The relationship between work-related psychosocial factors and burnout among Iranian nurses: Job Demand-Control-Support model

Background:Nursing work environment consists of a number of work-related psychosocial risk factors such as excessive workloads, lack of social support, emotional demands, job insecurity and confronting with challenging situations all of which may induce burnout. The aim of the current study was to investigate the relationship between work-related psychosocial factors and burnout among Iranian nurses.Methods:A cross-sectional study was carried out among 522 nurses. The data related to work-related psychosocial factors and burnout was gathered using Job Content Questionnaire (JCQ) and Maslach Burnout Inventory (MBI), respectively. Pearson’s correlation coefficients were used to examine the relationship between work-related psychosocial factors and burnout.Results:Mean scores of the dimensions of burnout for emotional exhaustion, depersonalization, and reduced personal accomplishment were 13.6 (SD=8.6), 18.42 (SD=7.1), and 28.45 (SD= 9.15), respectively. Psychological and physical job demands were positively correlated with different dimensions of burnout while social support and job control showed negative correlation with them.Conclusion:Appropriate interventions on reducing job demands both psychologically and physically and increasing social support and job control are suggested in prevention of burnout among the studied nurses.Key words: Burnout, psychosocial factors, nurses, job demands, job control, social support     

Evaluation of the effect of cognitive behavioral therapy on tocophobia: A systematic review and meta-analysis

Non-medical approaches including cognitive behavioral therapy (CBT) have been proposed for the management of tocophobia. A new method of performing CBT is through internet. The aim of this systematic review and meta-analysis was to evaluate the effect of internet-based and traditional CBT on tocophobia. A literature search was conducted on qualitative and quantitative articles from 2000 to 2019 in Pubmed, Scopus, Web of Science and Cochrane databases using search terms referring to tocophobia and CBT. Identified articles were screened in two steps; 1) title and abstract and 2) full text screening. The quality of the quantitative and qualitative studies was assessed using the quality criteria proposed by the Cochrane Collaboration and Jonna Briggs Institute (JBI) checklist respectively. Out of the 382 relevant studies, 9 studies were eligible for the review. A high level of heterogeneity was observed in the studies (I² = 94%, P < 0.001). The meta-analysis showed that both internet-based, and traditional CBT were effective in reducing tocophobia. CBT was more effective in interventions in the Middle Eastern compared to European countries. More than five CBT sessions could significantly reduce tocophobia. Healthcare providers and midwives should have basic knowledge on physiological interventions to reduce tocophobia.     

Boyfriends,lovers, and “peeler pounders”: experiences of interpersonal violence and stigma in exotic dancers’ romantic relationships

Abstract

Drawing on ethnographic data collected during my doctoral research, in this study, I explore how women who work as exotic dancers in Winnipeg, Canada, negotiated the stigma of sex work and interpersonal violence in their romantic relationships with men. What are the connections between the stigma of sex work and the violence that occurs in exotic dancers’ relationships? What are the ways in which exotic dancers make sense of, and attempt to manage, this violence? I address these questions through feminist ethnographic research methods, including participant observation, open-ended interviews, and participant collaboration. Through an analysis of participants’ stories about their romantic relationships, I suggest that the stigma of sex work is a form of structural violence that manifests as direct violence in women’s relationships with men. I conclude by suggesting that the de-stigmatization of sex work is an important part of ending violence in sex workers’ interpersonal relationships.     

Surgery or Conservative Treatment of Forearm in Patients Diagnosed with Pediatric Floating Elbow? Retrospective Analysis of 60 Consecutive Cases

BackgroundThe coexistence of supracondylar humerus fracture and forearm fracture is a rare trauma (3–13%) and it is called floating elbow. The aim of this study is to clinically compare the treatment outcomes of the patients diagnosed with floating elbow who underwent surgical treatment and who were followed up forearm with immobilization with splint.Materials and MethodsWhen scanned retrospectively, 60 patients who were treated with the diagnosis of floating elbow due to traumatic causes and followed up for at least 1 year were included in our study. Surgical treatment was performed on 42 patients for forearm fracture. Eighteen patients followed up with immobilization with a long arm splint. The results were evaluated according to the criteria modified by Templeton and Graham, in comparison with the patient’s intact side.ResultsIn the patients whose forearms were followed up conservatively, the mean age was 5.67 ± 2.25 years, and the mean follow-up period was 62.17 ± 45.91 months. In the patients who underwent surgery for the forearm, the mean age was 8.79 ± 2.01 years, and the mean follow-up was 47.14 ± 34.25 months. Eighteen patients whose forearms followed up conservatively, 12 had excellent and good clinical results and 6 had poor and moderate clinical results. Excellent and good clinical results in 27 patients who underwent surgical treatment for their forearms, moderate and poor clinical results obtained in 15 of them. There was no significant difference between the two groups (p = 0.357).ConclusionsIn conclusion, satisfactory clinical and radiological outcomes can be obtained with immobilization of the forearm fracture with splint, if acceptable reduction can be provided for the forearm following fixation of the supracondylar humerus fracture with the K-wire for treatment of floating elbow injury.     

Cervicofacial actinomycosis

Cervicofacial actinomycosis is an uncommon, chronic, suppurative, and granulomatous bacterial infection. It is often of dental origin and tends to mimic other dental infections, granulomatous disorders, and cancers. The initial diagnostic workup, predicated upon imaging and tissue biopsies, is frequently nonspecific. A definitive diagnosis is usually rendered only after surgical excision and histologic examination of the cervicofacial mass. We propose a classification of three stages: localized infection without sinus involvement, localized infection with sinus involvement, and disseminated infection, to facilitate recognition, diagnosis, and early aggressive treatment. Untreated infection may be life-threatening. Therapy may require long-term antibiotics; however, many cases may also necessitate complete surgical excision.     

Mutual trust in infant care: the nurses and mothers experiences

The relationship between healthcare providers and parents of infants in neonatal intensive care unit is based on trust and constitutes a core measure of family-centred care and health. The aim of the present qualitative study was to explore mothers and nurses experiences of trust in one another around the caregiving of the hospitalised infant in intensive neonatal care unit. Focused ethnographic research study conducted through observations and in-depth interviews with 20 mothers and 16 nurses in NICU of Tabriz (Iran) in 2017. Two main themes of ‘gradual and fragile trust of mother-to-nurse’ (subthemes: Primary trust-mistrust, mother's trust to responsible nurse, mother trust Increase with skilful nurse performance, and vulnerability to trust) and ‘gradual and fragile trust of nurse-to-mother’ (subthemes: Nurse's initial assessment of trust to mother's readiness to participate, Development of trust to mother, and vulnerability of nurse's trust to mother) were obtained. The present study revealed that mutual trust between the nurse and the mother in the care of the infant was a gradual and progressive process that was achieved over time. Complexities around the care of a hospitalised infant influenced how fragile or vulnerable the trust became between nurse and mother. Findings from this research can be used in supporting increased maternal participation in infant care and improvement of family-centred care in the neonatal intensive care unit.     

The effect of l‐carnitine supplementation on serum levels of omentin‐1, visfatin and SFRP5 and glycemic indices in patients with pemphigus vulgaris: A randomized,double‐blind,placebo‐controlled clinical trial

Pemphigus vulgaris (PV) is a chronic autoimmune disorder with potentially fatal outcomes. The aim of this study was to investigate the effect of l ‐carnitine (LC) on secreted frizzled‐related protein‐5 (SFRP5), omentin, visfatin, and glycemic indices in PV patients under corticosteroid treatment. In this randomized, double‐blind, placebo‐controlled clinical trial, 52 patients with PV were divided randomly into two groups to receive 2 g of LC or a placebo for 8 weeks. Serum levels of SFRP5, omentin, visfatin, and also glycemic indices were evaluated at the baseline and end of the study. LC supplementation significantly decreased the serum level of visfatin (95% CI [?14.718, ?0.877], p = .05) and increased the serum levels of SFRP5 (95%CI [1.637, 11.380], p < .006) and omentin (95% CI [9.014, 65.286], p < .01). However, LC supplementation had no significant effects on the serum levels of glycemic factors such as insulin (95% CI [?1.125, 3.056], p = .426), fasting blood sugar (95% CI [?4.743, 3.642], p = .894), homeostatic model assessment of insulin resistance (95% CI [?0.305, 0.528], p = .729), and quantitative insulin‐sensitivity check index (95% CI [?0.016, ?0.010], p = .81). LC supplementation decreased visfatin serum level and increased omentin‐1 and SFRP5 serum levels in patients with PV. However, it has no significant effect on the serum levels of insulin and glycemic indices.     

Massive repeated nose bleeding after bimaxillary osteotomy

In LeFort I surgery, the separation of the pterygomaxillary junction is done by osteotomy. Although the osteotome is positioned too close to the maxillary artery and its branches during pterygomaxillary separation, postoperative complications from vascular injuries are uncommon. We describe an unusual occurrence of a maxillary artery pseudoaneurysm after LeFort I and bilateral sagittal split osteotomies for maxillary advancement and mandibular setback as well as (anterior sliding) genioplasty. In a patient with class III occlusion and midface retrusion, the significant bleeding began 10 days postoperatively, which was controlled by anterior and posterior nasal packing. The bleeding recurred 28 days after surgery; thus, vascular anatomy in the pterygomaxillary area is reviewed, pseudoaneurysm was diagnosed on selective carotid angiography and successfully treated by embolization; and 2-year follow up was uneventful.