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Exploring the barriers of utilizing theoretical knowledge in clinical settings: A qualitative study

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International Journal of Nursing Sciences 2019年第4期6卷 399-405页

作者： Mina Hashemiparast Reza Negarandeh Dimitrios Theofanidis department of Public Health Maragheh University of Medical SciencesMaraghehIran Nursing and midwifery Care Research Center School of Nursing and MidwiferyTehran University of Medical SciencesTehranIran Nursing department School for HealthATEITHGreece

Objectives: Although effective performance in clinical settings requires the integration between theory and practice,there is a gap between theoretical knowledge as taught in the classroom and what the students experience in clinical settings.This study aimed to elicit and explore the barriers of utilizing theoretical knowledge in clinical settings.Methods: A qualitative study was adopted with a conventional content analysis approach.Fifteen nursing and paramedic's students,faculty members and experienced nursing staff participated in the study.Data were collected by semi-structured individual interviews until data saturation and concurrently analyzed via MAXQDA 10.Results: Five main categories emerged as barriers of utilizing theoretical knowledge in the clinical settings i.***.non-standard practices in clinical settings;lack of trust in clinical competence;lack of perceived professional support;insufficiencies in teaching and learning process;and differences between doing things in simulated and real clinical situations.Conclusion: Transferring theory into practice in a structured manner requires professional support in the workplace,trust and the opportunity for direct experience,using valid and up-to-date knowledge by clinical staff and bridging the simulated situations with real life scenarios.

关键词： Clinical competence Medical education Knowledge Practice Qualitative research Transfer

Axial length and anterior chamber indices in elderly population: Tehran Geriatric Eye Study

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International Journal of Ophthalmology(English edition) 2023年第11期16卷 1876-1882页

作者： Hassan Hashemi Samira Heydarian Alireza Hashemi Mehdi Khabazkhoob Noor Research Center for Ophthalmic Epidemiology Noor Eye HospitalTehran ***Iran department of Rehabilitation Science School of Allied Medical SciencesMazandaran University of Medical SciencesSari ***Iran Noor Ophthalmology Research Center Noor Eye HospitalTehran ***Iran department of Basic Sciences School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehran ***Iran

AIM:To determine the normative distribution of axial length(AL),anterior chamber depth(ACD),anterior chamber volume(ACV),anterior chamber angle(ACA),and some of their associated factors in subjects aged 60 and over.METHODS:In this cross-sectional study,160 clusters were sampled using multi-stage cluster sampling in Tehran,Iran.After a preliminary interview,the participants underwent optometric examinations including visual acuity and refraction measurement followed by slit lamp biomicroscopy.Finally,ocular imaging was done using the Pentacam AXL to measure AL,ACD,ACV,and ACA.RESULTS:A total of 4519 eyes of 2436 participants were evaluated,of whom 58.0%(n=1412)were female.The mean age of the subjects was 67.32±6.05y(range:60-95y).The mean AL,ACD,ACV,and ACA was 23.22 mm(23.18-23.27 mm),2.61 mm(2.59-2.62 mm),126.56 mm3(125.08-128.04 mm3),and 30.61°(30.3°-30.92°),respectively.In the multivariable model,after adjusting for the effect of both eyes,the longest and shortest AL was seen in myopic and hyperopic subjects,respectively.AL,ACD,ACV and ACA were significantly larger in men compared to women(P<0.001).Except ACA,other evaluated parameters showed an inverse correlation with age(P<0.001),however,this correlation was insignificant for AL(P=0.623).CONCLUSION:Normative value of AL,and other biometric parameters are specific for each ethnicity,age and sex group.Any alteration in these parameters and their effect on refraction should be considered in this age group,especially in case of cataract surgery.

关键词： biometry elderly axial length anterior chamber depth

Normal Range of Head-to-body Delivery Interval by Two-step Delivery

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Chinese Medical Journal 2016年第9期129卷 1066-1071页

作者： Hong-Yu Zhang Ren-Fei GUO Yan Wu Yi Ling department of midwifery Hainan Medical University Haikou Hainan 571119 China department of Obstetrics Haikou Maternal and Child Hospital Haikou Hainan 571101 China

Background： The one-step method was routine practices in China, scientific evidence to support this intervention is scarce. The purpose of this study was to observe the natural process of head-to-body delivery interval by waiting for at least one contraction （two-step） after head delivered in normal birth. Methods： From March 1 to March 30 in 2015 at Haikou Maternal and Child Hospital in China, normal vaginal birth with normal baby condition were recorded by video. Videotapes were transferred to computer then replayed and observed. Results： Ninety-two cases were enrolled in this study. The average head-to-body delivery interval by two-step delivery was 71.04± 61.02 s, （mean ＋ 2 standard deviation - 193.07 s, 95% confidence interval [15.65-229.15] s）. Fifty-one patients （51/92, 55.43%） were 〈60 s, 41 patients （41/92, 44.57%） were over 60 s. Shoulders delivered at the first contraction were 96.74% （89/92）, 3.26% （3/92） had delivered by the second contraction. Shoulders emerged from perineum were 71.73% （66/92）, 15.21% （14/92） transversely, and 13.04% （12/92） emerged from under pubic arch. Babies cried before the shoulder were 31.52% （29/92）, cried after birth 52.17% （48/92）, and 16.30% （15/92） did not cry after birth. Baby activities included as making faces, sucking, and bubbled from mouth and noses, and the lighter blue color of skin with good perfusion. Conclusions： The average time of head-to-body delivery interval was longer than 60 s by two-step delivery. Majority shoulders were delivered at the first contraction. Majority shoulders emerged from perineum rather from under pubic arch. The routine one-step method of shoulder delivery where the downward force applied is not necessary and is not the right direction. Baby＇s breath, making faces, sucking, bubble from noses and mouth, and the light blue color of the faces, all those signs during shoulder delivery indicated a normal live birth.

关键词： Head-to-body Delivery Interval Neonatal Asphyxia One-step Delivery Two-Step Delivery

Evidence-Based Practice among Critical Care Nurse’s/Midwives in Qatar

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Open Journal of Nursing 2022年第1期12卷 42-59页

作者： Badriya Al-Lenjawi Jibin Kunjavara Nesiya Hassan Kamaruddeen Mannethodi Ederlie Martinez George V. Joy Kalpana Singh department of Nursing and midwifery Research Hamad Medical Corporation Doha Doha Qatar

Background: Successful implementation of evidence-based research into clinical practice was determined by four core elements, self-belief, the nature and level of evidence, the conductive context into which the study is to be implemented, and organizational factors facilitating the process. Aim: The current study aimed to examine barriers influencing evidence-based practice among critical care nurses in QATAR. Methods: A cross-sectional survey was utilized for the study resulting in data collected from 278 nurses during the period of Feb-2021 to March 2021 using the Barriers to Research Utilization Scale (BTRUS). The BTRUS consisted of data on various information sources utilized by nurses for support in practice, potential barriers for evidence-based practice, and perceived skills on applying research-based evidence. Result: The most significant organizational barriers were lack of time, lack of empowerment to change practice, lack of support from colleagues in implementing research evidence, and lack of access to research articles. Self-perceived barriers were irrelevance of research evidence to current practice, studies having methodological flaws, skepticism about research findings, a large amount of research evidence, and inability to understand statistics. The Nurse’s age, years of nursing practice, academic attainment, and organizational position influenced self-reported barriers and utilization of sources of Evidence. Conclusion: Organizational support, improved self-belief, and evidence-based practice expertise may reduce barriers to implementing research evidence in clinical Practice.

关键词： EBP—Evidence Based Practice CNS/CMS—Clinical Nurse/Midwife Specialists

基于自我调节常识模型的健康教育对高血压患者血压和自我管理的影响

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International Journal of Nursing Sciences 2023年第3期10卷 294-301页

作者： Zohre Kordvarkane Khodayar Oshvandi Younes Mohammadi Azim Azizi Student Research Committee School of Nursing and MidwiferyHamadan University of Medical SciencesHamadanIran School of Nursing and midwifery Hamadan University of Medical SciencesHamadanIran department of Epidemiology School of Public HealthHamadan University of Medical SciencesHamadanIran Member of Chronic Diseases(Home Care)Research Center School of Nursing and MidwiferyHamadan University of Medical SciencesHamadanIran

目的本研究旨在确定基于自我调节常识模型(Common-Sense Model of Self-regulation)的健康教育对高血压患者的血压和自我管理的影响。方法本研究为随机对照临床试验,于2021年4月至2022年3月选取72例转诊到伊朗哈马丹省法尔希奇扬医院门... 详细信息

目的本研究旨在确定基于自我调节常识模型(Common-Sense Model of Self-regulation)的健康教育对高血压患者的血压和自我管理的影响。方法本研究为随机对照临床试验,于2021年4月至2022年3月选取72例转诊到伊朗哈马丹省法尔希奇扬医院门诊的高血压患者为研究对象,随机分为干预组(n=36)和对照组(n=36)。干预组患者接受基于自我调节常识模型的培训项目,为期1个月,共5次,每次30~45 min,每3 d进行1次电话随访。对照组接受常规健康教育。在干预前、干预后3个月,护士测量患者血压,采用自我管理问卷对患者进行调查,比较两组的干预效果。结果共有68例患者完成研究。在干预前,两组患者的自我管理得分及其维度得分、收缩压、舒张压和平均动脉压差异无统计学意义(P>0.05)。干预后3个月,与对照组相比,干预组患者的收缩压[(116.21±14.52)mmHg比(128.62±16.88)mmHg,1 mmHg=0.133 kPa]和平均动脉压[(88.03±8.47)mmHg比(98.11±11.69)mmHg]水平下降,自我管理问卷总得分及其各维度得分均提高,且高于对照组(P<0.05)。结论基于自我调节常识模型的健康教育改善了高血压患者的自我管理水平,患者血压得到控制,护士可将其作为一种有效的健康教育模式。

关键词：健康教育高血压伊朗护士病人

Effects of cinnamon on perineal pain and healing of episiotomy: a randomized placebo-controlled trial

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Journal of Integrative Medicine 2014年第4期12卷 359-366页

作者： Azam Mohammadi Sakineh Mohammad-Alizadeh-Charandabi Mojgan Mirghafourvand Yousef Javadzadeh Zahra Fardiazar Fatemeh Effati-Daryani Students Research Committee Faculty of Nursing and Midwifery Tabriz University of Medical Sciences Iranian Center for Evidence Based Medicine Tabriz University of Medical Sciences midwifery department Faculty of Nursing and Midwifery Tabriz University of Medical Sciences department of Pharmaceutics Faculty of Pharmacy Tabriz University of Medical Sciences Women Reproductive Health Research Center Tabriz University of Medical Sciences

BACKGROUND： Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area. OBJECTIVE： The aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： In this double-blind, randomized, placebo-controlled trial, 144 postpartum women were allocated into two groups, using stratified block randomization, 1 h after completion of episiotomy repair. They received cinnamon or placebo ointment, 2 mL every 12 h for 10 d. MAIN OUTCOME MEASURES： Perineal pain and wound healing were assessed using visual analogue scale （0-10）and Redness, Edema, Ecchymosis, Discharge, Approximation scale （0-15）, respectively. General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratified factors. RESULTS： Follow-up rate was 100% up to the 8 h time point in both groups, and 86% （62 of 72） in the cinnamon group and 85% （61 of 72） in the placebo group at day 10-11 after delivery. Pain score in the cinnamon group was significantly lower than that in the placebo group at （4±1） h （adjusted difference： -0.6, 95% confidence interval： -1.0 to -0.2） and （8＋1） h （-0.9, -1.4 to -0.3） after intervention, and on the 10-11th day after delivery （-1.4, -2.0 to -0.7）. Also the cinnamon group showed significantly more improvement than the control group in healing score at （8±1） h （-0.2, -0.4 to -0.04） and the 10-11th day after delivery （-1.6, -2.0 to -1.1）. CONCLUSION： Cinnamon can be used for reducing perineal pain and improving healing of episiotomy incision.

关键词： Cinnamomum zeylanicum episiotomy postpartum period pain wound healing randomized controlled trial

Use of complementary and alternative medicine in general population during COVID-19 outbreak: A survey in Iran

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Journal of Integrative Medicine 2022年第1期20卷 45-51页

作者： Mahlagha Dehghan Alireza Ghanbari Fatemeh Ghaedi Heidari Parvin Mangolian Shahrbabaki Mohammad Ali Zakeri Nursing Research Center Kerman University of Medical SciencesKerman 76169-13555Iran Anesthesiology and Critical Care Research Center Shiraz University of Medical SciencesShiraz 14336-71348Iran Faculty of Nursing and midwifery Isfahan University of Medical SciencesIsfahan 81746-73461Iran Non-communicable Diseases Research Center Rafsanjan University of Medical SciencesRafsanjan 77179-33777Iran Social Determinants of Health Research Center Rafsanjan University of Medical SciencesRafsanjan 77179-33777Iran department of Critical Care Nursing Faculty of Nursing and MidwiferyKerman University of Medical SciencesKerman 76169-13555Iran

Objective: Some epidemic diseases such as coronavirus disease 2019(COVID-19) have caused many physical, psychological, and social challenges, despite the existence of treatment strategies. Many people are looking for complementary and alternative medicine(CAM) to prevent such diseases. The present study was performed to determine how some types of CAM were being used during the COVID-19 epidemic in Iran.Methods: The present study had a cross-sectional descriptive correlational design. All Iranian residents above 17 years old were eligible to participate in the study. A total of 782 participants completed a demographic information questionnaire, a questionnaire about their use of CAMs and a questionnaire about their satisfaction with the CAMs they used. Web-based sampling was conducted from 20 April 2020 to 20 August 2020.Results: Of the participants, 84% used at least one type of CAM during the COVID-19 outbreak. The most used CAMs were dietary supplements(61.3%), prayer(57.9%), and herbal medicines(48.8%). The majority of the participants(50%–66%) have used CAMs to prevent the transmission of COVID-19 or to reduce anxiety caused by the COVID-19 pandemic. CAM use was associated with sex, having children, place of residence, COVID-19 status, and source of gathering information about CAM(P < 0.05). All 32 participants who had been infected with COVID-19 used at least one type of CAM for treatment or alleviation of the disease symptoms.Conclusion: During the COVID-19 outbreak, some types of CAM, particularly nutritional supplements,medicinal herbs, and prayer, were commonly used to prevent COVID-19 and reduce pandemic-related anxiety.

关键词： Alternative and complementary medicine Coronavirus disease COVID-19 Cross-sectional study

Using preceptors to improve nursing students' clinical learning outcomes: A Malawian students' perspective

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International Journal of Nursing Sciences 2017年第2期4卷 164-168页

作者： Ellemes Phuma-Ngaiyaye Thokozani Bvumbwe Mep Coretta Chipeta Mzuzu University Department of Nursing and MidwiferyP/Bag 201MZUZU 2Malawi

Objective: Clinical environment remains an important aspect in the development of student's compe-tence, confidence and fulfillment of their expected learning outcomes. Preceptors and clinical teachers play a significant role in preparing students to achieve their professional goals through continuous support and resource provision. This study explored the students' perception of using clinical preceptors to improve their clinical learning outcomes.Methods: The researchers used semi structured interviews to collect qualitative data. A total of 48 stu-dents were purposively and conveniently sampled from 8 hospitals to participate in the study. Content analysis was used to analyse the data. Findings: Two themes emerged from the study findings namely: creating a positive clinical learning environment and facilitating academic clinical collaboration. Conclusions: The findings of the study revealed that students gained more confidence and competence in clinical practice when supported by preceptors as well as achieved clinical learning outcomes. These findings suggest the need to train more clinical preceptors for improvement of students' clinical learning outcomes.

关键词： Clinical environment Clinical learning outcome Clinical teaching Preceptor Preceptorship

Circulating tumor cells and circulating tumor DNA in breast cancer diagnosis and monitoring

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Oncology Research 2023年第5期31卷 667-675页

作者： EFFAT ALEMZADEH LEILA ALLAHQOLI HAMIDEH DEHGHAN AFROOZ MAZIDIMORADI ALIREZA GHASEMPOUR HAMID SALEHINIYA Infectious Diseases Research Center Birjand University of Medical SciencesBirjand***Iran midwifery department Ministry of Health and Medical EducationTehran***Iran Student Research Committee Birjand University of Medical SciencesBirjand***Iran department of Health Assistant Shiraz University of Medical SciencesShiraz***Iran Social Determinants of Health Research Center Birjand University of Medical SciencesBirjand32048321Iran

Liquid biopsy,including both circulating tumor cells and circulating tumor DNA,is becoming more popular as a diagnostic tool in the clinical management of breast cancer.Elevated concentrations of these biomarkers during cancer treatment may be used as markers for cancer progression as well as to understand the mechanisms underlying metastasis and treatment resistance.Thus,these circulating markers serve as tools for cancer assessing and monitoring through a simple,non-invasive blood draw.However,despite several study results currently noting a potential clinical impact of ctDNA mutation tracking,the method is not used clinically in cancer diagnosis among patients and more studies are required to confirm it.This review focuses on understanding circulating tumor biomarkers,especially in breast cancer.

关键词： Breast cancer Liquid biopsy Circulating tumor cells Circulating tumor DNA