Background: Fistula needle insertion constantly exposes dialysis patients to pain, mitigation of which improves acceptance of hemodialysis and quality of life in these patients. Objectives: Therefore, the present research was conducted to investigate the effect of Arnica ointment and distraction on the pain caused by fistula needle in hemodialysis patients. Methods: This double-blind clinical trial was performed on 93 hemodialysis patients attending the dialysis wards of Ali Ibn Abi Talib and Khatam-al Anbia hospitals. The participants were chosen using the convenience sampling method and randomly assigned to three groups of Arnica ointment, distraction, and placebo. The pain intensity caused by arteriovenous needle insertion in two hemodialysis sessions was measured by visual analogue scale (VAS). Then, the collected data were analyzed by SPSS, version 22. P value less than 0.05 was considered statistically significant. Results: We found a significant difference in pain intensity between the Arnica and placebo groups and between the distraction and placebo groups (P < 0.001). Further, pain intensity in the Arnica group was significantly lower than in the distraction group (P < 0.001). Conclusions: Arnica ointment and distraction are palliative and convenient methods, which are even trainable to patients themselves. Considering the low cost of these methods, they are recommended to be applied before inserting the fistula needle.

No abstract

Background:Qualitative research methods can help investigators ascertain the depth of people's needs and their perceptions. This study was designed to describe mothers' experiences and perceptions of lay doula services during labor and delivery.Materials and Methods:This study was conducted using a qualitative approach and conventional procedures of content analysis. The participants consisted of 13 nulliparous women at three hospitals affiliated with Zahedan University of Medical Sciences in 2016. Data were collected using face-to-face semi-structured interviews. Purposive sampling continued until data saturation was ensured. All interviews were tape-recorded and transcribed in verbatim.Results:Participants' experiences were categorized into 11 subthemes and five major themes including (1) achieving self-esteem and empowerment, (2) more trust in God, (3) promoting mental health of the mother, (4) willingness toward normal childbirth, and (5) lay doula as a listener and perceiver.Conclusions:In our study, the mothers evaluated the presence of a lay companion as an effective helper during childbirth and someone who promoted a remarkable willing toward normal childbirth. Healthcare professionals must be cognizant of the needs, values, beliefs, preferences, and emotional well-being of disadvantaged women during labor and delivery in poverty-stricken areas of Iran. Also, this study highlighted that it is important to include the perspective of support persons (such as husbands) in research design of future studies.

Background: Providing high-quality nursing care is the vision of healthcare systems. Several factors contribute to providing high-quality care, which many of them need further investigation. In this line, qualitative research that helps researchers to access the thoughts and feelings of participants can play an important role in identifying care challenges. Objectives: Therefore, this study aimed to identify nurses’ concerns about the nursing care quality process in Intensive Care Units (ICUs). Methods: In this study, a conventional content analysis was used for data analyses. Data were collected by unstructured interviews with 10 ICU nurses. Participants were selected using the purposive sampling technique. The sampling continued upon reaching data saturation. Results: In total 290 codes were extracted, that using analysis and compare were categorized into three main themes: "care obstacles", "motivational obstacles", and "management obstacles". Twelve secondary themes were also extracted, including: "high workload", "not considering the educational needs", "not considering the work standards", "out of duty cares", "ward's bad structure", "personal motivation shortage", "poor work motivation", "personal and organizational motivation interference", "rules without work support", "work inconsistency in the ward", "keeping the position", and "inefficient communications between nurses and physicians". Conclusions: In this study, barriers to nursing high-quality care and its related motivational and managerial dimensions were investigated. In other words, the present study identified barriers in different dimensions, and by identifying the effective factors in providing quality care has facilitated the implementation of measures to address the problems.

In case the individual is not capable of resisting stressful conditions, s/he would be exposed to psychologicalphysical-behavioral symptoms and effects. One of the most important outcomes resulting from the long-lasting psychological pressures is the job burnout. The present study's objective is to survey the job burnout rate among Zahedan University of Medical Sciences staff. The present study is a descriptive-analytical cross-sectional research which has been conducted on 172 individuals among Zahedan University of Medical Sciences staff. To collect the required information a two-part questionnaire was used. Data were analyzed by the use of SPSS 19 software and descriptive statistics, Pearson correlation, variance analysis, and independent t-test. The individuals' average age was 36.49 6 9.85; 106 individuals were women, and 146 individuals were married. The job burnout mean score was 58.46 6 10.17, and the mean scores for emotional exhaustion, depersonalization, and reduced personal accomplishment were 23.21 6 4.92, 10.30 6 3.56, and 21.51 6 4.68, respectively. The relationship between gender and marital status with job burnout and each of its indicators and components was not statistically significant (p  0.05). The relationship between age and job burnout (p 5 0.005) and emotional exhaustion (p 5 0.05), depersonalization (p 5 0.04), and reduced personal accomplishment (p 5 0.003) was statistically significant. The existence of varied levels of job burnout in Zahedan University of Medical Sciences staff makes it necessary to pay careful attention to staff health and the creation of supporting-system facilities to reduce job weariness and exhaustion.