Showing 7 results for Khoddam
Atharalsadat Mirkarimi, Homeira Khoddam, Mohammad Ali Vakili, Mohammad Bagher Sadeghi , Mahnaz Modanloo,
Volume 13, Issue 1 (6-2016)
Abstract
Background: Hypertension is a risk factor for many diseases. Nutritional methods are considered as major tools in lifestyle modification for lowering blood pressure. The present study was conducted to determine the level of dietary adherence in hypertensive patients.
Methods: This descriptive-analytical study was performed in 2015, on hypertensive patients who were referred to Heart Clinic of Sayyad Shirazi Hospital in Gorgan. Overall, 200 patients (62% female) were selected by purposive sampling. The dietary adherence was evaluated in five following groups of salt-, fat-, fruit-, vegetables- -and dairies-intake through daily completion of data collection form within two weeks. This form was designed by the researchers and its validity and reliability were tested in a pilot study. Data were analyzed using Mann-Whitney, Chi-square, and logistic regression analysis tests.
Results: The mean and standard deviation (SD) of age of patients was 48.6±7.51 years. Mean and SD of systolic and diastolic blood pressure in patients were 152.31±9.1 and 93.53±2.87 mmHg, respectively. The results showed that 7% of patients had complete dietary adherence, 66.5% had poor adherence, and rest of the subjects had average dietary adherence. The highest level of dietary adherence was observed in the case of diaries intake (43.5%) and the lowest was related to fruit intake (3.5%).
Conclusion: Given the importance of dietary adherence in controlling hypertension and lack of dietary adherence in hypertensive patients, it is recommended to conduct further studies to identify factors affecting dietary adherence and implement necessary interventions to improve this issue in patients.
Jamileh Mirzaali, Mohammadali Vakili, Homeira Khoddam,
Volume 17, Issue 1 (4-2020)
Abstract
Background: One of the important criteria in patients receiving artificial respiration is the time of weaning from the mechanical ventilator. As physician’s decision might be somehow subjective, several tools have been suggested for prediction of the time of weaning more objectively. This study aimed to determine the predictive value of Persian Weaning Tool (PWT) compared with Physician- directed approach as the gold standard.
Methods: This diagnostic accuracy study was done in 2016-2017 in Two Medical and Educational Centers of Gorgan, Iran. 97 admitted patients in intensive care units, under mechanical ventilation were evaluated. The patients were recruited into the study by a convenience sampling method and evaluated for readiness to wean using two approaches (physician’s decision and using PWT). Successful weaning was considered as the ability of patient to breathe spontaneously during the first 48 hours after weaning. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR), as well as the agreement (kappa coefficient) between the two approaches, were calculated. In addition, to compare the differences between variables in two groups, chi-Square, T and man-Whitney tests were used. All analyses were performed using SPSS software ver.16, and MedCalc program ver.13. P<0.05 was considered as statistically significant.
Results: Most patients (64.9%) were men. The mean age, duration of hospital admission, and duration of mechanical ventilation of the participants were 46.49±18.15 years, 67.11±7.14 days, and 31.5±2.5 days, respectively. Weaning was successful in 87.6% of the patients. PWT had a significant agreement with the physician’s choice (kappa coefficient=0.637, P<0.001) with sensitivity, specificity, PPV, NPV, PLR, and NLR of 100%, 50%, 93.4%, 100%, 2, and 0, respectively. The cut-off level of 53 was considered as the best point to improve the diagnostic accuracy to 92.94%, 75%, 96.3%, 60%, 3.72, and 0.094, respectively.
Conclusions: Findings showed that PWT is an accurate tool for predicting the readiness of patients for weaning objectively. This tool can be used as a complementary approach by physicians and other care providers in intensive care units.
Ghanbar Roohi, Ghahraman Mahmoodi, Homeira Khoddam,
Volume 17, Issue 2 (4-2020)
Abstract
Background: The gap between knowledge and practice is a global issue that reduces service quality by creating barriers to knowledge implementation, and thus strategies should be developed to resolve it. The present study aimed to explain barriers and strategies for implementing knowledge implementation into Iranian health system management.
Methods: This qualitative study was conducted on 53 managers and health management graduates in 2018. Participants were recruited through purposive sampling in Medical Sciences Universities in Iran. Data were collected by semi-structured interviews based on the "Promoting Action on Research Implementation (PARiHS)" framework, focus group discussions and Delphi technique. The PARiHS framework has three main elements including; evidence, context and facilitation. The Lincoln and Guba criterion was used to assess the rigor of the study. Data were analyzed in MAXQDA software version 10 using directional content analysis.
Results: After data analysis 9 subcategories and 3 main categories including; evidence, context, and facilitation were emerged. In addition to three subcategories including, culture, leadership and evaluation, the socio-political subcategory was a context for knowledge implementation main barrier in the organizational context. The systematic structural planning for the combined use of four sources of knowledge is the most important strategy.
Conclusion: The lack of context readiness in using knowledge and lack of efficient system impeded knowledge implementation in the health system management. Therefore, managers and policy makers need to design a comprehensive system based on current knowledge and successful experiences.
Razieh Talebi, Mahnaz Modanloo, Fatemeh Heydari , Neda Mehrdad, Abbasali Keshtkar, Homeira Khoddam,
Volume 19, Issue 1 (1-2022)
Abstract
Background: Despite the expansion of knowledge of neonatal pain assessment and management, there is still a considerable gap between nurses' clinical practices in Iran and available evidence. The aim of this study was to develop an evidence-based protocol for neonatal pain management and to evaluate its effectiveness on nurses' clinical practice.
Methods: The present study will be based on the Johns Hopkins nursing evidence-based practice (JHNEBP) model and the three stages of practice question and project planning, evidence, and translation (PET). In this way, after forming an interprofessional team, clinical practice questions will be defined, and the main stakeholders will be identified. Then, the types, levels, and quality of evidence will be assessed to summarize their final strength using the proposed tools of the model, and finally, recommendations will be developed. In the translation phase, the recommendations will be implemented during a stepped wedge cluster randomized trial, and its implications for nursing practices in the management of pain in hospitalized neonates will be evaluated.
Results: The results of this study will lead to the production of an operational and applicable protocol in the management of pain in hospitalized neonates. It can provide the basis for improving the clinical practice of nurses and subsequently improving the quality of neonatal care.
Conclusion: One of the strengths of this study is the use of an interprofessional team approach, considering the clients' priorities, and the improvement of organizational culture in order to endeavor for knowledge translation and change in clinical practice.
Leila Barati, Sajjad Khatami, Mitra Valizadeh, Homeira Khoddam,
Volume 20, Issue 1 (4-2023)
Abstract
Background: Available evidence on the efficacy of sweet solutions for reducing pain in infants is insufficient. This study aimed to assess the effects of 10% oral dextrose on the pain of infants during venipuncture.
Methods: This randomized controlled clinical trial was done on 60 infants undergoing venipuncture. Eligible infants were randomly assigned into an intervention and control group. Two minutes before venipuncture, 2 ml of 10% oral dextrose solution and 2 ml of water were given to the intervention and control groups, respectively. The infants' pain intensity during the procedure was measured by two independent experts based on the Face, Legs, Activity, Cry, and CONSOL ability Behavioral Pain Scale. Data were analyzed using independent t-test and ANOVA tests. A P-value of ≤0.05 was considered statistically significant.
Results: The mean (±standard deviation) age of infants in the intervention and control groups were 6.37 (2.96) and 9.03 (3.10) months, respectively (P0.05). In addition, the standardized mean difference in pain score between the two groups was -0.2 (95% confidence interval: -0.30 to 0.71). Despite a significant difference (P=0.003) in the pain score between females and males, the effect of intervention after gender effect correction was not statistically significant.
Conclusion: Using 2 ml of 10% oral dextrose 2 minutes before venipuncture has a weak and non-significant effect on the pain of infants. Based on the effect size and 95% confidence interval, conducting further trials with a larger study population is recommended.
Mahnaz Modanloo, Solmaz Halakou, Homeira Khoddam, Nasrin Nikpeyma,
Volume 20, Issue 1 (4-2023)
Abstract
Background: Anxiety is a common experience in patients undergoing surgery. It is one of the major challenges for preoperative health care providers. The aim of this study was to explore the experience of health care providers in taking care of anxious patients under surgery with spinal anesthesia.
Methods: This qualitative content analysis study was conducted at a referral hospital in Gonbad-e-Kavous city, northeastern Iran, between 2020 and 2021. Data were collected through semi-structured individual interviews. The primary focus of this research was to explore the perspective of health care professionals when providing care to nervous patients who are being considered for surgery with spinal anesthesia. The study included 16 health care providers who had experience in caring for anxious patients undergoing surgery with spinal anesthesia. Participants were selected using purposive sampling. Interviews were implemented in MAXQDA 10 software and then analyzed by the conventional content analysis method.
Results: Five main categories and 19 subcategories were extracted from data analysis. The categories included “emergence of anxiety,” “basis of anxiety formation,” “patient advocacy,” “abilities of health care providers,” and “anxiety management factors.”
Conclusion: Health care providers consider patient anxiety as a problem that can be affected by various factors. Different methods are used to manage patients' anxiety, but it is necessary to apply appropriate context-based interventions.
Sepideh Yahyaei, Dr Homeira Khoddam, Dr Seyedmahrokh Alinaghimaddah, Dr Mahnaz Modanloo,
Volume 20, Issue 1 (4-2023)
Abstract
Background: Fatigue and indifference among critical care nurses due to intermittent and sometimes false alarms are common problems associated with working with alarming equipment. This study aimed to determine the prevalence of alarm fatigue and its relevant factors among critical care nurses in Golestan province, Iran.
Methods: This descriptive-analytical study examined critical care nurses in Golestan province in 2019. A total of 308 critical care nurses (working in ICUs and CCUs) from 11 hospitals were included in the study using the census method based on the inclusion criteria. Data were collected through a 13-item questionnaire assessing nurses’ alarm fatigue. The researcher randomly recorded the number and type of alarms per hour during morning, afternoon, and evening shifts. Simple and multiple linear regression tests analyzed the association between alarm fatigue and nurses’ demographic and professional characteristics as underlying factors. Data analysis was conducted at a significance level of 0.05 and a confidence interval of 95% using SPSS16.
Results: Most nurses, who were predominantly female (79.2%) and had a clinical work experience of 5 years or less in critical care units (69.5%), reported a mean alarm fatigue score of 24.1±6.52. Additionally, 63.3% of the nurses experienced moderate alarm fatigue. It was found that female nurses (87.5%), those working as compulsory medical service workers (35.9%), those assigned to variable shifts (87.2%), and those required to work mandatory overtime (81.5%) reported higher levels of moderate alarm fatigue compared to others. When multiple linear regression analysis was conducted, controlling for the effects of confounding variables, it was observed that among all independent demographic and occupational variables, only gender (b=-0.18, p=0.01), education level (b =0.14, p=0.02), and type of overtime (b=0.15, p=0.01) had statistically significant effects on the response variable, namely the alarm fatigue score (b=-0.18, p=0.01)
Conclusion: Given that most nurses experience moderate alarm fatigue, it is recommended to implement strategies to enhance the quality of care and patient safety, such as providing critical care nurses with appropriate training on the practical and safe management of alarm systems.
