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Background: Teaching clinical reasoning to nursing students is essential for professionalizing and improving cancer patient care. This study investigates how training duration with Virtual Patients (VPs) impacts clinical reasoning and learners' evaluation of their experiences. Materials and Methods: The present semi-experimental study was conducted with a pretest–post-test design and a control group. Through the census sampling method, 74 nursing students from Isfahan University of Medical Sciences, Iran, (in their 4th and 5th semester) who had taken the cancer course were selected (2019-2022) and, upon obtaining their consent, were enrolled in the study. The study began with a pretest, followed by engagement in five VP scenarios over 6 weeks, which was followed by the post-test phase. Data were collected via 23-item tests and the Huwendiek Questionnaire. The collected data were analyzed in SPSS software using correlation tests and t -tests. Results: The outcomes revealed a noteworthy disparity between the mean scores recorded in the pre-test and post-test stages after training, for both the 4th and 5th semester cohorts (p ≤ 0.001). Moreover, a notable discrepancy surfaced between the duration of training with VPs and the average post-test score (p ≤ 0.001). The correlation coefficient, for the 4th semester, stood at 0.65, while for the 5th semester, it was 0.213. Notably, the participants exhibited contentment with the learning experience through VPs. Conclusions: The survey found that 85.60% of participants prefer using VPs for clinical reasoning education. Our study underscores the link between the duration of VP interaction and improved clinical reasoning skills in nursing students. [ABSTRACT FROM AUTHOR]

Objectives: The progressive and unpredictable course of heart failure (HF) has made the provision of palliative care (PC) services to older adults with HF a serious challenge. This study aimed to explain the barriers and facilitators of PC in older adults with HF. Methods: This qualitative study was conducted using the content analysis approach. A sample of 15 participants, including 6 patients, 2 family caregivers, and 7 healthcare team members (4 nurses, a psychiatric nurse, a nutritionist, and a PC physician) were selected by purposive sampling over 10 months (November 21, 2020 to September 1, 2021). The data were collected using semistructured in-person interviews until data saturation and analyzed with conventional qualitative content analysis. Results: The findings revealed the main category of "neglecting the provision of PC," with 4 subcategories of "weak organizational structure," "poor social support," "older adults' and healthcare teams' poor knowledge," and "limited financial resources" as the barriers of PC and the main category of "enjoying support potentials" with 3 subcategories of "the cooperation of the government, benefactors, and nongovernmental organizations," "empathy from the family and relatives," and "benefiting from the presence of healthcare workers" as PC facilitators. Conclusions: The findings of this study explained the barriers and facilitators of PC in older adults with HF. Removing the barriers and supporting the facilitators give older adults with HF better access to PC. Therefore, to expand PC centers for older adults with HF, health system officials, and policy-makers should pay attention to organizational infrastructures and remove the barriers at organizational, social, educational, and economic levels with the cooperation of governmental organizations, benefactors, and nongovernmental organizations. [ABSTRACT FROM AUTHOR]

Objectives: Subacromial impingement syndrome is one of the most prevalent causes of shoulder pain in dialysis patients. The aim of this study is to evaluate the effectiveness of Kinesio tape in combination with mobilization versus mobilization alone on rest pain, shoulder abduction pain, shoulder abduction range of motion (ROM), and... [ABSTRACT FROM AUTHOR]

Background: It seems that improving the spiritual dimension of cancer patients can play an effective role in their mental and emotional peace. Meanwhile, oncology ward nurses are one of the most important healthcare providers that can help improve patients' relationship with God due to their more interaction and communication with patients. For this reason, this study aimed at explaining nurses' spiritual needs in an oncology ward. Materials and Methods: This study was conducted based on the qualitative content analysis method. The participants included 11 nurses from the oncology ward of Seyed Al Shahada Hospital in Isfahan from 2021 to 2022. A semi-structured interview was administered to determine nurses' spiritual needs. Results: Analysis of 11 interviews conducted with nurses revealed a total of four main codes, 13 sub-codes, and four sub-sub-codes. According to nurses' point of view, their spiritual needs can be classified into four dimensions as follows: communication with God, communication with oneself (intrapersonal communication), communication with others (interpersonal communication), and communication with environment. Administered interviews revealed the role of communication with God with six sub-codes as nurses' most important point of attention. Conclusions: According to nurses' point of view, nurses' spiritual needs were divided into the dimensions of communication with God, communication with oneself, communication with others, and communication with environment. Therefore, it is necessary to simultaneously pay attention to oncology nurses' personal and social aspects to increase their spirituality. [ABSTRACT FROM AUTHOR]

Buttermilk is an important by-product of the manufacture of butter. Sweet-cream buttermilk (SCBM) is similar in composition to skim milk, except for its high phospholipid and milk fat globular membrane protein content. The main objective of this investigation was to produce optimum quality cream cheese by replacing whole milk with different proportions of SCBM (5, 10, 15, 20, 25, 30, 35, 40, 45, and 50%). Statistical analysis showed that there were significant differences (p < 0.05) between the chemical and organoleptic properties of the samples. As the percentage of SCBM increased, the chemical composition of total solids, fat, protein, fat in dry matter (FDM) and ash of cheese milk decreased significantly, leading to a softer, moister curd. Samples prepared with more than 25% SCBM were not acceptable to the taste panel. The cream cheeses prepared using 25% and 30% SCBM had the highest yields. Total solids and FDM were strong predictors of cheese yield (r2 ≈ 0.589). The results also showed that the best range for replacement using SCBM is 20–25%.

Background: Breast Cancer (BC) is one of the most common cancers in the world, including in Iran. Chemotherapy as one of the basic treatments for BC leads to many side effects such as fatigue. This study aimed to examine the effect of a combined exercise program on the intensity of fatigue in patients with BC undergoing chemotherapy. Materials and Methods: This clinical trial study was conducted on 64 patients with BC undergoing chemotherapy referring to the Seyyed al-Shoada and the Al-Zahra clinics from January to April 2022. Eligible patients who met inclusion criteria were recruited by the convenience sampling and then assigned randomly to intervention and control groups. The combined exercise program in the intervention group was done for 8 weeks as three sessions a week (34 sessions) each for 35-40 min. Piper's Fatigue Scale was completed for both groups before and after the intervention. Data were analyzed using descriptive and inferential statistical methods. Results: The results showed that the mean score of fatigue intensity in both control and intervention groups had a statistically significant difference after the intervention (p = 0.004). The mean fatigue intensity score in the intervention group decreased significantly from mean (SD) 8.17 (1.88) to 5.56 (1.74). Conclusions: Based on the results, a combined exercise program can reduce fatigue in patients with BC. Therefore, nurses can utilize exercise programs and practices as a subset of complementary medicine alongside other treatment methods, which can effectively promote cancer patients' quality of life by reducing their fatigue. [ABSTRACT FROM AUTHOR]

Background: The Covid-19 disease was raised as a fundamental public health problem worldwide, and nurses were exposed to many problems and challenges at the front line of fighting this disease. Therefore, the present study aimed to explain the experiences of nurses who took care of Covid-19 patients. Materials and Methods: This study was a conventional content analysis qualitative study using Granheim and Lundman approach. The study participants included 20 nurses working in Corona referral hospitals in Isfahan, Iran. Participants were selected using purposive sampling and in-depth semi-structured interviews were conducted from September 2020 to March 2021. To assess the trustworthiness of the obtained data, credibility, dependability, confirmability, and transferability criteria were used. Results: Data analysis led to the production of 700 primary codes, 15 sub-sub-categories, 5 sub-categories and 2 main categories. These two main categories consisted ofpsychological reactions and organizational challenges. Negative emotional experiences and positive emotional experiences were placed in the category of psychological reactions and expectations from superiors, lack of facilities and resources and insufficient quality of care in the category of organizational challenges. Conclusions: The results of the present study showed that managers and policy- makers should prioritize the nursing empowerment to ensure effective epidemic fight and the psychological and financial support of Covid-19 ward nurses. [ABSTRACT FROM AUTHOR]