Shirdel Zandi

Introduction: Brain tumors, as a life-threatening diagnosis, often lead to profound psychological and existential crises. Understanding the lived experiences of these patients is crucial for providing holistic care. This study explored the lived experiences of patients with brain tumors following a positive diagnosis. Methods: This qualitative study employed a descriptive phenomenological approach. Participants were purposefully selected based on their experiences, and data were collected through in-depth, semi-structured interviews with 12 patients at Besat Educational Hospital in Hamadan, Iran. Data analysis was conducted using Colaizzi’s seven-step method to ensure a rigorous and systematic exploration of participants’ experiences. Results: The analysis revealed four main themes: (1) Emotional Storm (shock, anger, anxiety, sorrow, and depression), (2) Psychophysical Transformations (physical deterioration, identity crisis, and personality changes), (3) Social Disintegration (self-imposed isolation, shifting roles, and social stigma), and (4) Adaptation to the Illness (hope-fear confrontation, seeking life’s meaning, gradual acceptance, and coping strategies). Conclusion: The findings highlight the severe psychological and social challenges faced by patients with brain tumors following a positive diagnosis. These experiences underscore the need for comprehensive, culturally sensitive interventions that address emotional, psychological, and social dimensions. Healthcare systems should prioritize patient-centered care, including counseling, support groups, and public education to reduce stigma.

Patients undergoing spinal surgery often experience chronic pain and functional limitations. These complications frequently lead to diminished quality of life, hope, and resilience. Inadequate family knowledge regarding home-based patient care exacerbates these challenges. This study investigates the effect of family support through education and follow-up after discharge on the quality of life, resilience, and hope in patients following spinal surgery. This quasi-experimental study was conducted on 50 spinal surgery patients in Hamadan from November 2023 to October 2024. Participants were selected through convenience sampling and randomly allocated to either intervention or control groups. The intervention group received two visual training sessions before discharge and one month of follow-up, while the control group received only routine care. Data were collected using SF-36 (Quality of Life), MHS (Hope), and CD-RISC (Resilience) questionnaires. Finally, the data were analyzed using Independent and Paired t-tests, Chi-square, and ANCOVA at the significance level of P < 0.05 in SPSS 24. The groups showed no significant differences in baseline characteristics (P > 0.05). Post-intervention, the intervention group demonstrated significantly higher scores in quality of life (P = 0.013, Cohen’s d = 0.73, 95% CI [0.21–1.25]) and resilience (P = 0.01, d = 0.76, 95% CI [0.25–1.27]) compared to controls, indicating medium-to-large effect sizes. No significant difference was found for hope (P = 0.543, d = 0.17, 95% CI [-0.18, 0.52]). Family education and post-discharge follow-up improved quality of life and resilience in spinal surgery patients, though no significant effect was observed on hope. These findings underscore the importance of structured family caregiving support and systematic follow-up in enhancing patient outcomes.

Background: Diabetic amputee patients require lifelong care and maintenance services, making self-care a particularly important aspect for these patients. Unfortunately, the realization of this concept faces challenges that require more attention. This study explored the challenges of self-care practice among diabetic amputation patients. Methods: This qualitative study was conducted with a Husserl’s descriptive phenomenological approach. The required data were collected at the Besat hospital in Hamadan, Iran, from August to October 2022. Semi-structured interviews were purposively conducted with 10 female and 7 male participants between the ages of 41–73. Eventually, the data were analyzed by Colaizzi’s method. Results: Four themes and fifteen sub-themes were extracted from the obtained data. The themes included the limiting nature of the disease, biological dependency, lack of a dedicated self-care model, and inhibiting psychological stresses. The sub-themes of the first theme were inhibiting movement limitations, need for vital care, phantom pain, risk of dangerous complications, and exhausting dietary restrictions. Those of biological dependency included the need for direct care, inability to assess one’s own needs, and importance of diet and medication., In addition, sub-themes related to the lack of a dedicated self-care model were lack of awareness, lack of self-care knowledge, and not being taught self-care methods in specific situations. The sub-themes of the fourth theme encompassed depression, despair, loss of motivation, and negative self-perception. Conclusion: By elucidating the various aspects of self-care challenges in diabetic amputee patients, it is possible to suggest necessary planning and successful self-care education to reduce the complications faced by patients, their families, and society.

Objectives: Heart valve replacement patients require lifelong adjustments in medication, diet, and lifestyle to maintain a stable clinical condition. This ongoing need for self-management necessitates effective self-care behaviors. This study aims to develop a comprehensive self-care pattern specifically tailored for heart valve replacement patients. Methodology: This qualitative grounded theory study was conducted in Iran, utilizing semi-structured interviews to gather data from January to April 2021. A total of 31 participants were included, comprising 13 heart valve replacement patients and 18 healthcare professionals involved in their treatment and care. Data analysis followed the grounded theory methodology of Strauss and Corbin, employing open, axial, and selective coding techniques. Results: A distinctive self-care pattern for heart valve replacement patients was established, centered around the core category of “Personal Health Promotion Activities.” Key components of this model include causal conditions such as “Self-Care Competence” and “Familiarity with Care Needs.” Contextual conditions identified were “Social Support” and “Educational Effectiveness,” while intervening conditions encompassed “Providing Care Strategies” and “Familiarity with Incidents.” The strategic elements of self-care involved “Prevention of Dangerous Situations,” “Adherence to Care Instructions,” and “Moderate Lifestyle.” The resulting consequences included “Self-Efficacy,” “Reduction of Medical Costs,” and “Achievement of Therapeutic Goals.” Conclusion: This study demonstrates that the phenomenon of self-care, framed as a personal health promotion activity, is influenced by a variety of factors. Strengthening these factors can enhance self-care practices among heart valve replacement patients, potentially mitigating surgical side effects and anticoagulant complications, ultimately leading to an improved quality of life.

The biggest challenge for osteoporotic patients after spinal stabilization is screw loosening. Therefore, the present study was conducted with the comparative aim of stabilizing the lumbar spine with 2-stage surgery and cement augmentation in osteoporotic patients. 66 patients selected through convenience sampling and randomly assigned to two groups: CAPS and 2-stage surgery. In the CAPS group, lumbar spine fixation was performed in a single stage, accompanied by cement augmentation. In the 2-stage surgery group, spinal stabilization was conducted in 2 stages. In the first stage, pedicle screws were implanted, followed by the pedicle screw anchoring process 6 months later. fusion rate, screw loosening, pain levels (VAS), and patients’ disability (ODI) were measured in each group. The fusion rate in the 2-stage Surgery group significantly increased. Screw loosening in the CAPS group showed a significantly higher difference. The rate of pain and disability in patients early postoperatively, in comparison to preoperative measures, significantly decreased in both groups. In the final follow-up, the CAPS group experienced a significant increase in pain and disability. The 2-stage Surgery stabilization, when compared to the CAPS technique, demonstrates superiority in enhancing the biomechanical stability of screws and achieving successful fusion.

Background: During the COVID-19 pandemic, some patients who were transported to the operating room for emergency surgery had COVID-19; operating room nurses should be in direct contact with these patients in a small and closed space of the operating room. This can lead to unpleasant experiences for these people. Accordingly, this study was conducted to understand the experience of operating room nurses during the surgery of COVID-19 patients. Methods: This qualitative study is a descriptive phenomenological study. Sampling was done purposefully and participants were selected based on the inclusion and exclusion criteria. The data of this study was obtained through semi-structured interviews with 12 participants and analyzed using the Colaizzi method. Results: Four main themes and 13 sub-themes were presented in this study: (1) feeling heroic (being a savior, self-sacrificing). (2) Exacerbating burnout (emotional exhaustion, feeling of incompetence, physical overtiredness). (3) Psychiatric crisis (destructive anxiety, horror of death, worrying about being a carrier, drastic feeling of pity). (4) Feeling the need for support (need for professional support, need for emotional support, need for social support). Conclusion: The results of this study show that operating room nurses experienced conflicting feelings during surgery on patients with COVID-19. So the feeling of being a hero was a heartwarming experience, but the aggravation of job burnout and mental crisis was unpleasant for them. Also, these people have experienced the need to be supported in various aspects.

Objectives: Musculoskeletal disorders are among the common problems in most work environments and work ability is considered a factor affecting the performance and productivity of employees. In the present study, the status of these two components and their relationship with each other in the staff working in the operating room were investigated. Methods: The current cross-sectional study was conducted in the winter of 2023. In this research, 96 employees working in the operating rooms of government hospitals in Hamadan, Iran were enrolled by census sampling method based on the inclusion criteria. The data were collected through the Nordic standard questionnaire and the work ability index questionnaire. The collected data were analyzed in SPSS software (version 24) at two levels of descriptive (frequency, mean, and standard deviation) and inferential (t-test) statistics. Results: In this study, 4 (4.2%) of the participants had one musculoskeletal disorder and the remaining 91 personnel (95.8%) had more than one disorder in their musculoskeletal systems. Average work ability index was 42.3±04.91. The results of the independent t-test showed that the work ability index among people with pain in the neck (P=0.003), shoulders (P=0.001), elbows (P=0.038), back (P=0.011), knees (P=0.001), and legs (P=0.002) were less than those without pain in these organs. Conclusion: Results indicated the need to pay more attention to the implementation of ergonomic work environment and management interventions to reduce the prevalence of musculoskeletal disorders and thereby increase the efficiency and effectiveness of personnel.