Perceived Nurses’ Ethical Challenges in End-of-life Care for Patients with COVID-۱۹

Implanting an artificial cardiac pacemaker can alter patients' body image and quality of life. Adaptation to a pacemaker is a key component of disease management among patients with implanted pacemakers. This study aimed to investigate the effects of an educational program based on Roy's Adaptation Model on psychosocial adaptation among patients with permanent pacemakers. This quasi-experimental study was conducted in ۲۰۲۰ using a one-group pretest-posttest design. Participants were thirty patients (fourteen males and sixteen females) with permanent pacemakers consecutively recruited from Madani Subspecialty Heart Hospital, Khorramabad, Iran. Data collection instruments were a demographic questionnaire, the Psychosocial Adjustment to Illness Scale, and Roy's Assessment Tool. Initially, participants’ maladaptive behaviors and educational needs were assessed using Roy's Assessment Tool. Then, a need-based educational program was developed and implemented in four ۴۰–۶۰-minute face-to-face educational sessions held in two weeks. Moreover, weekly contacts were made with participants during the first month after the intervention to answer their questions and encourage them to use the education for self-care. Participants’ psychosocial adaptation was assessed at four points: before, immediately after, one month after, and three months after the intervention. The variations of the mean scores of psychosocial adaptations and their healthcare orientation, vocational environment, social environment, and psychological distress across the four measurement time points were statistically significant (P < ۰.۰۵). Roy’s Adaptation Model-based education effectively improves psychosocial adaptation among patients with permanent pacemakers.

کلیدواژه ها:

ethics ، terminal care ، COVID-۱۹ ، qualitative research