Monir Mazaheri

Validation and reliability test of Persian version of The Spirituality and Spiritual Care Rating Scale (SSCRS).

Validation and reliability test of Persian version of The Spirituality and Spiritual Care Rating Scale (SSCRS)

Impact of the 26 December 2003 Bam Earthquake on Activities of Daily Living and Instrumental Activities of Daily Living of Older People

INTRODUCTION This study compares self-reported Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) status among elderly survivors of the 2003 Bam Earthquake before, two months after, and five years after the event, and explores related determinants. METHODS A two-stage cluster survey was conducted on 210 elderly survivors in the earthquake-stricken area five years after the event. RESULTS Both ADL and IADL scores decreased two months after earthquake compared to prior status (p <0.001). No differences were observed between two months and five years after the event (p >0.05). Access to medical services were not related to level of ADL or IADL (p = 0.52 and p = 0.74, respectively). Elderly survivors with lower functional capability in terms of ADL experienced more problems in access to relief items (p = 0.04), but no similar association was found for IADL (p = 0.26). CONCLUSION The Bam earthquake adversely affected functional capacity of the elderly. Disaster responders must take into account functional capacity of elders when planning for medical and relief operations.

Difficulties in Recruiting Participants for a Research Study on Immigrant Dementia Caregiver: Challenges in Conducting Research with a Culturally Diverse Population

Difficulties in recruiting participants for a research study on immigrant dementia caregivers : Challenges in conducting research with a culturally diverse population.

Experiences of dementia in a foreign country: qualitative content analysis of interviews with people with dementia

BackgroundDementia is a worldwide health concern of epidemic proportions. Research in the field of subjective experience of dementia suffers from a lack of diversity of their participants including immigrants. Different portraits of life with dementia could help us understand how people with dementia conceptualise their experiences of dementia and how they live. Our study aimed to explore the subjective experiences of living with dementia among Iranian immigrants in Sweden.MethodsQualitative content analysis of interviews with fifteen people with dementia from Iranian immigrant backgrounds were conducted (8 females and 7 males).ResultsThree themes and seven associated sub-themes were revealed. The themes included: Being a person with dementia means living with forgetfulness (personal sphere), living with forgetfulness in the private sphere means feeling incompetent but still loved, living with forgetfulness in the public sphere means feeling confident and secure but also isolated.ConclusionsLiving with dementia for the participants meant living with forgetfulness. They experienced feeling incompetent but still loved within their families and feeling confident and secure but also isolated in the society. Educating people with dementia and their families about the course and process of dementia may help them understand the changes better and adjust their expectations. Our study can provide a basis for healthcare workers to understand the experiences of living with dementia from this specific perspective.

Thai Nurses’ experiences of post-operative pain assessment and its’ influence on pain management decisions

BackgroundWhile many studies have addressed various issues with regards to pain management, there is limited knowledge about how nurses assess pain in surgical wards. This study aimed to describe Thai nurses’ experiences of pain assessment in a surgical ward.MethodsA cross-sectional explorative study was conducted. Participants were selected through theoretical sampling. Data was collected through interviews with twelve registered nurses working in surgical wards. Qualitative content analysis guided the analysis of the data.ResultsNurses use a double/triple check system, communicated to the healthcare team via records and protocols, and they used their skills and experiences in pain assessment. The results showed that nurses missed the opportunity to include the patients’ self-reported pain in their accounts. Though much evidence of pain was collected, this did not seem to benefit the patients. Furthermore, the nurses were not using instruments to measure pain, which illustrates the potential unreliability of professionals who have differing opinions concerning the patients’ pain.ConclusionsThai nurses worked based on a ‘patient-evidence’ paradigm when assessing patients in pain; this should be shifted to an evidence-based paradigm. Furthermore, by including the patients’ self-reported pain in their assessment, nurses would both improve the quality of the pain assessment and empower patients in their pain management. Pain management practices in Thailand should be improved through education, training, supportive innovation, and collegial competence development in order to improve the quality of care in the post-operative field.

Immigrants with dementia in Swedish residential care : An exploratory study of the experiences of their family members and nursing staff

BackgroundWorldwide, there is a growing population of older people who develop dementia in a country other than that of their origin. When their dementia has reached an advanced stage, residential care is most often needed. People with dementia in Sweden are often cared for in group homes. For immigrants, this may mean a linguistically challenging care environment for both healthcare staff and the patients’ family members.The aim of this study was to explore and describe the experiences of family members and professional caregivers regarding the care provided to immigrants with dementia in group homes in Sweden.MethodsAn exploratory, descriptive study with a qualitative approach was chosen. In-depth semi-structured interviews were conducted with nine professional caregivers and five family members of people with dementia with Finnish, Estonian, Hungarian and Ingrian backgrounds; all were chosen purposefully. All people with dementia had lost their Swedish language skills as their second language. The data was analysed using qualitative content analysis.ResultsThree main categories and seven subcategories were identified. The first main category: A new living situation comprised the subcategories: adjusting to new living arrangements and expectations regarding activities and traditional food at the group home, the second main category: Challenges in communication with the subcategories: limited communication between the immigrant with dementia and the Swedish-speaking nursing staff and the consequences of linguistic misunderstandings and nuanced communication in a common language and the third main category: The role of the family member at the group home with the subcategories: a link to the healthy life story of the family member with dementia and an expert and interpreter for the nursing staff.ConclusionsThe family member played a crucial role in the lives of immigrants with dementia living in a group home by facilitating communication between the nursing staff and the PWD and also by making it possible for PWD to access the cultural activities they wanted and which professional caregivers were either not able to recognise as needed or could not deliver.

Clear conscience grounded in relations: Expressions of Persian-speaking nurses in Sweden

Background: Conscience is an important concept in ethics, having various meanings in different cultures. Because a growing number of healthcare professionals are of immigrant background, particularly within the care of older people, demanding multiple ethical positions, it is important to explore the meaning of conscience among care providers within different cultural contexts. Research objective: The study aimed to illuminate the meaning of conscience by enrolled nurses with an Iranian background working in residential care for Persian-speaking people with dementia. Research design: A phenomenological hermeneutical method guided the study. Participants and research context: A total of 10 enrolled nurses with Iranian background, aged 33–46 years, participated in the study. All worked full time in residential care settings for Persian-speaking people with dementia in a large city, in Sweden. Ethical considerations: The study was approved by the Regional Ethical Review Board for ethical vetting of research involving humans. Participants were given verbal and written study information and assured that their participation was voluntary and confidential. Findings: Three themes were constructed including perception of conscience, clear conscience grounded in relations and striving to keep a clear conscience. The conscience was perceived as an inner guide grounded in feelings, which is dynamic and subject to changes throughout life. Having a clear conscience meant being able to form a bond with others, to respect them and to get their confirmation that one does well. To have a clear conscience demanded listening to the voice of the conscience. The enrolled nurses strived to keep their conscience clear by being generous in helping others, accomplishing daily tasks well and behaving nicely in the hope of being treated the same way one day. Conclusion: Cultural frameworks and the context of practice needed to be considered in interpreting the meaning of conscience and clear conscience.

The effect of weight monitoring and recording on control of obesity and overweight.

BACKGROUND: Obesity is one of the dilemmas of the recent century and imposes huge costs related to its complications and diseases on people and societies. This study aims to investigate whether recording and monitoring weight and its changes can modify eating habits and therefore weight control. METHODS: This is a quasi-experimental interventional study. Seventy nine of the staff of the University of Social Welfare and Rehabilitation (USWR) were randomly placed in two intervention (N=40) and control (39) groups. A standard weight scale and height meter was used to measure weight, height and body mass index (BMI). For the intervention group, weight was measured, recorded and announced to the participants twice a week for 3 months. For the control group, weight measurement and recording was done once in the beginning of the study and once at the end of the study. Data were analyzed using SPSS ver.11.5 and compared between groups. RESULTS: There were no significant differences in the average age between the groups. Mean pre-intervention weight was 87.08±10.9 Kg and 85.83±16.44 Kg in the intervention and control groups, respectively and was not significantly different. Mean post-intervention weight was 83.5 Kg in the intervention group, which was significantly different from pre-intervention weight. Mean post-intervention weight was 86.31 Kg in the control group that was not significantly different from pre-intervention weight. CONCLUSION: Recording and monitoring weight and its changes in overweight people can affect weight control since knowledge and insight about weight may motivate people to modify their eating habits. We therefore recommend this strategy as an adjuvant to weight control programs.

Meanings of troubled conscience and how to deal with it: expressions of Persian-speaking enrolled nurses in Sweden

INTRODUCTION A feature of the healthcare system in Sweden, particularly in the care of older people, is its cultural diversity in terms of having considerable numbers of both caregivers and care recipients with an immigrant background. Considering the influence of culture in ethical decision-making processes, the idea of conscience and the adverse effects of a troubled conscience, it is important to study the concepts of conscience and troubled conscience in culturally diverse populations. There is no published study regarding troubled conscience among immigrant populations that includes enrolled nurses. AIM To illuminate the meanings of troubled conscience and how to deal with it among enrolled nurses with Iranian backgrounds working in Swedish residential care for Persian-speaking people with dementia who have emigrated from Iran. METHOD The study was conducted with a phenomenological hermeneutic design. Ten enrolled nurses with an Iranian background, with at least one years experience of taking care of older people with dementia, were interviewed. The study was reviewed by the Regional Ethical Review Board for ethical vetting of research involving humans. Appropriate measures were taken to ensure confidentiality and voluntary participation. RESULTS The meanings of having a troubled conscience for the participants comprise not being a good person, including being an uncaring person, not acting according to ones values and living in a state of unease. Dealing with a troubled conscience involves trying to compensate for the harm one has caused and trying to prevent similar situations by being a responsible caregiver. CONCLUSIONS The enrolled nurses understood themselves as caring people and not only caregivers. They knew that they should hear their conscience and respond to it by trying to be a caring person and acting according to their values. The findings should be interpreted in the given specific context.

Engagement and availability in shaping nurses’ management of postoperative pain: a qualitative study

Background Studies reporting inadequate nursing care for patients indicate that nurses are negatively affected in such situations, and research is needed to study nursing care in postoperative situations. Objective To describe situations of postoperative pain management in a surgical ward in Thailand. Methods A qualitative approach using the Critical Incident Technique was chosen to investigate situations of postoperative pain management from the perspective of surgical nurses in Thailand. Data were collected through multiple semi-structured interviews with nine nurses over a five-week period. Results The situations of surgical nurses described three elements that heavily influenced the quality of postoperative pain management: engagement in a trustful nurse-patient relationship, availability of pain medication and nursing care when needed, and imbalance between meeting the patient’s needs and completing routine nursing duties. Conclusion The results help to expand our understanding of how Thai nurses manage pain in postoperative situations and indicate areas that could be improved in terms of how nurses respond to patients’ pain. Nurses challenge existing guidelines and facilitate development of new nursing guidelines and/or policies in pain management.