Iranian Biomedical Journal

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Effect of Communication Boards on Facilitating Patient-Nurse Interaction and Anxiety in Mechanically Ventilated Patients: A Systematic Review of Randomized Controlled Trials

Amirhossein Khakbaz, Ali Akbari, Nazanin Fard Moghadam, Sajad Vosoughi, Nahid Naseri,
Volume 28, Issue 0 (Supplementary 2024)

Abstract

Introduction: Communication difficulties in mechanically ventilated patients pose a significant challenge that can harm their recovery process and quality of life. Implementing appropriate solutions can lead to enhanced patient-nurse interaction and psychological well-being. Consequently, the present study aimed to conduct a systematic review to determine the effect of communication boards on facilitating patient-nurse interaction and anxiety in mechanically ventilated patients.
Search Strategy: This systematic review was conducted in 2024 by analyzing articles from foreign databases such as PubMed, Scopus, Science Direct, Web of Science, Medline, and Google Scholar. Keywords such as “communication board”, “nurse-patient interaction”, “nurse”, “patient”, “hospital anxiety”, “ventilator”, and “randomized controlled trial” were searched in English. The search was performed from the beginning of February 2024. Initially, 552 studies were identified in the identification stage. Then, 162 articles were excluded in the screening stage, and 55 remained after the eligibility assessment. After further review, 11 articles that met the inclusion criteria were included in the review. The PRISMA checklist was used to report the findings better. Also, all short articles and review articles for which full versions were unavailable for any reason were excluded from the analysis.
Results: Among the 11 studies reviewed, the findings consistently indicated a positive impact of communication boards on improving nurse-patient interaction and patient anxiety. Using communication boards led to a significant improvement in nurse-patient interaction in mechanically ventilated patients. This included an increase in the frequency and quality of interactions, as well as better mutual understanding between patients and nurses. The use of communication boards was also associated with a significant reduction in anxiety levels in mechanically ventilated patients. Patients who used communication boards felt more in control and were able to express their needs and concerns, which in turn helped to reduce their anxiety.
Conclusion and Discussion: Our study shows that communication boards improve intensive care unit (ICU) patients' perceptions of care. Nurse managers can implement this by creating standardized boards, ensuring ICU availability and training staff to improve patient communication and care.

Effectiveness of an Evidence-Based Home Care Intervention on Treatment Outcomes for Schizophrenia Patients: A Systematic Review of Randomized Controlled Trials

Amirhossein Khakbaz, Ali Akbari, Nahid Naseri, Sajad Vosoughi, Nazanin Fard Moghadam,
Volume 28, Issue 0 (Supplementary 2024)

Abstract

Introduction: Schizophrenia is a disabling chronic disorder with a complex and persistent nature that has resulted in limited treatment success. The first-line treatment for these patients has been medication, which has been somewhat successful in controlling symptoms; however, most of these patients require rehospitalization. This review study aimed to examine the effectiveness of evidence-based home care interventions for patients with schizophrenia.
Search Strategy: This is a systematic review conducted in 2024 by analyzing articles from databases such as PubMed, Scopus, Science Direct, Web of Science, Medline, and PsycINFO. Keywords such as "schizophrenia", "evidence-based", "home care", "psychiatric care", "treatment outcome", and "randomized controlled trial" were searched in both English and Persian. The search was conducted from the beginning to March 2024. Initially, 221 studies were identified in the identification stage. Then, 197 articles were excluded in the screening stage, and 41 remained after the eligibility assessment. After further review, 24 articles that met the inclusion criteria were included in the review. The PRISMA checklist was used to enhance the reporting of the findings. Also, all short articles and review articles for which full versions were unavailable for any reason were excluded from the analysis.
Results: Twenty-four randomized controlled trials (RCTs) examined the effectiveness of home-based care (HBC) for individuals with schizophrenia. Findings demonstrated that HBC interventions significantly reduced symptom severity, duration, and readmission rates. Additionally, these interventions led to meaningful improvements in positive, negative, and general psychopathology symptoms one year after discharge. The efficacy of these interventions extended beyond patients to encompass broader aspects, including reduced caregiver burden and healthcare costs. Improved medication adherence, enhanced psychosocial support, and early identification and intervention of relapse were underlying mechanisms of the favorable treatment outcomes.
Conclusion and Discussion: Strong evidence from RCTs demonstrates that home care intervention is a practical and cost-effective treatment intervention for patients with schizophrenia, leading to significant improvements in both clinical and economic outcomes home care intervention should be considered as an alternative or complementary treatment option to traditional hospital-based care.

Moral Distress as a Result of Futile Care Among ICU Nurses: A Systematic Review

Sajad Vosoughi, Nazanin Fard Moghadam, Ali Akbar, Amirhossein Khakbaz,
Volume 28, Issue 0 (Supplementary 2024)

Abstract

Introduction: Futile care means providing any intervention that improves patients' chances of survival without considering their quality of life. In other words, futile care refers to changes in the clinical condition of patients without affecting their comfort and satisfaction. Providing proper care and comfort to patients is the ultimate goal of the nursing profession. The understanding of futile care among nurses is influenced by various factors, including religious beliefs, personal experiences, individual values, and cultural backgrounds. The4se factors can result in differing reactions to situations involving futile care. One of the remarkable reactions in nurses is moral distress. Therefore, the present study examined the impact of futile care in nursing care and the occurrence of moral distress.
Methods and Materials: This study was conducted using a systematic review method. Evidence published from 2014 to 2024 was analyzed by searching the international databases, including PubMed, Scopus, Web of Science, and Google Scholar, in English with keywords “Futile Care”, “Moral Distress”, “Nurse”, and “intensive care unit”. From the 74 studies, 10 original studies were analyzed with inclusion criteria such as free full-text availability and English language.
Results: The results showed a significant relationship between futile care and moral distress, especially for nurses working in critical care units. Moral distress is pain or anger following a person's awareness of an inappropriate moral situation. Moral distress in nurses resulted in decreased job satisfaction, increased turnover, and indifference to patients' requests. On the other hand, futile care led to an increase in the cost of the health care system, in the length of hospitalization for patients, and in the possibility of contracting various hospital infections, such as infections caused by invasive procedures.
Conclusion and Discussion: Moral distress resulting from the provision of futile care by nurses can have detrimental effects on both patients and nurses. This issue is particularly pronounced in many countries, including Iran, where there is a lack of a specific framework governing the care of end-stage patients and the associated dimensions of Do Not Resuscitate orders.

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