Nursing Practice Today

A Systematic Review of Intervention to Enhance Mental Health Outcomes of Persons with Schizophrenia during the COVID-19 Pandemic

2025-06-02T14:30:25+0430

Background and Aim: Schizophrenia is a chronic mental disorder requiring continuous care. During the COVID-19 pandemic, people with schizophrenia (PLWS) faced disproportionate challenges due to healthcare disruptions. Ensuring continuity of care is essential to mitigating the burden of the disorder, and evaluating mental health outcomes helps assess the effectiveness of interventions. This systematic review examines the impact of various interventions on the mental health outcomes of PLWS during the pandemic.
Method and Materials: The protocol was registered on PROSPERO. A comprehensive search was conducted in MEDLINE, Embase, CINAHL, and ScienceDirect for studies published between 2019 and 2023. Eligible studies included experimental (randomized controlled trials and quasi-experimental studies) and non-experimental (observational) designs investigating the effects of interventions on mental health outcomes in PLWS aged 18 years and older. A narrative synthesis was used to report findings, and the quality of included studies was assessed.
Results: Of the 1,236 records screened, nine studies met the inclusion criteria, comprising five experimental and four non-experimental studies. Experimental interventions included virtual and in-person guided walking, animated audio-visual videos, animal-assisted therapy, and nutritional programs. Non-experimental interventions encompassed Metacognitive Reflection and Insight Therapy, Cognitive Behavioral Social Skills Training, vitamin D supplementation, and dietary interventions. These interventions contributed to improvements in physical activity, executive and social function, healthy behaviors, and quality of life. Additionally, positive effects were observed on anthropometric profiles, cardiovascular health, and metabolic syndrome.
Conclusion: This review highlights effective interventions that support mental health outcomes in PLWS during the COVID-19 pandemic. Integrating these approaches into routine schizophrenia care could help mitigate the pandemic’s impact and enhance long-term well-being in this vulnerable population. Further research is needed to evaluate their long-term sustainability and effectiveness.

Nurses’ perceived demands and burnout level in the critical care units during the COVID-19 pandemic crisis

2025-06-05T20:56:18+0430

Background & Aim: The coronavirus disease (COVID-19) pandemic challenged the physical and psychological well-being of critical care nurses because of the increasing number of infected patients, demands of care, and shortage of healthcare front-liners, particularly nurses. This study determined nurses’ perceived demands and the significant predictors of their burnout level in critical care units of tertiary hospitals in Saudi Arabia during the COVID-19 pandemic crisis.
Methods & Materials: This study used a cross-sectional research design. It was conducted from November to December 2021. Two hundred seventy nurses working in critical care units of tertiary hospitals in Saudi Arabia were surveyed using adopted questionnaires.
Results: The findings of this study revealed that the nurses’ demands concerning safety, communication, and relationships between team members, and psycho-socio-emotional aspects were moderate, whereas their demands concerning organization and decision-making were slight. Furthermore, nurses’ levels of emotional exhaustion and depersonalization/ loss of empathy were high, and personal accomplishment was low, which indicates a high level of occupational burnout. Interestingly, the correlations between the dimensions of burnout and perceived demands were highly significant (p<0.001).
Conclusion: The safety demands of critical care nurses significantly predicted emotional exhaustion due to an increased workload during COVID-19. The demands were significant predictors of depersonalization and personal accomplishment due to their perception that staff shortage, imbalanced workload, increasing care demand, and fatigue might have compromised the quality of patient care. Nurses experienced increased emotional distress and frustration in conveying their feelings of exhaustion, which led to high burnout levels during COVID-19.

Effects of red light on sleep quality in cardiac intensive care unit patients: A randomized controlled trial

2025-05-31T11:32:27+0430

Background & Aim: Sleep disturbances are prevalent in cardiac intensive care units. Due to the side effects of sleep medications, complementary methods are recommended. This study aimed to assess the impact of red light on the sleep quality of patients in cardiac intensive care units.
Methods & Materials: In a randomized clinical trial, 80 patients at the CCU at Shahid Beheshti Hospital in Kashan, Iran, in 2024. The participants were allocated to two groups using block randomization. In the intervention group, red light replaced the white light in the room for two consecutive nights from 10 pm to 6 am. In the control group, no changes were made to lighting. The sleep quality, insomnia severity, and frequency of insomnia causes of the patients in both groups were assessed before the intervention and on the first and second days after the intervention using the St. Mary's Hospital Sleep Quality Questionnaire. Data were analyzed using chi-square tests, independent t-tests, repeated measures ANOVA, Friedman tests, and Cochran test (SPSS V: 19).
Results: There was no statistically significant difference between the two groups before the intervention in terms of demographic information and sleep quality score (P>0.05). The sleep quality score of patients in the intervention group was higher after the intervention than in the control group (p=0.001). A statistically significant difference was observed between the two groups in the first and second days after that for sleep quality score and frequency of insomnia, and insomnia severity (P= 0.001). Comparing the scores of the dimensions of Sleep Latency, Awake onset latency, the duration of the entire sleep process, and napping before and after the intervention in the two groups showed that the two groups did not have a statistically significant difference in these dimensions before and the first and second days after that (p>0.017).
Conclusion: Red light led to an improvement in sleep quality scores and a reduction in the severity and frequency of insomnia in patients admitted to the cardiac intensive care units. Its simplicity and low cost make it a recommended approach for improving their sleep.

Preserving patient dignity in critical care units: A qualitative content analysis

2025-06-02T15:40:32+0430

Background & Aim: Patient dignity is a fundamental aspect of human rights, particularly when individuals are most vulnerable. Although maintaining patient dignity seemed to be challenging in Critical Care Units due to the complexity of medical procedures and critical condition of patients, a paucity of evidence exists exploring dignity preservation in Critical Care Units as well as its requirements from the patients' perspective. Thus, we aimed to explore patients’ dignity in Critical Care Units and the requirements for its preservation.
Methods & Materials: This qualitative study was conducted on 20 patients selected from the Critical Care Units of Imam Khomeini Hospital, Tehran, Iran, through purposeful sampling. Data were collected via semi-structured interviews and were analyzed using Graneheim and Lundman’s conventional content analysis method. Interviews explored patients' experiences and expectations regarding dignity preservation.
Results: The analysis revealed three main categories and nine subcategories essential for preserving patient dignity in Critical Care Units: (1) Care Ethics: Informed Decision-Making, Respecting Patient Concerns, and realistic interaction; (2) Humanity Preservation: Empathetic Acceptance, Avoiding Objectification, and Maintaining Patient Privacy; and (3) Personalized Care: Identifying Needs Proactively, Adapting Care to Individual Conditions, and Ensuring Comfort and Well-being. Participants emphasized the importance of empathetic communication, respect for their personal values and preferences, and maintaining a clean, comfortable environment.
Conclusion: The findings highlight the necessity for healthcare professionals to engage in ethical care, foster empathetic patient interactions, and proactively address the unique needs of each patient to enhance dignity preservation in critical care settings.

Barriers experienced by nurses working in psychiatric wards in caring for patients with mental disorders: A qualitative study

2025-06-02T15:28:33+0430

Background & Aim: Providing quality care to hospitalized psychiatric patients is vital, but many barriers hinder it. This study aimed to identify the barriers faced by nurses working in psychiatric wards in providing care for inpatients with mental disorders.
Methods & Materials: This qualitative study used a conventional content analysis approach and was conducted from July 2023 to September 2024 in three hospitals in Iran. Twenty psychiatric nurses with at least six months of experience were selected through purposive sampling. Data were collected through 20 semi-structured interviews (about 45 minutes each) and analyzed using conventional content analysis with MAXQDA software (Version 10).
Results: The findings revealed two main categories of barriers that psychiatric nurses face. The first, individual-social-professional factors, include nurses' inappropriate perceptions and actions, societal and family misconceptions about psychiatric care, and mental fatigue. The second, organizational-managerial factors, include staff shortages in both quantity and quality, excessive workload, management misunderstandings about psychiatric care, lack of organizational support, lack of effective guidelines, unfavourable physical environment, inadequate healthcare and recreational facilities, and lack of financial support for nurses. In particular, lack of knowledge about mental disorders and perceived institutional neglect emerged as major barriers that significantly reduced nurses' motivation and compromised the overall quality of psychiatric care.
Conclusion: This study highlights the complex barriers to optimal psychiatric care. Overcoming these challenges through targeted interventions, such as enhancing professional support systems and organizational reforms, is essential to fostering a more conducive care environment. These measures can improve psychiatric care quality.