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Aim. This study was conducted to determine the association between knowledge management and social value among nurses working in hospitals of Tehran University of Medical Sciences. Background. Knowledge management plays a significant role in healthcare systems. Healthcare providers require knowledge in every aspect of their work, and they must be able to rely on a knowledge management system to access the newest research and practice to ensure the highest quality of care. One of the evident goals of knowledge management is creating value in organizations. Creating value does not necessarily mean creating economic value, but creating social value is a category proposed as a prerequisite for knowledge management. Methods. This research is a descriptive‐analytical study conducted in Tehran in 2021 on two groups of nurses (N = 228) selected through a stratified random method. The data collection tools were Choi knowledge management questionnaire and a researcher‐made questionnaire on social value validated in Iranian society. Results. There was a positive and significant correlation between the variables of knowledge management and social value in Bachelor of Science (BSc) nurses (P value ≤0.01, r = 0.43), and no significant correlation was observed in Master of Science (MSc) nurses (P value >0.05, r = 0.14). Conclusions. In the BSc nurses' group, a direct and significant association was found between knowledge management and social value of BSc nurses so that by increasing the score of knowledge management in the nursing community, individuals feel more self‐worth, resulting in achieving a favorable level of customer satisfaction. Implication for Nursing Management. It is suggested that an accurate program should be designed for all academic levels of nurses in hospitals, the principal elements of creating knowledge and learning and its provision should be assessed, and the necessary measures should be taken. [ABSTRACT FROM AUTHOR]

The use of home mechanical ventilation is increasingly developing. The present study aimed to examine the effect of a family-centered training program on patients under home invasive mechanical ventilation. A total of 60 adult patients under invasive mechanical ventilation were selected and randomly allocated into two groups. The supportive home care program consisting of six training sessions using a teach-back technique and follow up training at home. The rate of hospital readmission and mortality in the intervention group was significantly lower than the control group(P =.02 and P =.03, respectively). Moreover, the home caregivers' level of knowledge in the intervention group was significantly higher than that of the control group(P = 0/000). In addition, implementing the intervention effectively increased home caregivers' ability of functional skills. Therefore, comprehensive preparation of the patient and family before discharge and coherent support and continuity of care after discharge with the effective presence of nurses. [ABSTRACT FROM AUTHOR]

The prevalence of patients on mechanical ventilation who are being supported at home is increasing. Due to these patients' complex and chronic conditions, the subjective burden on their family caregivers increases after discharge. The aim of this study was to evaluate the effectiveness of a supportive home care program on the caregiver burden of families caring for patients on invasive mechanical ventilation at home. Sixty patients hospitalized in three university-affiliated hospitals in Tehran, Iran between 7/2020 and 8/2021 were randomly assigned to one of two groups: A supportive home care program, and routine hospital education. The supportive home care program included six educational sessions delivered in the hospital before discharge, and home visits and continued education after discharge. Caregiver burden was measured using the Zarit Burden Interview. Results showed that caregiver burden increased significantly (p ≥.001) after discharge without the supportive home care program intervention. Follow-up by nurses after discharge is essential to reduce the psychological burden of caring for patients on invasive mechanical ventilation at home. [ABSTRACT FROM AUTHOR]

Background: It is widely believed that using personal protective equipment (PPE) provides high levels of protection for healthcare workers (HCWs) in the fight against coronavirus disease (COVID‐19). However, the long‐term use of PPE is inconvenient for HCWs and may cause physical discomfort. These factors could result in poor compliance and disrupt the health and safety of HCWs, which may negatively affect the patient's safety. Objective: This study aimed to investigate the literature for the purpose of collecting convincing evidence of HCWs' physical problems associated with PPE use during the COVID‐19 pandemic. Methods: This scoping review was conducted using PubMed, Embase, ProQuest, Science Direct, Springer, Biomed Central, and Google Scholar to identify the related literature. Results: HCWs have experienced various physical disorders including skin, respiratory, musculoskeletal, nervous, urinary, and circulatory system problems that are associated with PPE in various body systems. Among these, skin problems were the most frequent physical problems. Conclusions: The literature demonstrated the adverse impacts of using PPE on HCWs. Therefore, healthcare policymakers should take the appropriate measures to improve the work environment during the COVID‐19 pandemic, which could consequently prevent and mitigate the adverse effects of using PPE. [ABSTRACT FROM AUTHOR]

Background: The accuracy of health care−associated infections (HAIs) statistics in many countries is questionable and the main reasons of this inaccuracy are not well-known. The study aim was to explore inhibitors of and corrective recommendations for HAIs case findings and reporting in some of Iran hospitals. Methods: Sixteen face-to-face interviews and an expert panel were performed with expertise of infection prevention and control (IPC) programs in hospitals, and Deputies of Health and Treatment in medical university and Ministry of Health from Feb 2018 to May 2019. Using conventional content analysis, code, subcategories and categories were developed. Result: Three categories emerged including improper structure preparation, conflict of interest, and inadequate motivation. Allocating distinct budget and adequate staff to IPC programs, developing a user-friendly surveillance system and engaging physicians and nurses for HAIs reporting are the main corrective recommendations accepted by the expert panel. Conclusion: Despite the improvement in growing case-findings and reporting of HAIs in Iran, there are many challenges which inhibit accurate case finding and reporting of HAIs. So it is necessary to update the structure, system and rules to reach accurate HAIs data in Iran. [ABSTRACT FROM AUTHOR]

Introduction: To date, no definitive results have been reported on the effect of omega‐3 fatty acids on premenstrual syndrome (PMS). Therefore, this systematic review and meta‐analysis aimed to determine the effect of omega‐3 fatty acids on PMS. Methods: In this systematic review and meta‐analysis, the databases were searched. In this regard, randomized clinical trials investigating the effect of omega‐3 fatty acids on PMS were included. The quality of the studies was assessed using the Cochrane Collaboration's Risk of Bias tool. Meta‐analysis was done based on random effects model and calculation of standardized mean difference (SMDs). Results: The results of meta‐analysis showed that omega‐3 fatty acids were efficient in reducing the severity of PMS in women (SMD = −0.968, 95% confidence interval [CI]: −1.471 to −0.464). In addition, the results showed that the studies were heterogeneous (I2 = 89.11%, p <0.001). Based on meta‐regression analysis, aging (β = −0.150, 95% CI −0.202 to −0.098, p <0.001) and increasing the duration of intervention (β = −0.579, 95% CI −0.781 to −0.378, p <0.001) had a significant effect on the severity of PMS. We also found that omega‐3 fatty acids could significantly reduce the somatic (SMD = −0.800, 95% CI: −1.126 to −0.474) and psychological (SMD = −0.373, 95% CI: −0.686 to −0.061) symptoms of PMS. Conclusion: Omega‐3 fatty acids could reduce the severity of PMS. However, we should caution in the conclusion in affirming the beneficial effects of n‐3 PUFAs on PMS, since the heterogeneity is evident in the analysis. The efficacy of the treatment was enhanced by increase of the treatment duration. [ABSTRACT FROM AUTHOR]

There is a lack of knowledge regarding perceptions, feelings, and experiences of Ghanaian patients living with ESRD. This study aimed to discover the experience and meaning of living with ESRD. This qualitative study was conducted using Heideggerian hermeneutic phenomenology. A total of 13 participants were purposefully selected, and data was collected through individual semi-structured interviews. The recorded interviews were transcribed and analyzed using Diekelmann, Allen, and Tanner method. After the final analysis, five main themes emerged: Spiritual fluctuation, Living in uncertainty, Period of agony and frustration, Tough fortification, and Changed roles and status. This study provided deep insight and understanding regarding the lived experiences of patients living with end-stage renal disease in Ghana. The results of this study may benefit nursing care in terms of considering the patients' lived experiences to provide quality and person-centered care. [ABSTRACT FROM AUTHOR]

Background: Out-of-hospital cardiopulmonary arrest is a common and fatal problem. Rescuing patients with this problem by pre-hospital emergency medical services is associated with various barriers and facilitators. Identifying these barriers as well as the facilitators in a qualitative and an information-rich way will help to improve the quality of performing the maneuver and to increase the patients' survival. Therefore, the current study was qualitatively conducted with the aim of identifying the factors affecting the cardiopulmonary resuscitation within the pre-hospital emergency medical services.Methods: This qualitative study was conducted using a content analysis approach in Iran in 2021. The participants were 16 Iranian emergency medical technicians who were selected through a purposive sampling method. For data collection, in-depth and semi-structured interviews were conducted. For data analysis, the Elo and Kyngäs method was applied.Results: The mean participants' age was 33.06 ± 7.85 years, and their mean work experience was 10.62 ± 6.63 years. The collected information was categorized into one main category called "complex context of the cardiopulmonary resuscitation" and 5 general categories with 17 subcategories. These categories and subcategories include patient condition (patient's underlying diseases, age, high weight, number of children, and place of living), dominant atmosphere in companions at home (companions' feeling of agitation, companions doing harm, and companions helping), policy (educational policy, human resource policy, up-to-date equipment and technology, and do-not-resuscitate policy), performance of the out-of-organizational system (disorganization in the patient handover process, and cooperation of the support organizations), and conditions related to the treatment team (conscience, cultural dominance, and shift burden).Conclusions: The results showed that the conditions related to the patient and his/her companions, as well as the organizational factors such as the policies and the out-of-organizational factors act as the barriers and the facilitators to the cardiopulmonary resuscitation within pre-hospital emergency medical services. Therefore, the barriers can be modified and the facilitators can be enhanced by taking various measures such as educating, human resource policy-making, upgrading the equipment, and considering appropriate management policies. [ABSTRACT FROM AUTHOR]

Purpose: To explore the concept of presenteeism in nursing. Method: A three‐phase concept analysis using a hybrid model was used. In the theoretical phase (first phase), a literature review was conducted using PubMed, Web of Science, Proquest, EBSCO, Scopus, OVID, Cochrane Library, PsycINFO, Google Scholar, SID, and Iranmedex. In the fieldwork phase (second phase), semistructured interviews with 17 nurses were used. In the final analytical phase (third phase), the results of the previous phases were combined. Findings: In the final definition, presenteeism can be considered as a kind of fall from balance, in whose nature lies the non‐actualization of capacities. If the imbalance of presence is due to the body, we are faced with the non‐actualization of movement capacity, and regarding the imbalance caused by the soul, cognitive and emotional actualization is challenged. Conclusion: Exploration of the concept of presenteeism in the nursing is the basis for identifying this concept in a profession that deals with health as the most valuable human property. Implications for nursing practice: The identified attributes of presenteeism provide a deep insight for nurse managers into the nature of presenteeism. Nurse managers cannot deal with a destructive phenomenon without exploring and identifying its exact meaning. [ABSTRACT FROM AUTHOR]

Aims and Objectives. To develop and test reliability and validity of the "factors affecting hypertensive treatment adherence" scale. Design. A sequential exploratory mixed method study was used. Methods. After item generation using a qualitative study and literature review, the psychometric properties of the scale were evaluated. Face, content, and construct validity, Cronbach's alpha, and test-retest reliability were used to validate the scales. Results. Data analysis showed that the scale had acceptable face and content validity. The scale had excellent stability (intraclass correlation = 0.89) and good acceptability of internal consistency (α = 0.71). The exploratory factor analysis showed that the scale consisted of five subscales which were meaningful. Conclusion. Psychometric properties of the scale achieved the standard level, and it was sufficient to recommend for general use in future measures of caring in nursing. [ABSTRACT FROM AUTHOR]

Diabetic foot ulcer (DFU) is a serious and costly complication in diabetes which affects different aspects of life and can reduce patient's quality of life. Various views to manage DFU have been introduced. The nurse‐led team, as a multidisciplinary team, can be effective due to a holistic approach to some disease management; but in patients with DFU it has not been assessed. Therefore, this study was designed to determine the effect of nurse‐led care on quality of care (QOC) and improvement of HbA1C in Patients with DFU. This was a randomized clinical trial study performed on 52 patients with DFU. Patients were randomly assigned into two groups: nurse‐led care intervention and standard care. The study was conducted in one of the hospitals affiliated to Tehran University of Medical Sciences. Data were collected using two questionnaires: Demographic characteristics and Quality Patient Care Scale (QUALPACS) and taking a blood sample for HbA1C. The nurse‐led Care interventions were conducted in three stages: Integrated, Interdisciplinary, and Comprehensive. Descriptive and analytic statistical methods were used to analyze the data. P <.05 was considered significant. The results demonstrated that according to repeated measures test, (before, 4 and 12 weeks after the intervention), the level of QOC dimensions (Psychosocial, communication and physical aspect) in the nurse‐led group had a significant difference with control group (P <.0001). Also, according to the results of Independent t test, there was a significant difference in total QOC scoring and HbA1c between intervention and control groups after the intervention and follow up (P <.0001). Considering the burden of diabetes and DFUs, it seems that the establishment of a nurse‐led care approach can be an effective strategy to manage and treat these patients, and eliminate the disruption of care and achieve optimal care quality. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hypertension (HTN) is a public concern and treatment adherence has a key role in its management. This study was conducted to develop and test the reliability and validity of the Hypertensive Treatment Adherence scale (HTA-scale). METHODS: This was a cross-sectional and methodological study. After item generation using a qualitative study and literature review, the scale was developed. The psychometric properties of the scale were evaluated using face, content, construct, and criterion validity and reliability. RESULTS: Data analysis showed that the HTA-scale had acceptable face and content validity. The scale had excellent stability [Intraclass correlation coefficient (ICC) = 0.74] and good acceptability and internal consistency (Cronbach's = 0.76). Exploratory factor analysis (EFA) showed that the HTA-scale consisted of 6 meaningful subscales including medication adherence and monitoring, adherence to safe diets, avoiding unsafe diets, self-medication, activity, and smoking. Participants in the controlled blood pressure group had significantly higher HTA-scale scores than the uncontrolled blood pressure group. At the cut-off point of 86, the scale had significant sensitivity and specificity. CONCLUSION: All of the psychometric properties of the HTA-scale achieved the standard level and were sufficient to recommend this scale for patients with HTN. [ABSTRACT FROM AUTHOR]

Background: Nurses can safely and effectively wean patients from mechanical ventilation (MV) by the use of proper instruments and planning. Objective: The aim of this study was to compare the effectiveness of 2 training methods on the decision-making skill of intensive critical care (ICU) nurses with regard to weaning from MV. Methods: In this quasi-experimental study, 80 nurses working in ICUs participated in 1 of 2 educational groups in 2016. The interventions were workshop and multimedia training for decision-making skill regarding weaning from MV. The data were gathered from a questionnaire based on the Burns Weaning Assessment Program tool before and 1 month after the intervention. Data were analyzed by independent t test, the χ² test, and the Fisher exact test using the software SPSS v. 17. Results: The decision-making skill with regard to awareness of weaning factors (physiological and respiratory) increased in both groups after the intervention (P ≤ .001), but the difference between the 2 groups was not statistically meaningful. Considering the mean scores before and after the intervention, the general skill of decision-making regarding weaning from MV was higher in the multimedia training group compared with the workshop training group (P ≤ .001). Conclusion: The multimedia training method, which has been more successful, is recommended owing to its characteristics of virtual education, such as accessibility, flexibility, learner centeredness, and expansibility, as well as nurses' lack of time. [ABSTRACT FROM AUTHOR]

Introduction: Poor treatment adherence reduces treatment effectiveness and increases healthcare costs. The promotion of treatment adherence necessitates valid and reliable tools to assess the effectiveness of adherence promotion strategies. This study was undertaken to develop and evaluate the psychometric properties of the Coronary Artery Disease Treatment Adherence Scale. Methods: This methodological study was conducted in two phases. In the first phase, a literature review was done and a 62-item scale was developed. In the second phase, different methods were used to assess the psychometric properties of the scale, namely its face validity, content validity, construct validity, internal consistency, and test–retest stability. Results: During face and content validity assessments, the number of items was reduced from 62 to 53. Moreover, in construct validity assessment via exploratory factor analysis, 18 items were deleted because their factor loading values were less than 0.3. The remaining 35 items were loaded on four factors, namely medication adherence, dietary adherence, exercise adherence, and healthy lifestyle adherence. The Cronbach's alpha values of the scale before and after factor analysis were 0.850 and 0.862, respectively. Its test–retest intraclass correlation coefficient was also 0.85. Conclusions: The Coronary Artery Disease Treatment Adherence Scale is a valid and reliable tool and can be used in different healthcare settings for the assessment of treatment adherence among patients' with coronary artery disease. Trial Registration: Tehran University of Medical Sciences, identifier, 35456. [ABSTRACT FROM AUTHOR]

Heart failure is associated with low quality of life and a high mortality rate. There is limited information about patients' experiences of living with cardiac resynchronization therapy (CRT). In the present study, we sought to explore the process of living with CRT defibrillator. This qualitative study was completed from December 2014 to April 2016 using a grounded theory approach. Twenty semistructured interviews were held with 17 patients with heart failure. Data analysis was done via a previously‐published approach. The core category of the process of living with the device is "doubtful accepting". This process includes three sequential phases: losing integrity, attempting to cope with the device, and coexisting. The process takes place in a context of barriers and facilitators, and results in a wide spectrum of outcomes, from frustration to empowerment. Nurses' awareness of this process can help them provide higher quality care, strengthen facilitators and reduce barriers to the process, and enable patients to effectively use coping strategies. [ABSTRACT FROM AUTHOR]

Introduction: Coping with disease is of the main components improving the quality of life in multiple sclerosis patients. Identifying the characteristics of this concept is based on the experiences of patients. Using qualitative research is essential to improve the quality of life. This study was conducted to explore the features of coping with the disease in patients with multiple sclerosis. Method: In this conventional content analysis study, eleven multiple sclerosis patients from Iran MS Society in Tehran (Iran) participated. Purposive sampling was used to select participants. Data were gathered using semi structured interviews. To analyze data, a conventional content analysis approach was used to identify meaning units and to make codes and categories. Results: Results showed that features of coping with disease in multiple sclerosis patients consists of (a) accepting the current situation, (b) maintenance and development of human interactions, (c) self-regulation and (d) self-efficacy. Each of these categories is composed of subcategories and codes that showed the perception and experience of patients about the coping with disease. Conclusion: Accordingly, a unique set of features regarding features of coping with the disease were identified among the patients with multiple sclerosis. Therefore, working to ensure the emergence of, and subsequent reinforcement of these features in MS patients can be an important step in improving the adjustment and quality of their lives. [ABSTRACT FROM AUTHOR]

Spiritual health is a unique force that can influence the physical, mental, and social dimensions of life. In order to know the positive effects of spiritual health, it is necessary to explain the adolescents' experiences in this area. This study, therefore, aimed to investigate Iranian adolescents' experiences regarding the effects of spiritual health. This study was conducted based on a qualitative approach using content analysis. The data were collected through semi-structured interviews with 20 adolescents aged 14–18 years. Subsequently, the obtained data were analyzed using the Graneheim and Lundman method. In total, three major categories emerged from data analysis, including mental health promotion, self-control, and purposefulness in life. Considering the significant effects of spiritual health on adolescents' development, it is essential to pay attention to this dimension of health and develop plans to enhance it. [ABSTRACT FROM AUTHOR]

The number of people with heart failure requiring implantation of a cardiac resynchronization device is increasing in Iran. Although this intervention is an effective life-saving treatment, several challenges are associated with patients' lifestyle after insertion. This study identified the challenges and coping mechanisms of Iranians with heart failure living with cardiac resynchronization therapy. A qualitative approach using conventional content analysis was adopted. Seventeen people with heart failure and three nurses were recruited between December 2014 and November 2015 from a teaching hospital and a private clinic in Rasht, Iran. Participants were interviewed using semi-structured interviews lasting 30-60 min. Five themes emerged: (i) fear of implantation, (ii) the panic of receiving a shock from the device, (iii) lack of control over life, (iv) inadequacies of the healthcare system, and (v) psychosocial coping. A heightened understanding of these challenges and coping strategies could prepare healthcare professionals to provide better routine care, education, and support to the recipients of cardiac resynchronization therapy prior to implantation, during the recovery period, and for long-term management. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hypertension is a global public health crisis. Poorly controlled high blood pressure is one of the major factors contributed to this crisis. As lack of treatment adherence is often considered the main reason for this failure, the Treatment Adherence Questionnaire for Patient with Hypertension (TAQPH) was developed. Since this questionnaire should be reliable and strongly valid to be used in clinics and research, this study was performed to test the reliability and validity of the TAQPH. METHODS: A cross-sectional study was conducted to validate the Persian version of TAQPH after using a modified forward/backward translation procedure. A total of 330 hypertensive patients were participated in this study. Construct and criterion validity, Cronbach¢s alpha, and test-retest reliability were used to validate the Persian scale. RESULTS: Data analysis showed that the scale had excellent stability (intraclass correlation = 0.95) and good acceptability of internal consistency (a = 0.80). The exploratory factor analysis (EFA) was meaningful but was not confirmed with confirmatory factor analysis (CFA). The scale score was correlated with Morisky Medication Adherence Scale (MMAS) score (= 0.27). CONCLUSION: In total, most of the psychometric properties of the 25-item P-TAQHP achieved the standard level and were sufficient to recommend for general use. [ABSTRACT FROM AUTHOR]

Aim: A crisis is an environment created in a rapidly changing and chaotic work setting which is found in a busy emergency department of a hospital with higher intensity. The objective of this study was to define and explore emergency room nurses' description of crisis in critical situations and to identify barriers and mitigating factors that affect how nurses handle crises. Methods: This study is a qualitative research with a content analysis approach. Eighteen emergency nurses were purposefully selected to take part in this study. Data collection was through face‐to‐face semistructured interviews until data saturation was finalized. Data analysis was conducted using content analysis. Results: The data analysis consisted of four main categories: (i) loss of balance; (ii) crisis control (anticipation–preparation, resource control, control skills, and supporting nurses); (iii) human factors related to staff (sufficient staff, competent staff, individual characteristics, ability to communicate); and (iv) teamwork (cooperation and reciprocal trust). Conclusion: Findings showed the meaning of the crisis and challenges and issues faced by emergency nurses throughout the crisis. Health services authorities can use these results to make comprehensive plans in order to reduce emergency crises. [ABSTRACT FROM AUTHOR]

Background: One of the most important challenges of Iranian health care system is “quality of care,” and it is assumed that motivated nurses are more ready to provide better care. There are limited studies investigating Iranian nurses' motivations; however, factors which motivate them have not been studied yet. Identifying the motivating factors enables nurse managers to inspire nurses for continuous quality improvement. The aim of this study was to identify motivating factors for Iranian hospital nurses. Materials and Methods: This is a cross‑sectional descriptive study in which 310 nurses working at 14 hospitals of Tehran University of Medical Sciences were selected by proportionate stratified random sampling. Data were collected in 2010 by a researcher‑developed questionnaire. Descriptive statistics and independent t‑test, analysis of variance, Tukey post‑hoc test, Chi‑Square and Fisher's exact test were used for statistical analysis by Statistical Package for Social Sciences (SPSS) version 16. Results: The mean score of motivation was 90.53 ± 10.76 (range: 59-121). Four motivating factors including “career development” (22.63 ± 5.66), “job characteristics” (34.29 ± 4), “job authority” (18.48 ± 2.79), and “recognition” (15.12 ± 2.5) were recognized. The least mean of the motivation score, considering the number of items, was 3.23 for career development, while the highest mean was 3.81 for job characteristics. Conclusions: The findings showed that motivation of nurses was at a medium level, which calls for improvement. The factors that have the greatest potential to motivate nurses were identified in this study and they can help managers to achieve the goal of continuous quality improvement. [ABSTRACT FROM AUTHOR]

This article examines the culture of family-centered care (FCC) in the pediatric intensive care unit (PICU) using focused ethnography. Data collection strategy was participant observation, fieldwork, and interviews with main actors of the PICU, namely supervisors, nurses, and parents. This study took place in one PICU in a hospital in Tehran, Iran. The results were in the main named as paternalism and were presented as five themes: 'non-possessed environment,' 'separation of the children from their parents,' non-interactive communication,' 'limited participation,' and 'affection and sympathy combined with superiority.' In conclusion, the prevailing atmosphere in care was paternalistic as there was a huge gap between conceptually or theoretically accepted application of FCC in PICU and what is practically administrated. Bridging such a gap between theory and practice can be helpful in improving social, environment, and organizational culture for the children, their parents, and health care providers as well as their performance in the context of PICU. [ABSTRACT FROM AUTHOR]

Background: The main objective of nursing is to provide comprehensive nursing care that is appropriate to patients' needs. However, the incidence of missed nursing care compromises the provision of comprehensive and safe care and threatens patients' lives. Thus, this in-depth qualitative study aimed to explore nurses' experiences of missed care and factors affecting it. The aim of this study was to describe nurses' experiences of missed care in clinical practice. Methods: In this study, qualitative research methodology, with a content analysis approach was used. The sample included 23 nurses in referral teaching hospitals. Data were collected through focus group discussions, face-to-face and telephonic interviews, using semi-structured questions. Results: Three themes, comprising several sub-themes, emerged, and included contextual conditions, coercion, and deprivation. Conclusion: The results indicated that organizational and personal factors facilitate the incidence of coerced, missed nursing care. High quality of care, the prevention of missed care incidences and patient safety depend on the provision of adequate staff, appropriate equipment and a sense of responsibility for patients' care needs among nurses. [ABSTRACT FROM AUTHOR]

Background: Providing holistic nursing care when there is a shortage of personnel and equipment exposes nurses to stress and a higher risk of occupational burnout. Humour can promote nurses' health and influence nursing care. The aim of this study was to describe nurses' experiences of humour in clinical settings and factors affecting it. Methods: This qualitative study investigated nurses' experiences of humour. Five hospitals affiliated to Tehran University of Medical Sciences provided the setting for this study. The participants comprised of 17 nurses with master's and Baccalaureate degrees (BSN) in nursing. These nurses worked at educational hospitals affiliated to Tehran University of Medical Sciences and had minimum work experience of 12 months in various clinical wards. Nurses from all wards were invited to participate in this study. The data were collected through semi structure interviews using guides comprising probing questions. Telephonic interviews were used to further supplement the data. The data were analysed using conventional content analysis. Results: The data were classified into five themes including the dynamics of humour, condition enforcement, Risk making probability, Instrumental use and Change: opportunities and threats. Conclusion: Understanding nurses' perceptions and experiences of humour helps identify its contributing factors and provides valuable guidelines for enhancing nurses and patients' mental, emotional and physical health. Spreading a culture of humour through teaching methods can improve workplace cheerfulness and highlights the importance of humour in patient care in nurses and nursing students. [ABSTRACT FROM AUTHOR]

In this study, the factors impacting membership and non-membership of nurses in nursing associations were identified and described. Participation in semistructured interviews was undertaken by 14 nurses working in a teaching hospital in an urban area of Iran. A qualitative design using a content analysis approach was used to analyze the data, from which three categories emerged: organizations' support of nurses' rights, professional obligations, and organizational power. Each of these categories contained several subcategories. Nurses' expectations of professional organizations might be one of the factors impacting associations being able to increase their membership, while retaining their existing members. Supporting nurses, tackling their professional problems, attempting to increase the power of legislative authorities, and clear explanations of their objectives are among the measures adopted by organizations in aiming to increase membership numbers and enhance organizational power. [ABSTRACT FROM AUTHOR]

Background: Medication therapy is one of the most complex and high-risk clinical processes that nurses deal with. Medication error is the most common type of error that brings about damage and death to patients, especially pediatric ones. However, these errors are preventable. Identifying and preventing undesirable events leading to medication errors are the main risk management activities. The aim of this study was to investigate the effectiveness of a risk management program on the pediatric nurses' medication error rate. Materials and Methods: This study is a quasi-experimental one with a comparison group. In this study, 200 nurses were recruited from two main pediatric hospitals in Tehran. In the experimental hospital, we applied the risk management program for a period of 6 months. Nurses of the control hospital did the hospital routine schedule. A pre- and post-test was performed to measure the frequency of the medication error events. SPSS software, t-test, and regression analysis were used for data analysis. Results: After the intervention, the medication error rate of nurses at the experimental hospital was significantly lower (P < 0.001) and the error-reporting rate was higher (P < 0.007) compared to before the intervention and also in comparison to the nurses of the control hospital. Conclusions: Based on the results of this study and taking into account the high-risk nature of the medical environment, applying the quality-control programs such as risk management can effectively prevent the occurrence of the hospital undesirable events. Nursing mangers can reduce the medication error rate by applying risk management programs. However, this program cannot succeed without nurses' cooperation. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the effects of telephone consultation and attendance education on the quality of life of patients with hepatitis B or C receiving interferon therapy. Subjects and Methods: Through a quasi-experimental study, 80 hepatitis patients were randomly assigned to one of the two educational methods. Patients completed the Quality of Life Questionnaire once upon entering the study and also 4 and 12 weeks after the treatment. Then, the results were compared. One group received education during monthly visits at the center, and another group got counseling over the telephone for 3 months. The data were analyzed using SPSS software (IBM, Armonk, NY). Results: The results showed that the overall quality of life in both groups 4 weeks and 12 weeks after the intervention had significant differences from the pre-intervention period; however, these differences were more significant in the telephone counseling group. Conclusions: By virtue of the fact that no significant difference was found between the results of traditional education and telephone consultation and considering the high volume of patients in centers, remote distance between patients and centers, and also limited staff time, telephone advice can take the place of traditional education methods. [ABSTRACT FROM AUTHOR]

Today, to increase effectiveness is a Strategy for success of organizations and their viability. In health care organization not only service cost- effectiveness is a major problem for productivity and organizational management but also customer-centred is in first priority. Because of these reasons, most of health organization trend to patient satisfaction for their viability. If complex process implemented for viability without attention to patient satisfaction, this is no success result. The FOCUS PDCA process is a new strategy for effectiveness of service quality. To this reason, the recent research done and its objective is to assess effect of FOCUS PDCA process strategy on patient satisfaction in surgery units of hospitals affiliated to Tehran Medical University. This research is a semi experimental with non-equivalent design. The sample was all of patients who hospitalized in two selected surgery units. Self-report was method of data gathering. Patient satisfaction assessed with questionnaire in pre and posttest. Then manipulation implemented as post-operation care process selected. Modelling and opportunity statement Diagrams prepared and improvement team organized. Flow process, convergences and cause-effect charts used to prepare list of items to be improved. Executive program was written. This include personnel training, standard implementation, election and training of quality control nurses (Q.C Ns), daily QC of caring and providing appropriate feed back to personnel, forming group session for determining corrective actions. Then after 1 month patient satisfaction was assessed. Statistical analysis shows this process increase patient satisfaction and it leads to care effectiveness. The findings of the pre-intervention phase indicated that the satisfaction level had been low in both groups and it is not significantly different in the two groups (P> 0.05). There was a significant difference before and after following intervention in the case study group (P>0.0001). FOCUS PDCA is effective method for access to various objectives especially patient satisfaction. it is suggested other researcher assess effects of this strategy for other indexes and total care process effectiveness. [ABSTRACT FROM AUTHOR]

Hematopoietic stem cell transplantation (HSCT) causes significant physical, social, psychological, and emotional stress in patients with leukemia. This qualitative study using semi-structured interviews explored the coping strategies of 10 adults with acute leukemia who were undergoing this form of treatment in transplantation units in a major hospital in Tehran, Iran, from 2009 to 2010. A content analysis identified eight themes and 13 subthemes that described the participants' coping strategies. The major themes were: attribution, denial and avoidance, connection with divine purpose, organizing treatment, seeking social support, modifying, reflection, and patience and resignation. A deeper understanding of the coping strategies that are used by patients with leukemia undergoing HSCT can help healthcare providers to encourage patients to use strategies that are likely to be more effective. Such coping strategies also can help patients to achieve a greater sense of empowerment. [ABSTRACT FROM AUTHOR]

Aim: Iran's health-care system has witnessed profound changes in the last decades. Despite its progress, the system has currently faced many challenges in one of the important subsystems, nursing. The present review article aimed to present an overview of the opportunities and challenges of the Iranian nursing system, based on recent literature. Methods: A broad search of the English and Persian-language literature was carried out, incorporating both electronic and manual components from 1999 to 2009. The results of the investigations among the searched literature are summarized. Results: The major challenges are nursing shortages, job dissatisfaction, poor social position of nurses, the gap between theory and practice, lack of community-based nursing care, lack of an appropriate student recruiting system, and shortages in the nursing educational curriculums. Conclusion: The authors believe that media, political and public support play a pivotal role in improving the image of nursing in society, increasing motivation among Iranian nurses, and promoting the sociocultural climate and the welfare of nurses, which will result in higher levels of quality of care as well as greater patient satisfaction. [ABSTRACT FROM AUTHOR]

The death of a spouse, as the most stressful event in old age, can put the older adult at risk of death if they do not adapt again. Since the process of adapting to bereavement occurs in the context of social interactions and is experienced in different ways in different societies, this research was conducted with the aim of explaining the background and factors affecting the adaptation of the older adult to the death of their spouse. The experiences of 21 participants were collected through semi-structured interviews and analyzed with Lundman and Granheim’s conventional content analysis approach, which led to the creation of three main categories1: how one perceives loss; 2:quality of life after the deceased; and 3: the quality of marital life. The findings indicate the importance and impact of background factors in how the adaptation process occurs. Identifying these factors can provide practical solutions to experts, caregivers and bereaved older adult. [ABSTRACT FROM AUTHOR]

Sexual dysfunction is a common concern in women with multiple sclerosis (MS). This study aims to assess the effect of counseling based on the BETTER model (Bring up, Explain, Tell resources, Time, Educate, and Record) on sexual function and satisfaction in married women with MS. This randomized clinical trial included 72 married women between the ages of 18–49 years from the MS Society of Iran. The data were collected using a socio-demographic questionnaire, Female Sexual Function Index (FSFI) and the Index of Sexual Satisfaction (ISS) at three points in time. The intervention involved the use of the BETTER model-based counseling approach with married women during four weekly sessions. The control group received routine care. The results of the analysis showed that the mean of FSFI for the women in the intervention group improved at 8 and 12 weeks after the counseling compared to the control group (p < 0.001). However, a significant difference was not observed between the mean score of ISS among the women in the intervention group compared to the control group (p = 0.06). These results suggest that intervention based on the BETTER model counseling can significantly improve the sexual function of married women with MS. However, in order to improve the sexual satisfaction of these women multidisciplinary interventions are also recommended. [ABSTRACT FROM AUTHOR]

Background: Due to changing population, culturally diverse clients with different perceptions of illness and health are present in healthcare settings. Therefore, it is increasingly important for nursing students to have high levels of cultural competence in order to meet diverse client needs. A training program is essential to enhance students' cultural competence. This study aimed to design, implement, and evaluate a cultural care-training program to improve cultural competence of undergraduate nursing students. Methods: This exploratory mixed methods study used six steps proposed in the Talbot and Verrinder model to design a training program. In the first step, a conventional qualitative study was conducted and 18 participants were interviewed using purposive sampling. In the second and third steps, literature review and the classic Delphi technique were used for initiation and finalization of the program. The fourth, fifth, and sixth steps were completed by implementing, monitoring, and evaluating the cultural care program (five two-hour sessions) among 73 nursing students using a quasi-experimental design. Finally, effectiveness of program was evaluated through the cultural care inventory before and 1 month after the program. Data were analyzed via SPSS25, independent samples t- test, paired t- test, chi-square test, analysis of covariance, and multivariate linear regression tests. Results: A systematic model was used to identify key elements of a cultural care program, including main topics, educational objectives and contents, assignments and activities for students, teaching and evaluation methods. The curricular objectives and educational contents were implemented in five sessions to produce measurable results. The quantitative step showed that nursing students' cultural competence in the intervention group (184.37 ± 22.43) improved significantly compared with the control group (153.19 ± 20.14) (t = 6.24, p = 0.001) after intervention. Conclusion: A cultural care training program can be designed by the model applied in this study in order to improve cultural competence of nursing students. This training program will be effective if students' learning needs, appropriate assignments, and acceptable teaching methods are addressed. Therefore, nurse educators can design comprehensive training programs to improve nursing students' cultural competence in different cultures and contexts. This training program is highly efficient because it is applicable in many disciplines of nursing education. [ABSTRACT FROM AUTHOR]

Background: The safety culture has recently attracted the attention of healthcare organizations. Considering the importance of the roles of nurses with regard to patient safety, their knowledge and experiences of the challenges that influence patient safety culture can facilitate the development and implementation of better strategies. The aim of this study was to explore the nurses' experiences of the challenges influencing the implementation and integration of safety culture in healthcare.Methods: A qualitative study with deep and semi-structured individual interviews was carried out using a purposive sampling method to select 23 nurses from four hospitals affiliated with a large medical university in Southeast Iran. Data were analysed using the conventional content analysis of Lundman and Graneheim.Results: Data analysis reflected the main theme of the study, "A long way ahead of safety culture". This theme includes four categories: 1) inadequate organizational infrastructure, 2) insufficient leadership effectiveness, 3) inadequate efforts to keep pace with national and international standards, and 4) overshadowed values of team participation.Conclusion: While practical strategies for creating a safety culture may seem simple, their implementation is not necessarily easy. There are several challenges ahead for cultivating an effective and positive safety culture in healthcare organizations. To keep pace with international standards, healthcare managers must employ modern methods of management in order to overcome the challenges faced by the institutionalization of safety culture and to make a difference in the healthcare system. [ABSTRACT FROM AUTHOR]

Background: Sexual harassment is complex and has occupational hazards in nursing. Nurses experienced it than other employees. Female nurses are with the highest rate in the profession. Our aim was to determine the prevalence of sexual harassment against female nurses, the types, perpetrators, and health consequences of the harassment. Method: We undertook a systematic review to synthesize quantitative research studies found in Pubmed, Scopus, ProQuest, Web of Science and Google Scholar databases. The studies included were observational, on sexual harassment against female nurse, full text, and published in peer-reviewed English journals up to August 2018. Two independent reviewers searched the articles and extracted data from the articles. The quality of the articles was evaluated using the Modified Newcastle Ottawa Scale for Cross-Sectional Studies Quality Assessment Tool. A descriptive analysis was done to determine the rate of items from the percentages or proportions of the studies. Result: The prevalence of sexual harassment against female nurses was 43.15%. It ranged 10 to 87.30%. The 35% of the female nurses were verbally, 32.6% non-verbally, 31% physically and 40.8% were being harassed psychologically. The 46.59% of them were harassed by patients, 41.10% by physicians, 27.74% by patients' family, 20% by nurses and 17.8% were by other coworker perpetrators. The 44.6% of them were developed mental problems, 30.19% physical health problems, 61.26% emotional, 51.79% had psychological disturbance and 16.02% with social health problems. Conclusion: The prevalence of sexual harassment against female nurses is high. Female nurses are being sexually harassed by patients, patient families, physicians, nurses, and other coworkers. The harassment is affecting mental, physical, emotional, social and psychological health of female nurses. It is recommended policymakers to develop guidelines on work ethics, legality and counseling programs. Nursing associations to initiate development of workplace safety policy. A safe and secure working environment is needed in the nursing practice and nursing curriculum in prevention strategy. Research is needed on factors associated with sexual harassment. Since only female nurses were the participants, it could not be representative of all nurses. There was no fund of this review. [ABSTRACT FROM AUTHOR]

Objective: Kidney donation from a relative is an ideal option for transplantation that would improve the recipients’ quality of life. The aim of the present study was to evaluate the challenges in the donation process faced by kidney donors related to patients. Materials and Methods: This is a descriptive qualitative study that uses a content analysis approach. In this study, 16 relative donors from kidney transplant centers of all the educational hospitals affiliated with Tehran University of Medical Sciences were selected through purposive sampling. Data were collected using face-to-face, in-depth, semi-structured interviews. Results: The data analysis results led to the extraction of three main themes: initial confrontation, hospitalization, and endless concerns. The second theme of the study had two sub-themes: being ignored and the rights of the donor. Conclusion: The challenges faced during the donation process were difficulties in performing tests, difficulties during hospitalization, and endless concerns. These challenges eventually become bearable for the donors because of their love for the recipient and because they totally forget themselves and their needs during the donation process. [ABSTRACT FROM AUTHOR]

Background: Nowadays, in light of gender inequity, new concern has been raised for health-seeking behavior of women in clinical setting. The aim of this study was to investigate the perceptions and health-seeking behaviors of Afghan immigrant women residing in Mashhad, Iran. Method: An ethnographic design was used to examine the health-seeking behavior of Afghan women. This study took place in Tollab Tabarsi area of Mashhad, Iran, from March 2013 to July 2014. For gathering of data, participant observations, fieldwork, and formal interviews were included. Data were analyzed using thematic analysis. Results: Fourteen Afghan women immigrants and five health care professionals were interviewed. The overarching category derived from the data was gender inequity. The emergent three themes were cultural taboos, women position, and information gap. Discussions: The displaced Afghan women were found to be at significant risk of adverse health events, which affected both their physical health and mental health. [ABSTRACT FROM AUTHOR]

Introduction: Health, which usually declines with age, is one of the determinants of quality of life. Mental health disorder is one of the most common health-threatening problems of older age. Aim: The present qualitative study was conducted with the aim to identify factors that affect the mental health of elderly population. Materials and Methods: This study was a qualitative study with content analysis approach, conducted on the elderly Iranians in Tehran. Purposive sampling method was used to select 15 elderly Iranians. Semi-structured and in-depth interviews were carried out with 15 elderly Iranians in the parks and homes in 2015. To analyze the data, the content of interviews was typed and entered into MAXQDA software. This software was also used to code the data. The interview began with a main question about their experiences of everyday life, and then, exploratory questions to encourage the participants and access to deeper information were required. Results: Two themes of "interaction" and "worthiness", 5 main categories (communication/relationship, empathy/compassion, entertainment/amusement, support and respect), and 15 subcategories (interpersonal communication, communication with others, communication with God, talking to people, being consulted, being employed, studying and learning, using the media, going to park, family support, social support, social respect, family respect, respect for personal space, and respect for beliefs) were extracted from the data. Conclusion: The results of this study encourage health care providers to identify the factors that influence the sense of worthiness in elderly by keeping continuous contact with them and taking advantage of the unique opportunity they have to interact with them and influence their belief. By designing educational programs, mental disorders can be prevented, that this population may develop. [ABSTRACT FROM AUTHOR]

Aim Poor nutritional status is common in older adult patients. The present study aimed to explore barriers and facilitators to nutritional care of elderly patients in acute care settings. Methods Data were collected through individual face-to-face interviews with 12 registered nurses, and analyzed using interpretive description methodology. Results Two core themes emerged from the analysis of data: (i) neglected care, with three subthemes of 'support but also independence,' 'unsupportive environment' and 'responsibility of the family;' and (ii) a humanitarian ethic, with two subthemes of 'respect and dignity' and 'humanitarian care.' Conclusions As an integral part of holistic care, elderly patient nutrition should be emphasised in health professional education, and promoted through managerial support, multidisciplinary collaborations, and implementation of appropriate monitoring and evaluation systems. Geriatr Gerontol Int 2015; ●●: ●●-●●. [ABSTRACT FROM AUTHOR]

Although it was thought that children were not susceptible to 2019-nCoV in the early days of the COVID‐19 infection outbreak, there are currently reports of children and even one-day-old newborns being infected by the virus and hospitalized around the world. Recognizing the symptoms of the infection in children is of great value since a large number of children are asymptomatic or have mild symptoms, which may act as facilitators of the virus transmission. This review aimed to identify and summarize the existing evidence on clinical characteristics of COVID-19 in pediatric patients. A systematic search was conducted in the PubMed, Web of Science, Scopus, Google Scholar, and WHO database for eligible publications. The review proposal was registered with the PROSPERO. The quality assessment was done based on JBI Critical appraisal tools. The random-effects model was used to pool clinical features in the meta-analysis. From the identified 256 potentially relevant studies, 32 articles met the predetermined inclusion and exclusion criteria. Twenty-one studies fulfilled the criteria for this meta-analysis. Fever (58%) and cough (48%) were reported as the most common symptoms of infected children. Disease severity was mild in 51% and moderate in 39% of cases. A total of 63% of cases had respiratory and 25% of children had gastrointestinal symptoms, particularly diarrhea and nausea/vomiting. Approximately 24% of patients were asymptomatic. Results demonstrated that fever and cough were the most common symptoms of COVID-19-infected children and the majority of cases had mild-to-moderate disease severity. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Today, critical care visitation is considered an important aspect of patient-centred care and its positive effects on patients and their relatives have been demonstrated. However, restricted visiting hours in the intensive care units ( ICUs) is often an adopted norm. The reasons for such restricted policies in Iran still remain unknown. Objectives The purpose of this study was to identify the rationales for restricted visiting hours in adult ICUs in Iran. Methods A qualitative design using a thematic analysis approach was used for data gathering and analysis. Participants in this study were six nurses, three head nurses, two patients and four visitors. They were chosen through purposive sampling method. Data were gathered through semi-structured individual interviews. Findings The data analysis resulted in three themes: 'health protection', 'safety promotion' and 'privacy preservation'. Conclusion The result showed that through restricted visiting hours, nurses try to protect vulnerable ICU patients from physical, psychological and legal risk. Although the ICU nurses' concerns seem reasonable in some cases, a review of visiting policies in order to meet the needs of patients and their families is essential. Relevance to clinical practice Effective supervision by charge nurses and regulation of environmental activities with visiting hours can resolve many concerns. Health care professionals, especially nurses, are required to create the conditions in which patients' family members are informed about the patients' health status and patients can be visited in suitable ward conditions. [ABSTRACT FROM AUTHOR]

Background: A challenge for intensive care nurses is providing the best possible care to patients in an end-of-life stage. The fact that some patients will die despite the efforts of the health care team can affect the psychological state of the nurses and families. Lack of attention to such an issue can bring about unpleasant consequences for both patients and nurses. Aim: Using a qualitative design, the aim is this article explores the experiences of intensive care nurses providing care for end-of-life patients. Methods: The data were collected through in-depth interviews with a purposive sample of 10 nurses working at intensive care units (ICUs). Interviews were transcribed and finally analysed through the conventional content analysis. Findings: Two themes emerged out of the experience of providing care to the end-of-life patients. The findings revealed that for Iranian intensive care nurses providing care to such patients was accompanied by emotional burden and values and beliefs. Conclusion: The results of the study have increased the current knowledge over the experience of providing care to end-of-life patients at ICUs. It also has revealed the need for providing the nurses with psychological support, accommodating the possibility for offering a complete care, attending to and managing the conditions of the patient and their families and engaging nurses in decision making about end-of-life patients. Relevance to practice: Managers ought to provide specialized units for providing care to end-of-life patients. Nurses working on these units will require emotional support. [ABSTRACT FROM AUTHOR]

To adopt an evidence-based approach to education there is a need for research-based evidence to support its effectiveness. This study investigated the impact of evidence-based education on the knowledge and attitude of nursing students. In this quasi-experimental study, all nursing students ( n = 41) studying the courses of musculoskeletal and gastrointestinal systems were chosen and assigned randomly to intervention and control groups. The groups were taught through an evidence-based or traditional approach. Students' knowledge and attitude were then evaluated. Data were gathered by three knowledge and two attitude questionnaires with multiple choice and Likert scales and then analyzed. It was shown that there was a significant difference between the average scores for attitude of the groups, but there was no statistically significant difference between the average scores of knowledge. The results suggest the evidence-based approach might be used as a complementary approach to nursing education. It was not only as effective as the usual method but also led to the acquisition of particular skills by students. The results can be used to formulate programs to design and implement evidence-based nursing education. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to explore the perspectives and experiences of Iranian patients regarding barriers and facilitators to their ability to cope with spinal cord injury (SCI). A qualitative design, based on the content analysis approach, was used to collect and analyze the experiences of 18 patients with spinal cord injury in two centers in Tehran, Iran. After using purposeful sampling for selection of the participants, semi-structured interviews were held for data collection. Lack of 'knowledge', 'financial resources', 'employment opportunities', 'suitable facilities and accessibility' as well as 'societal acceptance and support' emerged as barriers; and having 'self-confidence', 'religious beliefs', 'support networks' and 'positive thinking' emerged as facilitators in coping with spinal cord injury. Participants believed that with these hindering factors in place, adapting to their new condition had been difficult, therefore they can only manage to adapt partially to their situation. Additional multidisciplinary endeavors are needed to help this group cope adequately and further research is required to influence policy making and legislation processes efficiently. [ABSTRACT FROM AUTHOR]

In most countries, nurses are the largest group of health-care professionals that provide direct and indirect care to patients in a variety of health settings. The quality of care is strongly linked to their performance, and shortages of nursing staff cause suffering and diminished patient care. In 2008, it was estimated that there were 90 026 nurses in Iran, but health-care facilities need ∼ 220 000 nurses in order to deliver optimal nursing care. This review article provides a detailed description of the nursing shortage and related factors in Iran. It is hoped that this will inform both Iranian and international policy-makers and administrators about the current situation in this country. [ABSTRACT FROM AUTHOR]

Spiritual health is an important dimension of health and forms part of a comprehensive care. This study was conducted to redefine and clarify the components of spiritual health based on different worldviews through Walker and Avant's concept analysis method. Being given a life and a soul and having beliefs are the antecedents of spiritual health. The attributes of this concept include a morality-oriented intellectual connectedness with the self, others, and the universe guided by a connection with the Transcendent and Superior being in order to create meaning in life and find its purpose in the context of culture and religion; transcendence is ultimately the consequence of spiritual heath. Using the attributes appeared in this conceptual analysis, nurses can evaluate the spiritual health of their clients and help them create positive outcome by providing appropriate interventions. [ABSTRACT FROM AUTHOR]

Introduction: Social well-being is one of the important aspects of individual's health. However, the social aspect of health, or social well-being, has not been attended to as equally as the other aspects. Social well-being is people's perceptions and experiences in social circumstances as well as the degree of successful responses to social challenges. The aim of the study was to investigate the social well-being of a sample of Iranian nurses. Methods: This study was a cross- sectional conducted in 2013. The study population consisted of all 1200 staff nurses working in all hospitals located in Ardabil, Iran. We invited a random sample of 281 practicing nurses to respond to the 33-item Keyes's Social Well-Being Questionnaire and the possible range of the total score is 33-165. Higher score reflect better SWB. The quantitative analysis of this study used the Statistical Package for Social Science SPSS version 13.0. Results: The results showed that Participants' mean score of social well-being was 105.45 (15.87). Social well-being was significantly related to participants' age, gender, work experience, satisfaction with working in hospital and with income, familiarity with nursing prior to entering it, official position, and type of employment. However, there was no significant relationship between nurses' social well-being and their marital status, their parents and spouses' educational status, as well as the type of hospital. Conclusion: Nurses' social well-being deserves special attention. Effective well-being promotion strategies should be executed for promoting their social well-being particularly in areas of social integration and social acceptance. Moreover, nurses, particularly female nurses, need strong financial, emotional, informational, and social support for ensuring their social well-being. [ABSTRACT FROM AUTHOR]

RETRACTION The following article from Nursing in Critical Care, Exploration of Iranian intensive care nurses' experience of end-of-life care: a qualitative study by Sina Valiee, Reza Negarandeh and Nahid Dehghan Nayeri, published online on 9 May 2012 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors and the journal Editors. The retraction has been agreed due to errors in the manuscript handling process which meant that an early version of the article was published that did not include all the amendments made as part of the peer review process. John Albarran and Julie Scholes Editors Nursing in Critical Care REFERENCE Valiee, S., Negarandeh, R. and Dehghan Nayeri, N. (2012), Exploration of Iranian intensive care nurses' experience of end-of-life care: a qualitative study. Nursing in Critical Care. doi: 10.1111/j.1478-5153.2012.00505.x [ABSTRACT FROM AUTHOR]