P2O5/SiO2 and sodium azide under solvent‐free microwave irradiation. Advantages of this procedure are selectivity, good yields, a simple operation, short reaction time, and solvent‐free conditions.

A facile and efficient procedure is developed for a one‐pot synthesis of fused 1,5‐disubstituted tetrazoles from cyclic ketones and sodium azide in the presence of aluminum chloride in solvent‐free media. Advantages of this method are chemoselectivity, with high yields in a simple operation, and short reaction time under solvent‐free conditions.