Journal of Client-Centered Nursing Care
Year:2025 | Volume:11 | Issue:1|Papers Count:8

Hospital-acquired pressure injuries are among the preventable complications in healthcare settings. Patients and their caregivers should be encouraged to actively participate in the prevention and treatment of these ulcers and follow evidence-based guidelines to improve healthcare outcomes and the safety of the patient. This requires that healthcare professionals support the education of preventive measures.

Background: Physical restraint (PR) is one of the most common methods nurses use to reduce patient movement, especially in intensive care units (ICUs); however, PR is considered one of the undesirable methods due to its related clinical and ethical issues. This study investigates Jordanian nurses’ knowledge, attitudes, and practices regarding using PR, its alternatives in different ICUs, and its associated factors.  Methods: This was a descriptive-cross-sectional study, conducted in the ICUs of four different hospitals in Jordan from October 2023 to March 2024. A convenience sample of 240 ICU nurses was recruited to fill out a self-administered PR questionnaire. The data were analyzed using an independent sample t-test, analysis of variance, and the Pearson correlation coefficient using the SPSS software, version 25. All conducted tests were two-tailed and considered significant when the P<0.05.  Results: The results revealed moderate knowledge (11.1±2.46), positive attitude (27.04±3.35) and good practice (37.19±3.33) regarding the use of PR. Receiving training on the use of PR had a direct significant relationship with the use of alternative methods before PR in the patients (P<0.001) and the total practice score (P=0.049). The presence of PR as part of the new hire orientation program and the number of times of using PR had a significant association with the use of alternatives before PR for the patients (P<0.0001 and P=0.043, respectively). In terms of total knowledge (P=0.01), use of alternatives (P=0.025) and practice (P<0.001) regarding the use of PRs, accredited hospitals were at a higher level, but the difference in nurses’ attitudes was not significant (P=0.839). There was a significant difference in terms of total alternatives (P=0.016), attitude (P<0.001), and practice (P=0.02) depending on the type of ICU. There were other significant relationships between the main variables among which the relationship between total knowledge and total practice (r=0.434, P<0.01), and total use of alternatives and total practice (r=0.43, P<0.01) were more powerful. Conclusion: The current study indicates variations in nurses’ knowledge levels, attitudes, and practices across different ICUs and hospital types. These findings emphasize the importance of in-service education as a golden role in improving nurses’ knowledge levels and practices toward PR. The journey to accreditation in the management of hospitals by nursing managers and policymakers has a positive impact on improving nursing knowledge and skills regarding PR application and enhancing patient safety and care outcomes.

Background: In India, 26 million children are born every year. These children (0-6 years) comprise 13% of the country’s population. Undernutrition is a fallout of malnutrition, malabsorption, and nutritional imbalance which causes a problem of being underweight in children. It can affect a child’s brain development and other developmental milestones. This study is designed to understand the role of Anganwadi Centers (AWCs) (community day-care centres) and women’s access to internet in reducing the undernutrition in children.  Methods: It was a retrospective cross-sectional study which was conducted during 2023-2024. The study population consisted of 724,115 Indian women in the age group of 15-49 years. We used anonymized, publicly available secondary data from the India National Family Health Survey (NFHS-5). The NFHS5 survey was carried out from the year 2019 to 2021. Information on various parameters was collected using a predesigned questionnaire. Statistical analysis including Pearson correlation coefficient analysis, simple linear regression and multiple linear regression analysis were carried out for independent variables including percent of operational AWCs and percent of women with internet access, and dependent variable (percent of underweight children per state). Statistical analysis of the data has been done by social science statistics tools. The significance level of 0.05 was considered for analysis. Results: The states or union territories (UTs) with lower number of AWCs had a higher percentage of women with Internet access as compared to UTs with more AWCs. Multiple linear regression for independent variables (operational AWCs, and women with internet access), and dependent variable (underweight children per state) was developed. It was shown that β0=37.1607; β1 (AWCs)=0.5659; and β2 (internet access)=-0.2907 and R squared value as 0.5709. This shows that independent variables have a significant influence on the number of underweight children in the state. Results of the Pearson correlation indicated that there is a significant large negative relationship between women’s access to Internet and the percentage of underweight children in the state, (r (34)=-0.733, P<0.001), meaning that with an increase in internet access for women the percentage of underweight children decreases. Conclusion: The study clearly shows that when compared, community daycare centers (AWCs) have a limited role in the child’s nutrition, but women’s Internet access can be a determinant of the child’s nutrition. Women’s access to the Internet can help reduce the number of underweight children under five and improve overall maternal and child health as well as public health.

Background: One of the aspects affecting the quality of life (QoL) of the older adults is sleep quality. Hospitalized older adults may experience a poor quality of sleep due to one or more diseases and their related disabilities. This study determines the predictive role of disability and comorbidities in the sleep quality of hospitalized elderly patients. Methods: This cross-sectional, correlational study was conducted on 300 hospitalized older adults admitted to the teaching hospitals affiliated with Qazvin University of Medical Sciences, Iran, in 2023. The subjects were recruited via convenience sampling. The data were collected using the demographic characteristics form, the Pittsburgh sleep quality index, the World Health Organization (WHO) disability assessment schedule 2.0 and the Charlson comorbidity index. They were analyzed using the chi-square test or the Fisher exact test, independent t-test, and binary logistic regression in the SPSS software, version 26. In addition, the statistical significance was set at P<0.05. Results: The Mean±SD sleep quality, disability and comorbidity scores were 6.12±2.99, 23.36±9.20 and 1.15±0.37, respectively. Half of the older adults (50%) had poor sleep quality. There was a significant relationship between the sleep quality scores and all domains of disability (P<0.05) except for participation and life activities (P≥0.05). The results of the logistic regression model showed that disability (odd ratio=1.044, P<0.004) and comorbidities (odd ratio=2.078, P<0.044) were predictors of sleep quality in hospitalized older adults. No significant relationship was observed between sleep quality and gender, education, smoking, and non-opioid analgesics in multivariate regression analysis. Conclusion: Disability and comorbidities are important predictors of sleep quality in hospitalized older adults; therefore, it is necessary to consider effective interventions to minimize hospitalization-associated disability and to help improve the sleep quality of older adults.

Background: Having a child with autism causes depression, anxiety, and distress in the parents. Accordingly, this study investigates the effect of Benson relaxation response on the anxiety of mothers of children with autism spectrum disorder (ASD).  Methods: It was a quasi-experimental study with pretest-posttest design and a control group. The subjects were 100 mothers with autistic children admitted to Shahid Zolfaghari Autism Support Center located in Tehran, Iran in 2023 who were selected using convenience sampling and were randomly assigned into two intervention and control groups (each with 50 participants). Participants in groups of 5-6 received Benson's relaxation method in eight steps. The steps were repeated until all groups had acquired the required skill. Then the subjects were asked to repeat this intervention twice a day for 30 days. The posttest was done after 30 days of relaxation sessions at home in both groups. The data were collected using the Beck Anxiety Inventory (BAI) and analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (analysis of covariance (ANCOVA) and Paired difference t-test) in SPSS software, version 26. The significance level was set at P<0.05).  Results: The findings showed no statistically significant difference between the mean anxiety scores of the mothers in the intervention group (31.26 ±4.58) and the control group (32.14 ±4.57) before the intervention (p-value > 0.05). However, after the intervention, a statistically significant difference was observed between the mean anxiety scores for the mothers in the intervention group (25.38 ±6.01) and the control group (33.04 ±4.41) (t=5.73; P=0.001). Also after controlling the effect of covariates, the participants’ anxiety scores after the intervention showed a statistically significant difference (F=52.76, p=0.001).  Conclusion: The Benson relaxation response was effective in reducing the anxiety of mothers of children with ASD. Thus, psychiatric nurses and mental health professionals can use Benson relaxation response along with other treatments to improve the anxiety of mothers of children with ASD.

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Accordingly, this study investigates the effect of oral capsules of cinnamon extract on the metabolic profile and hormonal status of women with PCOS. Methods: This blinded randomized clinical trial was performed on 66 women with PCOS referred to the gynecology and infertility clinics in Tehran City, Iran from 2016 to 2017. Eligible women were randomly allocated into intervention (n=33) and placebo (n=33) groups. The oral capsule of 3 g cinnamon extract was taken once a day for 12 consecutive weeks by the intervention group and the placebo capsule was given in the same way to the control group. Before and 12 weeks after starting the intervention, blood tests were performed to measure fasting blood sugar (FBS), fasting insulin (FI), triglycerides (TG), total cholesterol, low-density lipoprotein, high-density lipoprotein, total testosterone (TT), and sex hormone binding globulin (SHBG). The student t-test, paired t-test, chi-square test, and analysis of covariance were used to compare groups using the SPSS software, version 16. Meanwhile, P<0.05 were considered significant. Results: Consumption of cinnamon extract only leads to a significant decrease in TT level compared to placebo (P=0.001), and has no significant effect on FBS, FI, TG, total cholesterol, low-density and high-density lipoprotein cholesterol, SHBG, and free androgen index (FAI). Conclusion: Cinnamon extract at a dose of 3 g/day for 12 consecutive weeks could decrease TT in women with PCOS, and had no significant effects on metabolic and hormonal indicators in these women. Nevertheless, it is suggested that more studies be conducted with a larger sample size and various doses of cinnamon.

Background: Patients undergoing bariatric surgery may need much more psychological and social support from their family and friends to maintain weight loss, recover, and cope with social appearance anxiety. This study determines the relationship between perceived social support (PSS) and social appearance anxiety (SAA) after bariatric surgery. Methods: This descriptive, correlational study was conducted between October and December 2022 in Turkey through voluntary response sampling technique. A total of 121 bariatric surgery patients generated the sample. The multidimensional scale of perceived social support (MSPSS) and the social appearance anxiety scale (SAAS) were used for data collection. Descriptive statistics, Mann Whitney U and Kruskal Wallis tests were performed to analyze the data. Statistical Package for the social sciences for Windows version 21.0. was used for data analysis. A p value <0.05 was considered statistically significant. Results: The average total score of perceived social support of the patients was 60.28±19.62 and the mean scores of family, friends, and significant others regarding the source of the support were 24.88±7.19, 19.70±7.06 and 18.69±8.69, respectively. The average total score of social appearance anxiety was 38.53±16.95. There was a statistically non-significant negative correlation between total scores of perceived social support and social appearance anxiety (ρ: -0.102 P: 0.27). The social appearance anxiety total score differed according to gender, preoperative, and postoperative body mass index (P<0.05).  Conclusion: The results showed that PSS does not affect SAA after bariatric surgery. Multicenter studies with more homogeneous samples in terms of time elapsed after bariatric surgery are recommended.

Background: After cancer diagnosis, death anxiety continuously challenges the patient's life. Individuals diagnosed with cancer are forced to think of and confront the end of their lives. The present research was conducted to determine the effect of paradox therapy (PTC) on death anxiety of female patients with cancer. Methods: This research was a quasi- experimental study with a pretest- posttest control group design. The statistical population consisted of all female patients with cancer, referring to a specialized cancer treatment center in Ahvaz province, Iran, from January 21 to February 19, 2023 who were first recruited by convenience sampling based on inclusion criteria and then were randomly assigned into experimental (n=26) and control (n=26) groups. The data were collected using death anxiety scale (DAS). The experimental group received 6 sessions of  individual, face-to- face paradox therapy (PTC). The duration of each session was 45 minutes. The dependent variable was assessed at three distinct time points: initially at the pre-test phase, subsequently upon the conclusion of the psychotherapy intervention, and finally, one month following the termination of psychotherapy. Data analysis was done using descriptive statistics and to test the research hypothesis, mixed analysis of variance was used in SPSS-25 software. The significance level was set at P < 0.05.  Results: A significant effect of time on death anxiety scores was observed (F=169.77, P<0.0001). Post hoc analysis revealed significant differences in the mean death anxiety scores across the pretest, posttest, and follow-up assessments. Additionally, a significant interaction between time and treatment group was noted (F=153.58, P<0.0001). According to the Bonferroni test, the experimental group exhibited a significant reduction in death anxiety at posttest compared to pretest (P<0.0001), and this reduction persisted at follow-up stage (P<0.0001). Moreover, death anxiety continued to decrease from posttest to follow-up. These results supported the study hypothesis. Conclusion: By elevating our understanding of the effect of PTC on death anxiety in cancer patients, the current research has tried to fill a major gap in psychosocial oncology. Perceiving the long-term effect of PTC can lay the groundwork for following care plans and long-term support for cancer patients.